New Customs Rule Threatens Access to Lower-Cost Canadian Medications
Starting Oct. 22, a federal customs policy will end a streamlined exemption for low-value shipments, making it harder and more expensive for Americans to receive medications from Canada. The rule applies broadly to international mail and is intended to collect tariffs and block illegal drugs, but critics say it will harm patients who rely on affordable foreign prescriptions. A 2020 study estimated that roughly 2.3 million U.S. residents purchase medications from other countries.
A federal customs policy will end a simplified exemption for shipments valued below $800 on Oct. 22. Although intended to collect tariffs and block illegal drugs, it applies broadly to international mail, including medicines. Low-value packages will require additional data and a bond guarantee, potentially causing delays or refusals.
A 2020 JAMA Network Open study estimated 2.3 million Americans buy drugs abroad. Ken Hunter of the Campaign for Personal Prescription Importation cited Eliquis: a three-month Canadian supply cost $565, compared with about $1,017 via Amazon Pharmacy and $1,029 via GoodRx. The administration has pursued most-favored-nation deals and TrumpRx.
Patients who rely on Canadian pharmacies may face higher costs, delays, or loss of access, especially if their medicines are unavailable domestically. The change could also affect broader cross-border mail, adding administrative burdens for small shipments. While the policy aims to improve tariff collection and drug enforcement, its practical effects may weigh most heavily on older adults and others managing chronic conditions. The outcome could depend on how customs implements the requirements and whether alternative affordable sources emerge.