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A U.S. Customs and Border Protection rule scheduled to take effect Oct. 22 will suspend the de minimis exemption for low-value international shipments, adding data and bond requirements that could complicate delivery of medicines ordered from Canada. Patient advocates warn some people may face delays, refusals or higher costs; the rule applies broadly to international mail, not specifically to Canadian drugs. The administration has not said whether it will change or pause the rule.
U.S. Customs and Border Protection is set to suspend the de minimis exemption for low-value international shipments on Oct. 22, a change that could make it harder for Americans to receive medicines ordered from Canadian pharmacies. The rule is not specific to drugs or Canada, but it will require additional shipment data and a bond guarantee, raising concern among patient advocates about delays, refusals and added costs.
The exemption previously allowed shipments valued at less than $800 to pass through customs more easily. Under the new rule, medications mailed from outside the United States will face additional data and bond requirements. The policy also covers many other goods, including textiles and toys, and is intended to collect tariffs and prevent illegal drugs from entering the country.
Patient advocates say the added requirements could affect people who depend on lower-cost medicines from Canada. Ken Hunter, executive director of the Campaign for Personal Prescription Importation, said the administration’s drug-price efforts do not cover every medicine or every patient. He cited the blood thinner apixaban, sold as Eliquis: a three-month supply of 180 5-milligram pills costs $565 through a Canadian mail-order pharmacy, compared with about $1,017 through Amazon’s pharmacy business or $1,029 through GoodRx, according to a study by his organization.
The report also described Susan Hooper, a 75-year-old Toledo resident who uses oxygen and takes two daily medicines from a Canadian pharmacy that are not available in the United States. Hooper said one of her medicines, theophylline, previously cost $85 including shipping and has become more expensive since additional tariffs on Canada were imposed in August. The report’s supplied account does not give the new price.
Risks for Patients Relying on Imports
The policy may create a practical barrier for people who rely on medicines they say are less expensive or unavailable domestically. If packages are delayed, refused or burdened with new processing costs, patients could face higher bills or difficulty maintaining access to their usual prescriptions. The scale of the effect is not established, but a 2020 JAMA Network Open study estimated that roughly 2.3 million Americans buy medicines abroad.
The change also puts two federal priorities in tension: customs enforcement and efforts to lower prescription costs. President Donald Trump has promoted drug-price measures, including most-favored-nation agreements with pharmaceutical companies and the TrumpRx discount-drug website. White House spokesperson Allison Schuster said the administration remains committed to lowering prescription costs and ensuring access to low-cost pharmaceuticals. Advocates counter that those initiatives may not help every patient or cover every medication.
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How the Import Exemption Changes
The de minimis exemption covered low-value shipments entering the country and allowed them to clear customs with fewer requirements. Its suspension is part of a broader federal change affecting international mail, rather than a measure written specifically for Canadian pharmacies. For medicines mailed from abroad, the new process calls for more shipment information and a bond guarantee.
Concern has drawn responses from both parties. Three Florida Republican representatives — Aaron Bean, Gus M. Bilirakis and C. Scott Franklin — wrote to the administration last month asking how the rule would affect constituents who cannot easily travel to Canada. Florida has federal authorization for a Canadian prescription drug importation program, but that initiative has stalled. More than 70 Democrats separately asked health and immigration enforcement officials to pause the rule unless they could assure access for medicines intended for personal use.
“The issue is a matter of life and death for me.”
— Susan Hooper, a 75-year-old Toledo resident
How the Rule Will Be Enforced
It remains unclear whether the administration will enforce the rule as scheduled, amend it or pause it. The report says the administration could take any of those steps, but no decision is described. Customs and Border Protection representatives did not respond to requests for comment.
The likely effects on individual prescriptions, delivery times and final costs are also not yet known. The rule applies to international shipments generally, and the available reporting does not establish how many medicine packages will be delayed or refused. The quoted price comparisons and patient accounts illustrate possible consequences, but they do not show the rule’s overall effect on all people who import medicines.
Decisions Before the October Start
The scheduled start date is Oct. 22. Before then, the administration could clarify how personal-use medicines will be handled or change the rule’s implementation. Lawmakers from both parties have asked federal officials for answers, while patient advocates are pressing for assurances that prescriptions will continue to reach recipients.
Patients and pharmacies will be watching for guidance from Customs and Border Protection and the Food and Drug Administration on required shipment information, bonds and any exceptions. Until officials provide that detail, the extent of disruption and the costs patients may face remain uncertain.
Key Questions
What changes on Oct. 22?
CBP is scheduled to suspend the de minimis exemption for low-value international shipments. Medicines mailed from outside the United States will require additional data and a bond guarantee.
Does the rule specifically target Canadian medicines?
No. The rule applies broadly to international mail and low-value shipments, not specifically to Canadian drugs. Advocates say the new requirements could still affect Americans ordering medicines from Canadian pharmacies.
How many Americans may be affected?
A 2020 JAMA Network Open study estimated that roughly 2.3 million Americans buy medicines abroad. The available reporting does not establish how many will experience delivery problems under this rule.
Has the government said it will pause the rule?
No pause or change is confirmed in the source material. The administration could alter or decline to enforce the rule, but its decision and implementation details remain unclear.
Source: rss
