The following abstract case study is intended as a general overview of the advantages of choosing a Canadian pharmacy online for ordering prescription drugs. The comparison will be between an average of pricing seen in a local pharmacy for a consumer, and then to the pricing that same consumer would have access to when using a Canadian pharmacy that is able to sell and ship to US residents.

This will then finish with conclusions based on the findings as well as additional information that relates to the increasing access US residents have to prescription medication ordered from Canada.


The number of Americans who struggle to afford prescription drugs that have been prescribed to them by their physicians grows every year. Much of this is related to the for-profit model of the healthcare system in the US, and the way the pharmaceutical industry operates within it. There is also the role of patents issued on new medications. These do not allow more affordable generic equivalents of drugs to be available for a minimum of 5 years.

This is a relevant issue for review as the struggles these people have with affording their medication affects their quality of life. This includes being able to afford proper nutrition, required monthly expenditures like home utilities, and in some cases even paying rent. The issue is particularly acute for people taking insulin or other medications that are essential for keeping them alive.


The objective of this study is as follows – to determine whether or not the lower prices on drugs from a Canadian pharmacy are lower than those paid on average at a local pharmacy in the USA to the point that ordering medication online from Canada becomes a better choice for the majority of Americans who have difficulty affording their medications.

A lesser focus will be on whether a Canadian pharmacy online has the same level of reputability that Americans would likely see with their local pharmacy. Plus, whether the products are the same level of purity, quality, efficacy, and safety.

The final objective will be to determine whether or not Americans who are facing high prescription drug costs should in fact look into ordering medication from a Canadian pharmacy that is able to offer the same drugs at lower prices.


It is well understood that the prices for prescription medications in America have gone up drastically in the past 10 years. As mentioned, much of this is indirectly related to the for-profit model of healthcare in America. Most specifically it is related to the different ‘middlemen’ that exist between the manufacturer of the drug and the pharmacist who dispenses it to the individual.

The markups that occur at each stage are considerable, whereas with a Canadian pharmacy the pharmacist will have a much more direct – and less costly – connection between the drug’s manufacturer and themselves. Coverage requirements imposed on government-funded drug benefits play a role too.

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

  • In 2019, per capita spending on prescription drugs in the USA was in the vicinity of $912, in comparison to around $420 in 19 other industrialized nations. In Canada the same number came in at around $417, so it is fair to say that Canadians have access to their medications at much lower prices. 1

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

  • A record $67 billion was paid out-of-pocket by US patients for all prescriptions filled in retail pharmacies in 2019, up from $61 billion in 2015 2
  • 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.
  • In Canada for the same time period, this rate was under 1%, and the general consensus is that cost of medication if the number one prohibitive factor leading to the 8% difference between countries.
  • While abandonment rates are less than 5% when the prescription carries no out-of-pocket cost, it rises to 45% when the cost is over $125 and 60% when the cost is over $500 3
  • Similar numbers for these abandonment rates are in the vicinity of 75% or higher less when looking at Canada and a Canadian pharmacy

A fair conclusion to this evidential part of the analysis being that the prices seen at the average Canadian pharmacy are not prohibitive to nearly the same extent as they are for Americans purchasing these same medications from American pharmacies.


It’s estimated that 19 million Americans order medication from outside the country to save money. This works out to roughly about 8% of the population. This is not to suggest that the entirety of the amount is imported from a Canadian pharmacy, but it’s likely that Canada is the most common source destination. It’s understood that Mexican pharmacies are also a popular choice.

Another interesting fact is this one; 70% of the most popular, non-controlled, brand name drugs sold in the U.S. are manufactured outside the U.S., then imported and sold to Americans at a higher price compared to patients in other countries. 4

This speaks to the markup model we talked about earlier here, and it’s a big part of why there are proven savings to be had if they order medications from Canada and a Canadian pharmacy.

Conclusions and Relevance

This has been intended to be only a brief overview in the comparison for Americans purchasing medication from a local pharmacy or ordering it from a Canadian pharmacy online instead. What it does is reinforce the conclusion that nearly any medication can be purchased and shipped to America for less money than what these individuals would be paying at a local pharmacy.

Canadian pharmacies are a legitimate alternative in this regard, and one of the things that is also promising for Americans is that there are Federal provisions in place and on the way that will make ordering medications online from Canada much more available to Americans.

Widespread adoption of the practice can likely be measured if over the next 5 years we see those per-capita drug spending amounts move to a similar range as compared to the less-than-half figures we see now when comparing Canada and the USA. A Canadian pharmacy seems to be a good alternative for Americans if they can get their medication from one and delivered to the US.


[1] Inviqia Institute, Medicine Spending and Affordability in the U.S., 04.20

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

3 [1] Inviqia Institute, Medicine Spending and Affordability in the U.S., 04.20

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