When Travis Paulson drove from his home in northern Minnesota to the Canadian border last month, he thought he’d have little trouble crossing over to buy his insulin.
Paulson, a Type 1 diabetic, has made the trip many times for himself and others as the price of the lifesaving drug has skyrocketed in the United States over the last decade. A vial in Canada costs roughly $25 US, a fraction of the $350 to $400 he would be charged in his home country.
Paulson called Canada Border Services ahead of time to see if he’d still be able to come into Canada. Travel between the two countries has been restricted during the COVID-19 pandemic, but Paulson said he was told he could still make the trip if he only went to the pharmacy and came back the same day.
But when he arrived at the border near Fort Frances, Ont., he said he was told there had been a policy change that very morning — and he couldn’t come into Canada because his trip was not deemed essential.
“It’s devastating because your life depends on it. You’re literally being denied the air that you need to breathe,” said Paulson, the director of the diabetes organization Northern Minnesota Advocacy Group.
“Every few hours you need it, every day. And that you might not be able to get it, I would say it’s a little terrifying.”
When coming to Canada, Paulson often buys insulin for himself and for others. (Submitted by Travis Paulson)
Many Americans rely on going up north to buy insulin, where it is roughly a tenth of the price. Canada’s Patented Medicine Prices Review Board, a federal agency that establishes the maximum price that can be charged for patented drugs, keeps the prices affordable.
But the COVID-19 border restrictions have meant that option is no longer available.
While some pharmaceutical companies in the U.S. are offering programs for cheaper insulin during the pandemic, advocates say still not enough is being done to make it affordable.
A spokesperson for the Canada Border Services Agency said Americans may be allowed to enter the country to purchase medications, but the agency offers little clarity on who will be allowed in and when.
“Entry to Canada is decided on a case-by-case basis and based on the information made available to the border services officer at the time of entry,” spokesperson Judith Gadbois-St-Cyr said in an email.
Until at least June 21, there is a temporary restriction on all non-essential travel between Canada and the U.S. That could be further prolonged if deemed necessary, Gadbois-St-Cyr said.
Transport trucks approach the Canada/USA border crossing in Windsor, Ont., in March. The border closure between the two countries has been extended until at least June 21. (Rob Gurdebeke/The Canadian Press)
Quinn Nystrom, a long-time diabetes and affordable health-care advocate in Minnesota, said she’s received several calls since the border closures began, including one from a panicked mother.
“She said her nine-year-old son was on his last insulin pen,” Nystrom said, adding that the woman’s husband had been planning a trip to Canada in the spring to buy more.
“They were just completely distraught over it.”
Quinn Nystrom holds the insulin she bought on her trip to Canada in the spring of 2019. (Submitted by Quinn Nystrom)
Nystrom gained international attention last year for organizing and taking part in several Caravans to Canada — trips to show just how easy and affordable it is to buy insulin outside of the U.S.
A Type 1 diabetic herself, Nystrom went to her congressman, Pete Stauber, last spring, begging him to protect people with pre-existing conditions and vote to help lower the cost of insulin.
“He promised me he would do that. And after leaving his office and following up with him over the next couple of months, he unfortunately voted against those things,” she said.
“It was so unfortunate to me that I decided to file and run against him.”
On Sunday, Nystrom won the Democratic nomination in Minnesota’s 8th congressional district and will be up against Stauber on the ballot in November.
The small group drove five hours from Minnesota to Ontario to buy insulin at one-tenth the cost in the spring of 2019. Travis Paulson and Quinn Nystrom are on the left, and Nicole Smith-Holt and Lija Greensied are on the right. (Rachel Nystrom)
Access to affordable insulin can be a matter of life and death for Americans.
Nicole Smith-Holt’s son died in June 2017 at just 26 years old, less than a month after he aged off of his parents’ insurance plan. He couldn’t afford the cost at a pharmacy in Minnesota and chose instead to ration his insulin.
Smith-Holt said the border closures to Canada and Mexico put up “one more barrier” for struggling Americans, especially as many of them have lost their jobs and therefore their insurance during the pandemic.
“People are going to start rationing and people are going to suffer some very long-term health effects or possibly death,” she said.
“A Type 1 diabetic really should not be lowering their dosage or missing doses. It proved fatal for Alec and countless other people.”
But Alec Smith’s family, friends and supporters worked to make sure his death wasn’t in vain.
Nicole Smith-Holt with her son, Alec Smith, who died in 2017 from diabetes complications after rationing his insulin when he couldn’t afford it. (Submitted by Nicole Smith-Holt)
On July 1, the Alec Smith Insulin Affordability Act will come into effect in Minnesota. It will allow people who cannot afford their insulin to access a 30-day supply at their pharmacy for just $35.
The new law also streamlines the process to access insulin in the long-term and manufacturers can be fined up to $3.6 million for not participating in the program.
“It means that we’re going to have the ability to save lives,” Smith-Holt said.
“People right now, especially during this COVID-19 pandemic, are really struggling. It’s going to be a lifeline for people.”
Pharmaceutical companies making pandemic programs
Since the pandemic started, some pharmaceutical companies in the United States have created programs to help struggling diabetics.
Eli Lilly, the U.S. manufacturer of fast-acting insulin Humalog, created a program in April to help those without insurance access a month’s supply for $35.
But these programs are difficult to apply for, advocates say, and often many people don’t meet the criteria to be eligible.
It’s also just a temporary solution, Nystrom said, adding that the issue of insulin affordability won’t go away when the pandemic does.
Several American groups made international headlines in 2019 for the Caravan to Canada, and launched a social media campaign under the hashtag #Insulin4all. (Submitted by Lija Greenseid)
With few options due to border restrictions, some Americans, like Paulson, are turning to online Canadian pharmacies.
Some Canadian pharmacies will ship insulin to the U.S., but the National Association of Pharmacy Regulatory Authorities in Ottawa said it’s important to verify the legitimacy of an outlet if ordering online by checking with the province’s regulating body.
One of the most well-known pharmacies to Americans is Mark’s Marine Pharmacy in Vancouver, just 40 kilometres from the U.S. border. It ships insulin to people across the U.S., but requires a doctor’s prescription to do so — a requirement in America.
People also turn to GoFundMe, social media and “underground networks.”
Lija Greenseid stands at a pharmacy in Fort Frances, Ont., last spring holding insulin for her teenage daughter. Greenseid organized the Caravan to Canada on the first weekend in May 2019 to buy cheaper insulin. (Submitted by Lija Greenseid)
Lija Greenseid, an insulin advocate in St. Paul, Minn., and mother of a 14-year-old daughter who has Type 1 diabetes, said people in local diabetes Facebook groups will share extra insulin if they switch brands and even give up unused vials if someone has died.
“That’s another strange consequence of our health-care system,” said Greenseid, who organized a Caravan to Canada last spring.
While some insurance companies have now capped their deductibles at $25 a month, the list price for insulin in the U.S. hasn’t been cut.
‘The ultimate goal is to be like Canada’
Greenseid had always been comforted by the knowledge that Canada was a short drive away. It’s an option no longer there.
“What is reassuring is knowing that there is an insulin underground network of people who get insulin and give it to people who need it. That’s always there.” Greenseid said.
Nystrom said Americans don’t want to have to rely on outside countries to get affordable medications — and she hopes to make that possible if elected in November.
“The ultimate goal is to be like Canada, where somebody can just go to a pharmacy and pick up insulin for $30 US. That’s our goal,” she said.
“So people don’t have to rely on a pharmaceutical company deciding to be charitable.”
WINNIPEG – Some 250 coloured tacks pepper a large-scale world map among bookshelves at Whodunit Mystery Bookstore.
Estonia, Finland, Japan and even Fenwick, Ont., have pins representing places outside Winnipeg where someone has ordered a page-turner from the independent bookstore that specializes in mystery and crime fiction novels.
For 30 years, the store has been offering fans of Agatha Christie’s Hercule Poirot or Arthur Conan Doyle’s Sherlock Holmes a place to get lost in whodunits both old and new.
Jack and Wendy Bumsted bought the shop in the Crescentwood neighbourhood in 2007 from another pair of mystery lovers.
The married couple had been longtime customers of the store. Wendy Bumsted grew up reading Perry Mason novels while her husband was a historian with vast knowledge of the crime fiction genre.
At the time, Jack Bumsted was retiring from teaching at the University of Manitoba when he was looking for his next venture.
“The bookstore came up and we bought it, I think, within a week,” Wendy Bumsted said in an interview.
“It never didn’t seem like a good idea.”
In the years since the Bumsteds took ownership, the family has witnessed the decline in mail-order books, the introduction of online retailers, a relocation to a new space next to the original, a pandemic and the death of beloved co-owner Jack Bumsted in 2020.
But with all the changes that come with owning a small business, customers continue to trust their next mystery fix will come from one of the shelves at Whodunit.
Many still request to be called about books from specific authors, or want to be notified if a new book follows their favourite format. Some arrive at the shop like clockwork each week hoping to get suggestions from Wendy Bumsted or her son on the next big hit.
“She has really excellent instincts on what we should be getting and what we should be promoting,” Micheal Bumsted said of his mother.
Wendy Bumsted suggested the store stock “Thursday Murder Club,” the debut novel from British television host Richard Osman, before it became a bestseller. They ordered more copies than other bookstores in Canada knowing it had the potential to be a hit, said Michael Bumsted.
The store houses more than 18,000 new and used novels. That’s not including the boxes of books that sit in Wendy Bumsted’s tiny office, or the packages that take up space on some of the only available seating there, waiting to be added to the inventory.
Just as the genre has evolved, so has the Bumsteds’ willingness to welcome other subjects on their shelves — despite some pushback from loyal customers and initially the Bumsted patriarch.
For years, Jack Bumsted refused to sell anything outside the crime fiction genre, including his own published books. Instead, he would send potential buyers to another store, but would offer to sign the books if they came back with them.
Wendy Bumsted said that eventually changed in his later years.
Now, about 15 per cent of the store’s stock is of other genres, such as romance or children’s books.
The COVID-19 pandemic forced them to look at expanding their selection, as some customers turned to buying books through the store’s website, which is set up to allow purchasers to get anything from the publishers the Bumsteds have contracts with.
In 2019, the store sold fewer than 100 books online. That number jumped to more than 3,000 in 2020, as retailers had to deal with pandemic lockdowns.
After years of running a successful mail-order business, the store was able to quickly adapt when it had to temporarily shut its doors, said Michael Bumsted.
“We were not a store…that had to figure out how to get books to people when they weren’t here.”
He added being a community bookstore with a niche has helped the family stay in business when other retailers have struggled. Part of that has included building lasting relationships.
“Some people have put it in their wills that their books will come to us,” said Wendy Bumsted.
Some of those collections have included tips on traveling through Asia in the early 2000s or the history of Australian cricket.
Micheal Bumsted said they’ve had to learn to be patient with selling some of these more obscure titles, but eventually the time comes for them to find a new home.
“One of the great things about physical books is that they can be there for you when you are ready for them.”
This report by The Canadian Press was first published on Sept. 15, 2024.
MONTREAL – Canada’s labour minister is praising both Air Canada and the union representing about 5,200 of its pilots for averting a work stoppage that would have disrupted travel for hundreds of thousands of passengers.
Steven MacKinnon’s comments came in a statement shared to social media shortly after Canada’s largest air carrier announced it had reached a tentative labour deal with the Air Line Pilots Association.
MacKinnon thanked both sides and federal mediators, saying the airline and its pilots approached negotiations with “seriousness and a resolve to get a deal.”
The tentative agreement averts a strike or lockout that could have begun as early as Wednesday for Air Canada and Air Canada Rouge, with flight cancellations expected before then.
The airline now says flights will continue as normal while union members vote on the tentative four-year contract.
Air Canada had called on the federal government to intervene in the dispute, but Prime Minister Justin Trudeau said Friday that would only happen if it became clear no negotiated agreement was possible.
This report from The Canadian Press was first published Sept. 15, 2024.
When it comes to plant-based alternatives, Canadians have never had so many options — and nowhere is that choice more abundantly clear than in the milk section of the dairy aisle.
To meet growing demand, companies are investing in new products and technology to keep up with consumer tastes and differentiate themselves from all the other players on the shelf.
“The product mix has just expanded so fast,” said Liza Amlani, co-founder of the Retail Strategy Group.
She said younger generations in particular are driving growth in the plant-based market as they are consuming less dairy and meat.
Commercial sales of dairy milk have been weakening for years, according to research firm Mintel, likely in part because of the rise of plant-based alternatives — even though many Canadians still drink dairy.
The No. 1 reason people opt for plant-based milk is because they see it as healthier than dairy, said Joel Gregoire, Mintel’s associate director for food and drink.
“Plant-based milk, the one thing about it — it’s not new. It’s been around for quite some time. It’s pretty established,” said Gregoire.
Because of that, it serves as an “entry point” for many consumers interested in plant-based alternatives to animal products, he said.
Plant-based milk consumption is expected to continue growing in the coming years, according to Mintel research, with more options available than ever and more consumers opting for a diet that includes both dairy and non-dairy milk.
A 2023 report by Ernst & Young for Protein Industries Canada projected that the plant-based dairy market will reach US$51.3 billion in 2035, at a compound annual growth rate of 9.5 per cent.
Because of this growth opportunity, even well-established dairy or plant-based companies are stepping up their game.
It’s been more than three decades since Saint-Hyacinthe, Que.-based Natura first launched a line of soy beverages. Over the years, the company has rolled out new products to meet rising demand, and earlier this year launched a line of oat beverages that it says are the only ones with a stamp of approval from Celiac Canada.
Competition is tough, said owner and founder Nick Feldman — especially from large American brands, which have the money to ensure their products hit shelves across the country.
Natura has kept growing, though, with a focus on using organic ingredients and localized production from raw materials.
“We’re maybe not appealing to the mass market, but we’re appealing to the natural consumer, to the organic consumer,” Feldman said.
Amlani said brands are increasingly advertising the simplicity of their ingredient lists. She’s also noticing more companies offering different kinds of products, such as coffee creamers.
Companies are also looking to stand out through eye-catching packaging and marketing, added Amlani, and by competing on price.
Besides all the companies competing for shelf space, there are many different kinds of plant-based milk consumers can choose from, such as almond, soy, oat, rice, hazelnut, macadamia, pea, coconut and hemp.
However, one alternative in particular has enjoyed a recent, rapid ascendance in popularity.
“I would say oat is the big up-and-coming product,” said Feldman.
Mintel’s report found the share of Canadians who say they buy oat milk has quadrupled between 2019 and 2023 (though almond is still the most popular).
“There seems to be a very nice marriage of coffee and oat milk,” said Feldman. “The flavour combination is excellent, better than any other non-dairy alternative.”
The beverage’s surge in popularity in cafés is a big part of why it’s ascending so quickly, said Gregoire — its texture and ability to froth makes it a good alternative for lattes and cappuccinos.
It’s also a good example of companies making a strong “use case” for yet another new entrant in a competitive market, he said.
Amid the long-standing brands and new entrants, there’s another — perhaps unexpected — group of players that has been increasingly investing in plant-based milk alternatives: dairy companies.
For example, Danone has owned the Silk and So Delicious brands since an acquisition in 2014, and long-standing U.S. dairy company HP Hood LLC launched Planet Oat in 2018.
Lactalis Canada also recently converted its facility in Sudbury, Ont., to manufacture its new plant-based Enjoy! brand, with beverages made from oats, almonds and hazelnuts.
“As an organization, we obviously follow consumer trends, and have seen the amount of interest in plant-based products, particularly fluid beverages,” said Mark Taylor, president and CEO of Lactalis Canada, whose parent company Lactalis is the largest dairy products company in the world.
The facility was a milk processing plant for six decades, until Lactalis Canada began renovating it in 2022. It now manufactures not only the new brand, but also the company’s existing Sensational Soy brand, and is the company’s first dedicated plant-based facility.
“We’re predominantly a dairy company, and we’ll always predominantly be a dairy company, but we see these products as complementary,” said Taylor.
It makes sense that major dairy companies want to get in on plant-based milk, said Gregoire. The dairy business is large — a “cash cow,” if you will — but not really growing, while plant-based products are seeing a boom.
“If I’m looking for avenues of growth, I don’t want to be left behind,” he said.
Gregoire said there’s a potential for consumers to get confused with so many options, which is why it’s so important for brands to find a way to differentiate themselves, whether it’s with taste, health, or how well the drink froths for a latte.
Competition in a more crowded market is challenging, but Taylor believes it results in better products for consumers.
“It keeps you sharp, and it forces you to be really good at what you’re doing. It drives innovation,” he said.
This report by The Canadian Press was first published Sept. 15, 2024.
