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According to the 2016 Kaiser Health Tracking poll, at least 19 million Americans buy meds from Canada or other countries to save money. In Canada drugs cost around 70% cheaper than in the US on average but are more expensive than elsewhere in the world. Not all online pharmacies claiming themselves to be Canadian source meds from Canada – international customers’ orders are frequently processed by affiliated retailers in India, Turkey, China and other countries. This raises concerns about the quality of products obtained from such ‘Canadian’ drugstores, so it is important to choose only those that are verified by quality monitoring services like Pharmacy Checker and similar, have a valid license in Canada and positive feedback from real customers.
Although personal importation of drugs into the US is technically illegal, US citizens rarely face problems with the authorities. When processing an order for abroad, the Canadian pharmacy asks for a prescription from the customer’s home country and requires a co-signing from a licensed Canadian doctor. To import meds for personal use purchased in a land-based or online Canadian pharmacy, American citizens must have a valid prescription from a US doctor present. Importing more than a 3-month supply is illegal.

Buying Meds from Canadian Online Pharmacies

Canadian pharmacy: woman with tablet

Customers purchasing medications online can find offers from dozens of Canadian pharmacies. For example, out of 32 online pharmacies verified by Pharmacy Checker 12 have ‘Canada’ or ‘Canadian’ in brand names and 3 more have the maple leaf in logos. This article checks whether such pharmacies are actually based in Canada or not.

What Is the Point in Buying Medications in Canada?

The cost of medication in Canada is second highest in the world and 23% higher than the average in OECD countries. However, compared to the prices in the US, they are 72.71% lower on average. The US pharmaceutical market is the largest in the world, so US citizens look north of the border when searching for a way to reduce treatment costs. The table below shows the prices of some medications in the US and Canada compared. The price comparison only includes the same brand-name drugs by the same manufacturers – the prices of generics, if available, would be even lower in Canada.

Eliquis, Lyrica, Strattera, Tecfidera, Triumeq
Medication Uses Price per unit in the US, USD Price per unit in Canada, USD
Eliquis, 5mg tablets Preventing certain blood clotting conditions $6.21 $1.60
Lyrica, 25mg capsules Treatment of epilepsy, pain and generalized anxiety disorder $6.04 $0.63
Strattera, 100mg tablets Treatment of attention deficit hyperactivity disorder (ADHD) $14.81 $3.86
Tecfidera, 120mg capsules Treatment of relapsing multiple sclerosis $119.24 $11.92
Triumeq, 300mg tablets Controlling HIV infection $83.36 $31.51

In the US the prices are regulated by the principles of the free market meaning that the drugs cost as much as the consumers can pay. In Canada the government plays a major role in defining medication prices. The authorities and drug manufacturers or suppliers need to follow the procedure described below:

  1. Pharma companies submit the desired price quotes to the Patented Medicine Prices Review Board of Canada (PMPRB)
  2. The PMPRB checks the prices of the medication across 7 comparator countries – France,
  3. Germany, Italy, Sweden, Switzerland, the UK and the US – to define the maximum average potential price for the Canadian market
  4. If the pharma company’s initial offering is at or below the PMPRB’s maximum average potential price, it can proceed with the sales
  5. If the initial offering exceeds the maximum average potential price, the drug manufacturer and PMPRB enter into negotiations. If the pharma company agrees to reduce the price, it is allowed to start selling its products
  6. If the manufacturer refuses to reduce the price, PMPRB holds a public hearing – and if it defines that the price is too high, an order to set the price at the recommended level is issued.

Canada also limits the rate of medication price growth to the rate of rise of the local Consumer Price Index over any period of 3 years.

Pros and Cons of Buying Meds from Canada

The benefits of purchasing medication from Canada:

  1. It’s cheaper than in the US
  2. It’s as safe as buying in the US
  3. Canada’s drug quality standards are like those in the US and the UK. Genuine drugs are available through licensed pharmacies. The guidelines on how to tell such reliable drugstores from rogue ones are listed in the following parts of this article.

  4. The delivery is fast
  5. Meds from Canada won’t take long to deliver to the US.

  6. Things are not likely to go wrong
  7. Nearly 19 million Americans order medications online from abroad. Taking the US FDA non-enforcement policy regarding personal importation of medications into account, it’s clear that the US authorities tend to close their eyes on online orders thereof. Of course, this doesn’t apply to narcotics and other medicines that ‘represent an unreasonable risk’. Any attempt to import these, even for personal use, is likely to end up with the medications getting seized and the person who has ordered them being prosecuted.

The disadvantages of buying meds from Canada:

  1. It’s still technically illegal
  2. The US authorities understand that buying cheap meds abroad offers the only way for up to 8% Americans to get proper healthcare which they would not afford otherwise – and do not object. Still, the lawmakers’ point of view on this one is clear – it is illegal to import drugs into the US.

  3. There are rogue online pharmacies pretending to be Canadian
  4. Not all online pharmacies that have ‘Canadian’ in the brand names or websites URLs are registered in Canada. And even those that are sometimes send the customers’ orders from countries like India or Turkey where the medications are manufactured. Although most online drugstores still sell authentic drugs, as this study by Robert Bate shows, there’s always a chance to run into a potentially dangerous fake.

  5. Meds are cheaper elsewhere
  6. Although medication prices in Canada are much lower than in the US, they are still higher than in the rest of the world.

Are All ‘Canadian Online Pharmacies’ Really Operating from Canada?

There are sites that exploit the American buyers’ readiness to buy quality drugs cheap from Canada. The 2017 study by National Association of Boards of Pharmacy showed that 80 out of 108 online pharmacies that had ‘Canada’ or ‘Canadian’ in brand names or URLs were sourcing drugs from outside of Canada. Some websites like CanadaDrugsOnline.com even state it explicitly that all domestic orders are processed by a licensed Canadian pharmacy and international ones – by ‘overseas partners’ in Turkey, Mauritius, India, etc.

Even websites verified by Pharmacy Checker and claiming to have some nexus to Canada are not always operating from Canada. For instance, this website has got a PO box in Winnipeg listed as the mailing address in the Contacts section but is supposedly operating from Barbados.

A medication purchased online will be identical to the genuine one in most of the cases, even if it is not made in Canada or approved by Health Canada. Use LegitScript, Pharmacy Checker or similar resources to look for reliable online pharmacies and don’t order from the first site you find online.

How to Tell If a Pharmacy Really Is from Canada?

There is a relatively easy way to check if a pharmacy is registered in Canada and licensed by the appropriate authorities.

  1. Look for the pharmacy’s address or license number on its website – on the Contact Us page or in the footer on every page.
  2. Go to this website.
  3. Choose the pharmacy regulatory authority in charge of the province that the pharmacy is located in – for example, Ontario College of Pharmacists.
  4. Go to the Find a Pharmacy section and type the license number, a part of the pharmacy’s address or its ZIP code into the search bar.
  5. Check the results – if the pharmacy is in the search results, then it is legit.

Once again, even pharmacies registered and licensed in Canada do not necessarily fulfill the international orders themselves – it may be done by their partners abroad. Look for relevant information in the FAQ section of the pharmacy’s website or ask the support service representatives about the origins of the medication.

Buying Drugs from Canada – Online vs Offline

At least 4 US states proposed importing medication in bulk from Canada in 2018 to help people receive adequate treatment up to 72% cheaper. Until then there are 2 options to choose from – either buying drugs in online pharmacies or going across the border in person to fill prescriptions. Whichever of these options is chosen, one’s prescription from a US physician needs to get co-signed by a Canadian physician in order to be filled.

To fill a prescription from a US doctor in Canada and take the meds across the border, do the following:

  1. Get a paper prescription from a US doctor. If you already have one in a US-based pharmacy, you will not be able to transfer it to a Canadian pharmacy, so a new prescription will be required.
  2. Find a Canadian pharmacy that has an affiliated doctor to check the prescription and cosign it. The doctor will need to perform a medical assessment – either by asking questions or by doing a physical examination. A WGRZ report claims Canadian doctors also accept recently emptied containers from a patient’s prescription medicine or a letter from a healthcare provider instead of a prescription.
  3. Buy the required medication – note that you will need to pay for it in full yourself. Domestic US health insurance plans do not work abroad. Make sure the Canadian medication contains the same active ingredient and has the same strength as its American alternative.
  4. Declare the drugs when crossing the border. The Customs officers will check the prescription if they find the medication suspicious. The maximum amount allowed for import for personal use is 90 days’ worth of medication.

To order from a Canadian online pharmacy and have the medication delivered to the USA, do the following:

  1. Get a prescription from a US doctor.
  2. Find a reliable online pharmacy – it’s best to choose the ones verified by Pharmacy Checker or similar services or, at least, those that have many positive and real-looking customer reviews.
  3. Order the medication – once again, remember that a 3-month supply is the allowed maximum.
  4. Send the prescription in digital form – e.g. as a scan.
  5. Wait for the order to be delivered.

Remember to have the prescription ready in case the customs decide to check the order. The US FDA has stated on multiple occasions that they don’t take legal action against those importing medications for personal use but target those who do it with the purpose of further reselling the drugs. However, the Customs service reserves the right to confiscate illegal medications and issue a warning to the person importing them.

Some medications sold only by prescription in the United States are available over the counter in Canadian online pharmacies – or, more likely, from foreign suppliers. For example, one doesn’t need a prescription to buy EpiPen or insulin. However, a valid prescription will still be required at the border to import these or other similar drugs into the US.

Up to 18 million Americans buy cheap medications for personal use in foreign pharmacies and bring them into the country even though it is still technically illegal. Vermont, Utah, Oklahoma and West Virginia have already taken steps to lift the import ban. Until then, those who consider buying meds from Canada are recommended to have a valid prescription in place if it is required by law in the US and use legitimate overseas pharmacies only. Hope that the advice provided in this article will help people reduce the cost of treatment without compromising safety.


author: Michel Swanski