This abstract case study is intended as a basic overview of both how ever greater US residents have difficulty affording Rx medications prescribed for them, and to what extent ordering these meds from a Canadian pharmacy may provide them with a legitimate and more affordable alternative. Including a comparison of the average prices paid locally in US pharmacies and those same consumers would pay to Canadian pharmacy for the same drugs in the same quantities.

The study will then wrap up with conclusions, if any, that can be made based on the findings, plus refer to actions taken by the US government to expand the access US residents have to prescription drugs ordered from Canada.


Millions of Americans have difficulty affording their medication. It’s predicted that prices for prescription drugs as a whole are going to continue to increase in coming years. Some drug prices may become lower, and in particular, as the Federal Government begins to roll out plans that will make it easier to order medications from a Canadian pharmacy.

The need for this is clear, as it’s been determined that drugs sold in the U.S. cost about 56 percent less in similar world countries. The consider estimates that are about 10% of prescriptions are ‘abandoned’, which means they’re not filled. In a country of 350+ million people, that’s a whole lot of people not getting the meds they should. That number rises to 45% when the prescription costs more than $125.

People can’t afford their medications. With total net payer spending in 2019 coming in at 4.1% increase to $509 billion over the past five years and many American households at or near the poverty line, we can state that there is going to be a need for lower-income Americans and Americans using Medicare Part D to have more alternatives when it comes to accessing affordable medication.


This is intended to provide a clearer focus on whether or not an average Canadian pharmacy online offers lower prices on drugs. And specifically lower in comparison to the average drug costs Americans pay for medications dispensed from their local pharmacy. Further, are these price differences significant enough to make medication ordered online from Canada a better choice for lower-income US residents who can’t afford their medication each month.

A secondary objective is on consumer concerns about any Canadian pharmacy they’d consider for filling their prescriptions out of the country. Prices seen in local pharmacies in different States may seem high to the consumer, so how extensive are the potential savings if they order medication online from Canada? Part of this consideration will be whether the products are the same level of purity, quality, efficacy, and safety.

The hope is then that consumers will be more inclined to look into ordering from a Canadian pharmacy for better prices on medications, and if greater numbers of them take advantage of it may have the effect of having some regulatory effect. One that curbs the increases in drug costs that are seen in America every year and makes for more affordable medication for Americans.


Costs are always passed down to the consumer, and this is very much the case with the pharmaceutical industry too. Wholesaler acquisition costs have gone up an average of 7.1% over the past five years, from $477 billion to $671 billion. This is a fundamental part of why medications have become so expensive in America.

You can look at pretty much any widespread serious disease in America and see examples of people having difficulty affording needed medication. Heart disease is a great example, with approximately one in eight adults suffering from a high-risk heart problem saying affordability issues have caused them to not take meds, delay filling a prescription, or take a lower dose than prescribed. The number for those under 65 rises to one in five.

To add some numbers to this, we can consider the following:

  • Estimates are that around 8% of the population in US (working out to about 19 million people) import medication from outside of the country to save money 1
  • Prices for brand name prescription drugs have increased 100% over the past 6 years in America
  • Per capita spending on prescription drugs in the USA was in the vicinity of $912 for 2019, while being around $420 in 19 other industrialized nations. The same number for Canada was $417, suggesting Canadians and a Canadian pharmacy have access to their medications at much lower prices. 2

For more information on per capita medication spending in the USA, click here

For more information on per capita medication spending in Canada, click here

  • An 8.3 million (18.2%) increase in the number of over-65 population experiencing a 13.7% increase in medication use with drugs having higher out-of-pocket costs, which is then only partially offset by 5.2% lower per-prescription costs. 3
  • In 2019, 9% of all new prescription starts were left unfilled at some point in the initial stages at retail pharmacies, and this when patient care with pharmaceuticals is recommended by a physician but not acted on by the patient 4
  • These abandonment rates are less than 5% when the prescription carries no out-of-pocket cost, but rise to 45% when the cost is over $125 and 60% when exceeding $500 4


Looking at the potential savings to be had from ordering medications for a Canadian pharmacy, it may be best to provide actual by-brand examples of price differences, with the idea being that the significant differences in consumer prices suggest that it does make sense to order medication from outside of the country, although not necessarily from a Canadian pharmacy. However, the proximity of the two countries will make it that shipping costs are lowest when ordering from these pharmacies.

Let’s start by looking at the brand drug Nexium, as GERD (gastrointestinal esophageal reflux disease) is an extremely prevalent condition in America. One 40mg Nexium pill costs more than twice in America what it does in Canada; $7.78 in America, and $3.37 in Canada.

Abilify is a much-need antipsychotic drug, and if we look it at it we can see the same large pricing difference; it sells for a whopping $34.51 in America, but you can purchase the same medication from a Canadian pharmacy for $4.65. Again, we can attribute this to the markup model applied to pharmaceuticals in America, with cost-sharing and deductibles factoring in the same way they’ve always been.

Conclusions and Relevance

Considering all that has been presented here in this brief study, it is accurate to state the following; Americans who purchase medications on an ongoing basis and have difficulty affording them should look into ordering from Canadian pharmacies. There are proven savings to be had, and often those savings are so significant that even having to pay for shipping to the USA will still make it a better and less expensive alternative.

Canadian pharmacies are a legitimate alternative here, and perhaps even more so considering Federal provisions in place and on the way that will make ordering medications online from Canada much more of a real option for Americans.

We can assume greater numbers of people adopting the practice if over the next 5 years we see per-capita drug spending amounts move to a less drastically different range when comparing Canada and the USA. A Canadian pharmacy is a good alternative for Americans who need lower prices on drugs while still receiving them in their home State.


1 Drugwatch, U.S. Drug Prices vs The World, 07.20

2 Inviqia Institute, Medicine Spending and Affordability in the U.S., 04.20

3 Inviqia Institute, Medicine Spending and Affordability in the U.S., 04.20

4 Inviqia Institute, Medicine Spending and Affordability in the U.S., 04.20