Is it safe to buy prescriptions from Canada?

It’s no secret that prescription drugs cost more on average in the U.S. than they do anywhere else in the developed world. In fact, a 2018 study found that, on average, Americans pay more than two-and-a-half times as much for prescription drugs as citizens of 32 other countries involved in the study. Naturally, this has people looking beyond the border for more affordable alternatives, and Canada seems like an obvious choice. But is it really cheaper to get prescription drugs from Canada, and is it safe and legal to do so?

Why buy medicine in Canada?

The most obvious reason to buy prescription medications from Canada is cost. Unlike the U.S., Canada regulates the prices of prescription drugs, resulting in much lower average drug costs to consumers.

“The major difference in Canada is we have regulations around pricing that are mandated when a drug gets approved,” says Mina Tadrous, Ph.D., an assistant professor in pharmacy at the University of Toronto and an investigator with the Ontario Drug Policy Research Network. “More specifically, prices are regulated through the Patented Medicine Prices Review Board (PMPRB).”

Created in 1987, the PMPRB arose out of concern that patent protections for new drugs could lead to a significant increase in price, making the drugs inaccessible to consumers. A quasi-judicial body, the PMPRB has a regulatory mandate to “prevent pharmaceutical patentees from charging consumers excessive prices.” 

As a result, American drug prices are, on average, 218% more of their Canadian counterparts—despite the fact that, in most cases, there are no differences between the products. “Canadian drugs are often produced or sourced by the exact same companies in the same factories,” Tadrous explains.

Is buying prescription drugs in Canada safe?

If you purchase brand name or generic prescription drugs from Canada legally, there’s little reason to worry about safety. In most cases, the drugs will be the same ones you would get from American pharmacies, and they’ll be just as rigorously tested for safety as they would be in the U.S. 

“We have a regulator called Health Canada, similar to the Food and Drug Administration (FDA), which works to ensure the safety of our drugs,” Tadrous says. Still, there are some things you should keep in mind to make sure you’re getting the right medications at the right dosages, and you should always check with your primary care provider before purchasing any drugs from Canada in person, online, or by mail order.

“There are some potential risks associated with purchasing drugs in Canada, such as counterfeit or expired medications or incorrect dosages,” says Kellie K. Middleton, MD, an Atlanta-based orthopedic surgeon. “I recommend consulting a physician to discuss their medical history and current medications before ordering drugs from Canada, and then research the Canadian pharmacy to make sure it is adequately licensed and regulated.”

For the most part, if drugs require prescriptions in the U.S., they’re only available by prescription in Canada, as well. Canadian pharmacies require a prescription from an authorized Canadian practitioner, but American doctors can call or fax prescriptions to Canadian pharmacies to be filled through a process called “cosigning.” Through this process, a Canadian healthcare provider reviews the U.S.-provided prescription and the patient’s medical history, and, if the prescription is approved, it is re-issued as a Canadian prescription. 

Cosigning is different from the usual process of prescribing a medication and sending it directly to the pharmacy to have it filled. However, most patients shouldn’t see a difference in the process for buying their prescription from a Canadian pharmacy. Some providers in the U.S. may have established relationships in Canada already and can handle the ordering process for you.

Can you order prescriptions from Canada online?

If you don’t live near the border between the U.S. and Canada and can’t drive across to purchase Canadian medications at the pharmacy, you can still purchase prescription drugs from Canada through the internet.

The FDA allows customers to purchase drugs from Canadian online pharmacies and have them shipped to the U.S. under the same guidelines that regulate bringing drugs across the border. That means that you will need a valid prescription from a licensed healthcare provider and the drugs must be approved for use in the U.S.

As far as safety is concerned, whether the online pharmacy is American or Canadian, the FDA warns that there are many unsafe online pharmacies and has the following suggestions. 

Beware of pharmacy websites that:

• Do not require a prescription.
• Are not licensed.
• Do not have a licensed pharmacist on staff to answer your questions.
• Send medicine that looks different than what you receive at your usual drug store, or arrives in packaging that is broken, damaged, in a foreign language, has no expiration date, or is expired.
• Offer deep discounts or prices that seem too good to be true.
• Charge you for products you never ordered or received.
• Do not provide clear written protections for your personal and financial information, including credit card numbers.
• Sell your information to other websites.

Safe, high-quality online pharmacies should always be licensed by the proper authorities in their country of origin, require a valid prescription, provide a physical address and telephone number, and have a licensed pharmacist on staff to answer your questions.

What are the restrictions for bringing meds back to the U.S.?

If you are traveling back from Canada by car or plane, you can bring prescription drugs purchased there back to the U.S.—provided they are among the most commonly prescribed drugs and you have a valid prescription or note from your healthcare provider. The general rule of thumb is to keep the medication in its original container and limit the amount you bring back to no more than a three-month supply.

Prescription drugs that may be restricted include controlled substances and medications that haven’t been approved for use in the U.S. However, different stipulations apply that could allow you to bring back these types of medications with certain limitations.

Controlled substances

If you are leaving or entering the United States with a controlled substance, the medication must be in the original, dispensed container and you must declare the drugs to a U.S. Customs and Border Protection (CBP) officer when you cross the border. Additionally, you must follow these FDA guidelines:

• The medication must be for your own personal use (or that of an animal accompanying you). You may not bring back medications for someone else to use.
• The container label must have the medication’s trade or chemical name or the name and address of the pharmacy or practitioner who dispensed the substance and the prescription number.
• The medication must be kept to 50 dosage units or less. That number can be for one prescription or split between two or more, but the total doses cannot exceed 50.

Non-FDA approved medications

If a medication hasn’t been approved for use in the U.S., the medication could be confiscated when you cross the border. If you purchase a drug that isn’t approved for use in the U.S., you can only bring it back into the country if you meet the following FDA requirements for personal importation:

• The product is for a serious condition for which effective treatment may not be available domestically.
• There is no known commercialization or promotion of the product to individuals residing in the U.S.
• The product does not represent an unreasonable risk.
• The consumer affirms in writing that the product is for personal use.
• The quantity is not more than a three-month supply.

Additionally, you will have to provide the name and address of the healthcare provider licensed in the U.S. responsible for your treatment with the product or provide evidence that you started treatment with the product in Canada.

No matter the type of medication, CBP agents may refuse a personal importation if the product is on an FDA import alert, appears to be intended for commercial distribution, or appears to present a serious risk to health. If a controlled substance in your possession exceeds the 50-dosage limit and appears to be for commercial distribution, you may face fines or arrest. But, if a refused medication appears to be for personal use, you can choose to have it confiscated.

The bottom line

If you want the best prices, ordering prescription medications from Canada is a great option. The federal laws around drug pricing keep costs low, and make Canada one of the best options for purchasing medications abroad. Remember to review the FDA regulations and ensure that you are selecting a licensed and credible pharmacy when looking for the lowest prices. 

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