More than 4 million Americans who buy lower-cost medicines from overseas pharmacies may lose easy access after Oct. 22 as Customs ends duty-free entry for prescription shipments.
USA TODAY reported that Customs and Border Protection plans to stop letting prescription drugs cross U.S. borders duty-free and with little paperwork. Packages will move through an automated process that demands documentation, tariffs, and product details the Food and Drug Administration requires.
Pharmacy experts say the shift hits people who already stretch fixed incomes to stay on needed drugs. Seniors make up the bulk of that group. The change flows from a broader crackdown on low-value shipments, and advocates warn the paperwork load could cut off affordable supply for the very patients who need it most.
Importer-of-record firm Zonos stated the new process on its website. Neither CBP nor the FDA answered requests for comment on the planned shift.
On Aug. 29, 2025, President Donald Trump suspended indefinitely the de minimis rule that let shipments of $800 or less enter freely and tax-free. The move first targeted China to slow the illicit flow of synthetic opioids into the United States. It later expanded to all countries.
That security step now collides with a long-standing consumer workaround. More than 4 million Americans buy cheaper prescription drugs directly from pharmacies in Canada, Australia, New Zealand, and the United Kingdom. The Campaign for Personal Prescription Importation says 89% of people who order from Canadian pharmacies are age 65 or older.
CPPI estimates U.S. consumers can save 52% to 89%, more than 64% on average, by ordering 90-day supplies from licensed Canadian pharmacies instead of paying higher cash prices at home through services such as GoodRx or Amazon.
One concrete comparison comes from pharmacologist Joe Graedon, co-founder of The People's Pharmacy. He flagged Wellbutrin XL 300, a common antidepressant. A month’s supply can retail for at least $2,500 in the United States. An online Canadian pharmacy offered a three-month supply for less than $200.
"Give that price differential more than a 5-second consideration. That is a lot of money, even for someone who is well off financially."
For retirees on limited budgets, the gap is not abstract. It is the difference between filling a prescription and skipping doses.
Ken Hunter, executive director of CPPI, described what the tighter entry process would demand of ordinary patients. Individuals would need customs bonds, a bill of sale, 10-digit classification numbers, and monthly online forms and duty payments.
"It's not practical for someone who may be immobile or 89 years old or with dementia. For someone like that, this is a ban (on their medications) that could jeopardize their lives."
Hunter said the savings at stake often run far beyond pocket change.
"This is something where people are not just saving $20 per month (by buying abroad) but hundreds and thousands of dollars per month. People may be retired with a limited income, and maybe get $2,000 per month in Social Security. If they have to pay another $500 or $1,000 month for their prescription, they can’t afford it."
He called the personal-importation fallout a possible unintended consequence of closing the de minimis channel and urged Americans to contact their members of Congress. Hunter also advised patients not to wait on resupply orders so medicine arrives before Oct. 22.
Asked about the border change, White House spokeswoman Allison Schuster stressed the administration’s work on drug prices through Most-Favored-Nation agreements.
"President Trump remains dedicated to lowering the cost of prescription drugs, as evidenced by his Most-Favored-Nation drug pricing agreements that now span nearly 90% of the branded drug market. The Council of Economic Advisors estimates the President’s MFN pricing deals will save Americans $600 billion over the next decade, and Americans have already saved over $1 billion in out-of-pocket costs. The Trump Administration continues working to ensure Americans have access to low-cost pharmaceuticals across the board."
That focus tracks with earlier Trump policy. In 2020, the America First Healthcare Plan executive order allowed states, wholesalers, and pharmacies to import medications from Canada for the first time. Trump highlighted the price gap directly.
"The American people pay an average of over, listen to this, three times more for medicine than Canadians. So you could be two feet away on each side of the border, three times more. And that’s the way it is. Canada is far more than many other countries... We will finally allow the safe and legal importation of prescription drugs from Canada."
Stopping fentanyl precursors and other illicit goods in low-value packages is a legitimate border priority. The open question is whether lawful personal prescriptions for seniors should carry the same importer-style burden designed for commercial freight.
Independent Medicare and Social Security policy analyst Mary Johnson placed the foreign-pharmacy route in a larger coverage failure at home. She said U.S. insurers can offer plans with weak or missing coverage for some drugs and steep co-insurance, which pushes people abroad.
"When people feel forced to go to Canadian pharmacies to afford their prescriptions, that means private U.S. insurers don’t foot the bill and the companies and their stockholders pocket the profits."
Johnson noted that Medicare open enrollment for 2027 coverage runs from Oct. 15 through Dec. 7. Beneficiaries can join, switch, or drop Medicare Advantage or Part D plans during that window. She said her own Part D plan carried a zero premium in 2026 and is set to rise above $19 a month in 2027, so she plans to compare options as she does every year.
For patients already relying on foreign fills, comparing Part D designs is one near-term step. It does not replace the price gap many still face on brand drugs, and it does not answer what happens after Oct. 22 if personal packages stall in the new paperwork system.
CBP’s planned process will require more FDA scrutiny on drug shipments. Exact tariff rates, bond costs, and form fields for personal orders were not detailed in the public guidance summarized so far. What is clear is the end of the prior low-friction path that millions used.
Americans should not have to choose between border security and filling a life-sustaining prescription. Common-sense rules can target illicit opioids without burying lawful patients in importer paperwork they cannot navigate.