Thousands of U.S. citizens have discovered that one way to beat the high cost of prescription drugs is to buy them from Canada, where the government controls drug prices. First there were organized bus trips across the border to fill prescriptions. Now, licensed Internet pharmacies with names like CanadaMeds.com and CanadaDrugs.com have sprung up across Canada to fill orders from American consumers.
The savings can be dramatic. A 30 tablet supply of the drug Abilify costs $199.70 from an online Canadian drugstore, but $711.83 if ordered at Walgreens. One 10 capsule dose of Tamiflu sells for $112.20 in the U.S. and less than $50 in Canada. (Note: these are 2013 prices.)
But is it legal to buy medications from Canadian pharmacies? The answer is, technically no, but U.S. officials are allowing it to happen.
Under the Prescription Drug Marketing Act of 1987, it is illegal for anyone other than the original manufacturer to bring prescription drugs into the country. However, federal officials have decided to exercise "enforcement discretion" in dealing with prescription drugs brought across the border, provided the drugs are not narcotics or other controlled substances. This means that as long as a person brings back no more than a three-month supply for personal use, border officials generally look the other way, Thomas McGinnis, director of pharmacy affairs for the U.S. Food and Drug Administration (FDA), told the Milwaukee Journal Sentinel in March 2001. Patients generally may order refills in amounts up to a three-month supply without interference.
What about ordering over the Internet? Prescription drugs cannot be legally mailed into the United States by foreign "e-pharmacies." But here again officials are employing "enforcement discretion," preferring to use limited resources to crack down on large commercial drug supplies and narcotics, not prescription-drug shipments for personal consumption. Thus, customs officials allow the companies to mail up to 90-day supplies of medications.
While it is relatively easy to buy prescription drugs from Canada over the Internet, it may be dangerous. According to Consumer Reports, the National Association of Boards of Pharmacy (NABP), which accredits online drugstores in addition to representing state pharmacy boards across the U.S., reviewed more than 8,300 online pharmacies in July 2011 and just over 3 percent appear to be sound, i.e., not "rogue" operations. In addition, some companies market themselves as selling Canadian drugs when they are actually selling drugs from all over the world and some of those drugs are counterfeit.
There are several Web sites patients can use to make sure they are using a legitimate online pharmacy.