An illustration showing a drug tablet with a Canadian flag.

To help Americans save money on their meds, last week the Trump Administration said it would launch a pilot program to test importing some prescription drugs from Canada.

The new plan would allow retail pharmacies, drug wholesalers, states, and even drug manufacturers to purchase certain drugs in bulk from Canadian suppliers at prices that are substantially lower than those in the U.S. Consumers would then be able to buy the cheaper Canadian medications through a U.S. pharmacy with a prescription from their doctor. 

Consumer Reports has long supported efforts to lower drug costs by promoting greater competition so consumers have more choices. And allowing imports from Canada and other countries can help, as long as drug safety is assured, says George Slover, senior policy counsel at Consumer Reports.

The Trump plan is unlikely to go into effect anytime soon—possibly not for years, according to Stephen Buck, a pharmaceutical supply chain consultant and a co-founder of GoodRx.com, a drug discount website. He says one safe way it could work is to allow consumers to buy medication directly from a store like Walmart or Costco in Canada.

More on Saving Money on Your Meds

But for now, Buck says the Trump plan does not apply to individual consumers who may want to buy medications from Canada or other foreign countries, for example by using an online pharmacy or crossing a border.

Mail-ordering drugs from a country outside the U.S., or buying them abroad and bringing them home, is and will remain illegal for consumers, according to emails from the Food and Drug Administration. (The only exception is for certain drugs, such as some cancer treatments, that are unavailable here.)

But U.S. consumers—who now pay more for prescription drugs than people in any other industrialized nation—have already resorted to buying drugs outside the U.S. A 2017 Consumer Reports nationally representative survey found that an estimated 3.4 million people had ordered at least one medication online from outside the U.S. in the last 12 months in order to save money. Buck says that “for the most part, neither the FDA nor U.S. Customs has cracked down on this practice.”

Buying drugs this way can be risky, according to the National Association of Boards of Pharmacy,  which tracks online pharmacy websites. Of the more than 11,000 such websites it reviewed, 95 percent operate outside U.S. state and federal laws—meaning that most did not require prescriptions or were selling foreign drugs or drugs not approved in the U.S.

And, in a recent review of more than 100 online pharmacies that claim to be shipping drugs from Canada, NABP found that most appear to actually source the drugs they sell from countries known to sell many counterfeit or adulterated drugs, such as India.

And just last year, the U.S. Department of Justice found a company called Canadian Drugs, through its subsidiary River East Supplies, guilty of distributing counterfeit cancer medications in the U.S. DOJ testing of the drugs ordered from that company found no active ingredient.

Sarah Peddicond, an FDA spokesperson, says the agency "remains concerned about drugs purchased outside of the legal U.S. supply chain and continues to warn consumers against purchasing unapproved or potentially counterfeit drugs through illegal channels."

The biggest problem, says Libby Baney, senior advisor to the Alliance for Safe Online Pharmacies, a nonprofit that monitors illegal international pharmacies and counterfeit medications, is that "people don’t often know if they are buying from an illegal site or not.”

Instead of taking unnecessary risks by ordering medications outside of the U.S., consider some of the other, safer ways to save on your meds instead.

Drug Manufacturer Discounts

If you have employer-provided health insurance, discount coupons offered by pharmaceutical companies can help cover the co-pay of your drug. These offers can be for otherwise expensive medications. 

If your co-pay is, say,  $40, the discount coupon might cover some—or all—of that amount. But there could be a limit to how many times you can use the coupon a year, or a date by which the discount expires.

Sometimes the discounts are more generous. Take Mylan, the manufacturer of EpiPens. Its coupon program will pay up to $300 of your out-of-pocket costs for a prescription of up to six two-packs of EpiPens in a calendar year. The offer expires at the end of 2019. To get the coupon, you’ll first need to fill out and submit a brief questionnaire online. Note: During the sign-up process, you can “opt out” of receiving any further communications from Mylan on other discounts and offers. (Read more about Mylan's privacy policy.)

These coupon programs aren’t available to people with most government-funded health insurance, including Medicare Part D, Medicaid, or coverage through the military or Veterans Affairs.

You can look up the medication you take to see if the manufacturer has any discount coupons or programs by visiting this government site, or either of the nonprofit websites that keep a database of such discounts, NeedyMeds.org or Partnership for Prescription Assistance.

Patient-Assistance Programs

If you don’t have health insurance, you may be eligible to use a patient-assistance program that many drug manufacturers offer. To participate, your income may need to be below a certain limit.

For example, AbbieVie, the makers of Humira, an expensive drug for rheumatoid arthritis, offers an assistance program to individuals who earn $74,940 or less, or families that earn up to $154,500. Your medication could be free if you qualify. To find out if you do, you’ll need to fill out an application form on their website. To speed the application process, have a copy of your federal tax return handy.

Know that the application process might take up to several weeks, so you shouldn’t wait until the last minute to apply. AbbieVie notes on its website that it takes about two business days to process applications for Humira or any of its other dozen or so medications that you could submit for (see the company's complete list). Once you’ve completed your application, your healthcare provider will be asked by AbbieVie to fill out their portion of the paperwork, adding more time.

Also, don’t assume that your physician will know about or recommend drug discount programs, says Richard J. Sagall, M.D., a co-founder of NeedyMeds.com, which tracks drug discount programs, including patient-assistance programs. Many physicians aren’t very familiar with these programs, he says.

Other Discount Coupons Might Be Available

If you don’t have health insurance, are enrolled in a high-deductible insurance plan, or if your insurance doesn’t cover the drug you need at all, using a pharmacy discount card may be a way to sharply lower your out-of-pocket costs. GoodRx.com and BlinkHealth.com both offer discount coupons for those not using insurance, and can cut the price of a drug down a good deal.

For example, the generic version of the cholesterol-lowering drug Crestor could be as much as $677 at a Walmart in Los Angeles. But with a GoodRx coupon, the price could come down to $23.37 for a three-month’s supply. 

Blink Health offered the same drug for $30.40 at either Walmart, Kroger, Safeway, or Albertson’s Pharmacy in the Los Angeles area, too. Blink Health uses a voucher system—you pay ahead of time using an account you set up at BlinkHealth.com, selecting the drug, the quantity and the strength (for example: 10 mg, 20 mg, etc.), and pay through BlinkHealth.com. Then you take the voucher (printed out or downloaded to your phone) to the pharmacy with you. The pharmacy will honor the voucher, charging you zero. 

Finally, if you ever have to pay for a drug entirely out of pocket, try asking the pharmacist for a better price or if there is a discount program he or she can apply. A secret shopper survey in 2017 by Consumer Reports found that there are in-store discounts, but they’re rarely applied unless you ask for them specifically.  

Additional reporting by Maggie Veatch.