An internet company based in Winnipeg is advertising drugs that are not approved by Health Canada, CBC News has learned.
TotalCareMart, which operates out of a St. James Street strip mall, has been ordered to shut down by the College of Pharmacists of Manitoba and it's being investigated by Health Canada.
The regulators acted after CBC News inquired about TotalCareMart's advertising.
Newspaper and web-based ads directed at Americans show hundreds of drugs available from TotalCareMart.com, which is not licensed as a pharmacy by the College of Pharmacists of Manitoba.
At least three American drugs that are not approved in Canada were listed for sale, including cholesterol-lowering medication Zetia, blood pressure pill Benicar and the antidepressant Lexapro. There are products under different names that have the same active ingredient and which are approved in Canada.
TotalCareMart.com said it does not offer these three drugs for sale in Canada and "does not stock or handle any medications as part of this process, as the medications are sold and delivered directly by the pharmacy to the patient," David Janeson, owner of TotalCareMart, said an email. He added his company only refers patients to licensed Canadian and international pharmacies staffed by licensed pharmacists.
Health Canada is responsible for enforcing the Food and Drugs Act. In an email to CBC News, the agency stated "it is a violation to advertise or sell, at retail or via the internet, drugs that are not authorized for sale in Canada."
Health Canada said it does not matter if the unapproved drugs never touch Canadian soil.
"[This rule applies] even in cases where the unapproved drugs do not enter Canada, but are dispensed by foreign pharmacies and delivered to patients outside of Canada," a 2006 letter posted on Health Canada's website reads.
"Health Canada has nothing to do with these medicines," said Amir Attaran, a law professor at the University of Ottawa, adding he believes TotalCareMart is breaking the law.
All retail sales of drugs in Manitoba are regulated by the College of Pharmacists of Manitoba, which licenses pharmacies and pharmacists.
Ron Guse, registrar for the college, said he sent TotalCareMart a cease and desist order in the last two weeks but did not specify the exact date the letter went out. As of today, TotalCareMart appeared open for online business and a customer service representative said it would take two to four weeks for a prescription to be delivered.
they're a Canadian pharmacy. They're not licensed in Manitoba," Guse said.
Janeson said his company is a prescription referral service that has been in business since 2009.
"We have worked with the pharmacy industry and regulators to address any questions about our business," Janeson said in an emailed statement.
64 websites target Americans
The Canadian Internet Pharmacy Association, also known as CIPA, represents TotalCareMart and 63 other websites that are operated by the 11 members of the industry group. CIPA's member companies must fulfil a number of requirements before they receive its seal of approval.
Having a licensed Canadian pharmacy as part of its corporate body is one of the requirements.
"Westview Pharmacy, it's associated to the member which operates TotalCareMart," said Tim Smith, general manager of CIPA.
Guse said he is looking at what role Westview pharmacy and its pharmacists, who are licensed by the Manitoba College of Pharmacists, may play at TotalCareMart.
"A licensed pharmacy in the province of Manitoba cannot be connected — related business connection, whatever — to someone who is operating illegally," Guse said, adding the college could force Westview to sever its ties with TotalCareMart depending on what its investigation reveals.
Corporate documents show TotalCareMart and Westview are owned by companies controlled by David Janeson, his wife, Lori, and James Fraser.
Attaran believes the Manitoba College of Pharmacists is not doing its job as a regulator.
"As long as it's earning some money and giving people jobs, the college of pharmacy does not appear inclined to spoil a good time,"Attaran said.
Janeson said TotalCareMart is providing a valuable service to underinsured American seniors on fixed incomes who would not be able to otherwise afford the drugs, and added "to our knowledge, we are not operating in violation of any Canadian laws."