The interview1 with Bernie Teitelbaum regarding the grey market reminded me of what our President said about buying drugs from Canada on the Internet—that there are no controls in place and that they may not be safe. I’ve found that many of these drugs, whether purchased in the US or Canada, are made down the street at a factory in Juarez, Mexico.
The title of the interview was “When Price Becomes the Fundamental Issue.” However, nothing could be further from the truth! Manufacturers are going to charge what the market will bear. If they can get a higher sale price from US or Canadian dentists compared to dentists from developing countries, they will do so for the exact same product.
I have been purchasing goods from a website that I suspect uses dealers that are going through the grey market. The big dealers can’t meet their prices. Manufacturers and the big dealers give me the same rationale as Mr. Teitelbaum to not “go grey.” But I have never had a problem with anything I’ve purchased. Same stuff, takes an extra week or 2 to get here, but with lower prices.
- JCDA Interview: When price becomes the fundamental issue J Can Dent Assoc 2010;76:a73.
Response from the Author
Cite this response as: J Can Dent Assoc 2010;76:a135
As self-regulated professionals, Canadian dentists are answerable to their own professional standards. The training dentists receive should prepare them to make proper choices when sourcing and selecting dental materials.
Dental materials are affected by shipping, storage and handling conditions. As such, Health Canada dictates that all manufacturing facilities (including those in Juarez, Mexico) have an ISO 13485 certification and a Medical Device Licence for any product offered for sale in Canada. Not all products, including some from the largest manufacturers, are licensed for sale in Canada. Most grey market resellers don’t know this, and they don’t care.
In addition, all importers and distributors of medical devices must have a separate Health Canada Establishment Licence, which certifies that all of their products have a Medical Device Licence, that they can account for the shipping, storage and handling of goods right back to the manufacturer, and that they have access to all recall notifications. Grey market resellers or rerouters simply cannot make the same claims.
Dentists are free to ignore these issues. But if they believe their exemption from Medical Device Licensing frees them from the responsibility of exercising a professional standard of care in choosing products, they may have to discuss this point of view with their regulatory body.
Remember, you are not buying an electronic gadget for your own use on the grey market and taking your chances. You are buying a product that is going inside a patient’s mouth and you only have to be wrong once for this to have serious consequences. I hope that Dr. Schrager is passing his discount on to his patients, as they are the ones paying the ultimate price.