Bernie Sanders has clearly had it with American pharmaceutical companies gouging customers, and on Sunday he brought Canada into the debate.

In a tweet sent out Sunday morning, Sanders continued his attack on big pharma in a style that has endeared the 75 year-old Vermont Senator to millions.

“Americans shouldn’t pay higher prices than Canadians for the same drugs simply because Congress is bought by the pharmaceutical industry,” said Sanders.

Included with the tweet was a chart listing the various prices paid for drugs in the United States compared to their Canadian prices. The chart says Canadians pay $290 for an Epipen versus the U.S. price of $620, and $160 for cholesterol drug Crestor against $730 for the drug south of the border, for example.

This isn’t the first time Sanders has railed against pharmaceuticals companies, nor the first time he has taken to Twitter to do so.

“Drug corporations’ greed is unbelievable. Ariad has raised the price of a leukemia drug to almost $199,000 a year,” he tweeted on October 14. That tweet, pointed out the Washington Post, sent shares of Ariad “tumbling”, as Sanders and Democratic Senator Elijah E. Cummings followed up with a letter to the company. Ariad responded by saying it had lost nearly $1.4-billion developing the drug.

Drug pricing scandals became an election issue more than a year ago when Martin Shkreli, the 32-year-old founder and CEO of Turing Pharmaceuticals bowed to public pressure and said the company would scrap plans to raise the price of Daraprim by more than 5,000%, from $13.50 to more than $750 per pill. Daraprim is a 63-year-old drug that is used to treat a life-threatening parasitic infection. The debate already had taken a Canadian turn, as earlier in 2015 after two members of the U.S. Congress who had been investigating generic drug price increases wrote to Canada’s Valeant Pharmaceuticals after it acquired two heart drugs, Isuprel and Nitropress, from Marathon Pharmaceuticals and then raised their prices. Shares of Valeant fell sharply last year and have not recovered.



On his website, Sanders lays out his case for changing the way drugs are priced in the United States.

“In any given month, more than half of all American adults take at least one prescription drug,” he said. “There is no question that medicines help millions of people live healthier and longer lives, and can also prevent more expensive illnesses and treatments. However, it is unacceptable that the United States now spends more than $370 billion on prescription drugs and spending is rising faster than at any point in the last decade. Instead of listening to the demands of the pharmaceutical industry and their 1,400 lobbyists, it is time that Congress started listening to the American people, who overwhelmingly believe that the cost of medication is too expensive. More than 70 percent of Americans believe drug costs are unreasonable and that drug companies are putting profits before people.”

The most recent large pharma scandal focused on the EpiPen, which is used to treat medical conditions such as anaphylaxis and cardiac arrest. It revealed the stark differences between the way drug pricing works in Canada and the United States.

EpiPen commands a virtual monopoly over the market in North America and is distributed in Canada by Pfizer. But its price has not risen in five years in Canada because drugs pricing here is controlled by a federal review board called the Patented Medicine Price Review Board.

“The regulatory pricing system here is different than in the U.S.,” says Laurie Harada, executive director for Food Allergy Canada, “and so we have not seen huge increases for the device year over year.”

Under Sanders plan, U.S. citizens would be able to import prescription drugs from Canada, but many aren’t waiting for that permission. Earlier this year, the Canadian International Pharmacy Association reported that dozens of the pharmacies it represents had seen an uptick in mail orders from the United States.

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