A vial of insulin costs far more in the U.S. than it does in Canada.
Drug prices are set by Canada’s Patented Medicine Prices Review Board which sets price caps by comparing drug prices across a group of 11 countries. The US used to be included in the formula, but was removed from the group in 2022 — because US drug prices are an insane global outlier.
https://en.wikipedia.org/wiki/Patented_Medicine_Prices_Review_Board
A group of Pharma companies including Pfizer and Merck have asked the Trump administration to put pressure on Canada. They are accusing the country of unfair trade practices.
We don't have the manufacturing resources to replace all foreign suppliers overnight. Going pirate would require that all the manufacturing facilities be built, secretly, before hand because once we start we'll be cut off.
If wikipedia is to be believed, we might not be as far off as you'd think. One third of our pharmaceutical consumption is already domestically supplied, and the amount we export amounts to about 40% of our consumption. Put the two together, and suddenly there's 70% of our needs already met. Imports from non-us suppliers should be able to fill the gap while domestic production is ramped up.
Now obviously reality is going to be far more complex than this napkin math, but I'm just pointing out that our domestic production is not starting from zero, and is already at the scale where supplying our own relatively small market is not out of the question.
The real problem is on a per-drug basis. Canada has the ability to make 70% of its medicine on average. But doubtlessly it's making 500% of its own needs for some medications and 0% for others. Cut that supply off overnight, and a lot of people unlucky enough to be reliant on the 0% ones are going to die.
It's not just building the factories. The FDA has to minutely inspect the factory and it's procedures, and give it's approval before they can sell anything made there. It takes time for that to happen, especially with the RIFs they're pushing through (which is relevant because they also re-inspect the factories every ... ?5? years and they're having problems keeping up with the current batch of factories).
Health Canada, not FDA. And I'm not 100% sure if it's Health Canada that deals with those inspections or provincial authorities.
Sorry, I mis-read the original comment and thought they were telling about building additional pharmaceutical plants in the States.