The sky-high cost of prescription drugs in the US has prompted approximately 1 million Americans to buy from Canadian pharmacies. Prescription drugs cost less in Canada than in the US because Canadalike most industrialized countries—has price controls to keep drug prices down. America does not have such price controls.

For Americans who have chronic conditions requiring long-term prescriptions that are not covered by insurance, ordering drugs from north of the border can cut the cost of medications by half-and sometimes even more.

But is it safe? Gary Passmore, who has taken tours of Canadian pharmacies for the Congress of Califomia Seniors, a senior advocacy group, provides some answers.

  • Why isn't it legal for Americans to order prescription medications from Canada? According to federal law, the US Food and Drug Administration (FDA) must approve the safety of all pharmaceuticals brought into the country and certify the safety of the companies that handle and sell them.

For the past decade, through both the Clinton and Bush administrations, the US government has declined to provide the necessary certification for Canadian pharmacies.

  • Do Americans risk prosecution when they import prescription drugs? No, not if they do so within reason.

While the FDA refuses to take steps to make importing prescription drugs legal, the US Customs Department will not take action against individual Americans who import prescription drugs for their own personal use if they have valid prescriptions and bring in no more than a 90-day supply. This is according to a statement made before the Senate by William K Hubbard of the FDA. This applies to drugs sent through the mail or driven across the border. (To avoid problems, bring your prescription with you if you intend to drive.)

  • The US government says that importing Canadian pharmaceuticals poses safety risks. Are Canadian drugs truly less safe than American drugs? Health Canada (the Canadian department of health) is as rigorous in its inspections of pharmaceutical makers and distributors as the FDA. There has been no documented death or illness caused by an unsafe drug sent to an American from a Canadian pharmacy. The only reason the US government is claiming that there are safety issues is that the pharmaceutical industry has considerable power in Congress and wants Americans to buy drugs at higher prices.
  • How should Americans select a Canadian pharmacy? I advise sticking with pharmacies that belong to the Canadian International Pharmacy Association (CIPA). They are listed on CIPA's Web site,

I have met with CIPA's leadership personally, and I'm convinced that it is committed to maintaining high professional standards.

Call the toll-free numbers of a few CIPA pharmacies listed on the site, and use whichever one makes you feel the most comfortable. The pharmacist should be able to answer any questions you have about your medications.

  • How much can an American save by ordering drugs from Canada? Is it important to shop around? The savings vary by drug and with fluctuations in the exchange rate between the US dollar and the Canadian dollar Generally, you can save between 40% and 80%, even after you account for shipping charges.

Certainly, you should shop around and check the prices at a few different pharmacies—but don't expect prices to vary much because the Canadian government regulates how much pharmaceutical companies can charge.

  • Are prescription drugs exactly the same in Canada as they are in the US? The medications made for the Canadian market generally are the same as those made for the American market, but occasionally there are minor differences. Some drugs have different names in different countries, and some are different in appearance.

Example: Nexium, a heartburn treatment, is widely advertised as "the purple pill" in the US. In Canada, it's pink.

If you work with a reputable Canadian pharmacy, the pharmacist will explain any differences to you to prevent confusion.

Canadian pharmacies are doing a booming business selling to Americans, so they're familiar with the potential sources of confusion.

  • Are Canadian pharmaceutical rules and practices different from those in the US? Not significantly, but there are two differences worth noting.

First, Canadian law requires that the pharmacist receive an original prescription-not a copy-before he/she can provide medication. If you place your order by phone or over the Internet, you'll be asked to mail in your prescription.

Second, Canadian law requires that all prescriptions be approved by a physician licensed in Canada. That isn't a problem for American customers Canadian pharmacies that deal with international customers have Canadian doctors on staff or on call to provide approvals at no extra fee to the drug buyer. Just be aware that you might receive a call from a Canadian doc tor after you order if there is some question about your medical condition or other drugs you're taking

  • Can any prescription be filled through a Canadian pharmacy? Most Canadian pharmacies provide only refills for Americans, not initial prescriptions. Side effects are most common when drugs are first used, so responsible pharmacies want a local pharmacy to handle the first order. That way, you have someone nearby to consult if there's a problem.

Most Canadian pharmacies also won't mail insulin or other medications that require refrigeration because they have no way of knowing how long the package might sit on your doorstep. (For more on this problem, see the last article on this page.) Controlled substances, such as morphine, usually are not available through the mail either.

  • Should people who live in the American Southwest consider heading to Mexico for their prescription drugs? I can't endorse that. The Mexican government doesn't have the same level of health safeguards as the US.
  • Is there any chance that the US government will start cracking down on citizens who import their prescription drugs from Canada? It is unlikely that US government officials will start arresting people at the border. No politician wants to be seen locking up grandmothers who can't afford to buy their medications in this country.

The greater risk to this savings opportunity is that the Canadian pharmaceutical system could be stretched beyond its limit. Some drugmakers now are capping their shipments to Canada so that there won't be enough to fill American orders.

Ordering from Canada is not a long-term solution to our nation's high drug-price problem. The American government will have to find a better way to make affordable pharmaceuticals available.

Best Ways to Buy Medications Online

Consumers who want to buy prescription drugs online are faced with the daunting challenge of finding the right provider. The US Food and Drug Administration (FDA) offers these suggestions...

  • Check with the National Association of Boards of Pharmacy at to see if a Web site is backed by a reputable licensed pharmacy.
  • Don't buy from sites that sell drugs without a medical doctor's prescription.
  • Don't do business with sites that have no access to a registered pharmacist to answer questions.
  • Avoid sites that do not identify the "staff" pharmacist or provide a US address and phone number.
  • Beware of sites that advertise a "new cure" for a serious disorder or a quick cure all for a wide range of ailments.

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