Drug Imports From Canada: What This Means for Your Medication Costs
Key takeaways:
In January 2024, the FDA cleared the way for Florida to import prescription medications from Canada to reduce the price of drugs in the U.S.
Florida’s application includes medications that treat HIV, mental health conditions, and prostate cancer. The state will purchase drugs for people who receive Medicaid or state government healthcare. Importing medications from Canada is expected to save Florida up to $183 million in the program’s first year.
For now, cost savings from drug imports won’t directly reach consumers who buy prescriptions from retail and mail-order pharmacies.
Table of contents
The high cost of prescription medications in the U.S. has been a concern for many years. In fact, 1 in 3 U.S. adults say they do not take medication as prescribed because of cost. It has been 2 decades since Congress allowed states to import less costly drugs from Canada with FDA approval.
In January 2024, the federal agency authorized Florida to buy less expensive prescription medications from Canada. Florida’s program is the first of its kind. The state intends to buy 14 drugs for its public health programs, including Medicaid. The FDA approval lasts 2 years.
Reducing drug prices has strong bipartisan support among the public and policymakers. People in the U.S. pay nearly twice as much for prescription medications compared with consumers in other wealthy countries. The Inflation Reduction Act of 2022 allowed the federal government to negotiate Medicare drug prices with manufacturers.
Here’s more about Florida’s program and how it could affect what you pay at the pharmacy counter.
Can I get prescription drugs imported from Canada?
Maybe. Florida’s drug importation program is limited to certain medications for people who receive healthcare from the following state government entities:
Agency for Health Care Administration: For people served by Medicaid
Agency for Persons with Disabilities: For people living in public facilities for individuals with developmental disabilities
Department of Health: For people served through county health departments
Department of Children and Families: For people in state mental health hospitals and treatment facilities
Department of Corrections: For people in the custody of state prisons
For the most part, individuals aren’t allowed to import prescriptions, though many people order medications by mail or travel across the U.S.-Canada border to make more affordable purchases. Under limited circumstances, the FDA allows people in the U.S. to buy prescription medications from Canada for personal use.
How does importing prescription drugs from Canada work?
The FDA’s Section 804 importation program lets states and Native American tribes buy certain prescription medications from Canada to reduce drug costs for U.S. consumers without risk to health and safety. States and tribes must develop programs and submit proposals to the FDA.
In 2020, the Trump administration allowed states and tribes to submit import proposals. In 2021, President Joe Biden directed the FDA to work with states to import drugs from Canada. Florida sued in 2022, alleging that the FDA was delaying approval of its application. Florida’s program was approved in January 2024.
These states have submitted proposals to the FDA or plan to seek drug import approval:
Colorado
Maine
New Hampshire
New Mexico
North Dakota
Texas
Vermont
Wisconsin
Florida’s program is approved for 2 years from the first shipment of medications. During that time, the state must report:
Savings
Adverse effects
Supply chain tracking
The state is also required to test and relabel the imported drugs.
Are drug imports from Canada cheaper?
Yes, and the prices beat the deep discounts Florida’s Medicaid program receives from drug manufacturers. Florida expects to save $183 million in the program’s first year and $196 million in the second year.
Drug prices in the U.S. are set by manufacturers. Canada regulates drug prices and negotiates discounts with manufacturers, which makes prices more affordable. To avert drug shortages, Canadian officials are restricting exports of medications in short supply.
Are drug imports from Canada safe?
Canada and the U.S. buy prescription medications from many of the same manufacturers. The FDA says drugs imported from Canada do not risk the health and safety of people in the U.S.
The Pharmaceutical Research and Manufacturers of America and other industry groups are opposed to imports. They say Florida’s program “poses a serious danger to public health.”
Who benefits from drug imports from Canada?
Taxpayers will benefit from drug import programs because states will spend less on medications. Eventually, consumers may benefit directly with lower drug prices.
Which drugs are authorized for import?
Florida has 14 prescription medications authorized for import from Canada:
The bottom line
In January 2024, the FDA authorized Florida to import prescription medications from Canada to reduce the price of drugs in the U.S. Florida is the first state to receive this approval.
Florida plans to buy 14 drugs from Canada that treat HIV, mental health conditions, and prostate cancer for its state government healthcare programs, including Medicaid. The state expects to save up to $183 million in the first year.
For now, drug imports and lower prices aren’t available to consumers who buy prescriptions from U.S. pharmacies.
Why trust our experts?
References
Agency for Health Care Administration. (2023). Cost savings.
Freed, M., et al. (2021). 10 FAQs on prescription drug importation. KFF.
Hajdu, P. (2020). Interim order respecting drug shortages (safeguarding the drug supply). Government of Canada.
Hughes, S., et al. (2023). Following the money: Untangling U.S. prescription drug financing. Center for American Progress.
Jewett, C., et al. (2024). F.D.A. issues first approval for mass drug imports to states from Canada. The New York Times.
Longo, N. (2020). Drug importation: An old idea that is still a bad idea. Pharmaceutical Research and Manufacturers of America.
Pharmaceutical Research and Manufacturers of America Foundation. (2024). PhRMA statement on FDA authorizing Florida’s importation plan.
Robbins, R., et al. (2024). Six reasons drug prices are so high in the U.S. The New York Times.
State of Florida v. Food and Drug Administration. (2022). Case No. 8:22-cv-1981-TPB-JSS. U.S. District Court, Middle District of Tampa, Tampa Division.
State of Florida. (2023). The state of Florida’s section 804 importation program (SIP) proposal for the importation of prescription drugs from Canada.
U.S. Food and Drug Administration. (2021). Is it legal for me to personally import drugs?
U.S. Food and Drug Administration. (2023). Personal importation.
U.S. Food and Drug Administration. (2024). FDA authorizes Florida’s drug importation program.
U.S. Food and Drug Administration. (2024). Importation program under section 804 of the FD&C act.
Wilkerson, J. (2024). Biden’s FDA is letting Ron DeSantis import cheaper drugs from Canada. Who gets to take credit? STAT.
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