A U.S. Customs and Border Protection rule suspending the de minimis exemption starting Oct. 22 would require additional steps for low-value shipments, raising concerns for Americans who buy medications from Canada.
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A U.S. Customs and Border Protection rule will suspend the de minimis exemption for low-value shipments starting Oct. 22, a change that critics say could make it harder and more expensive for Americans to receive affordable medications mailed from outside the United States.
The de minimis exemption previously allowed shipments valued under $800 to pass through customs more easily, and the rule is intended to collect tariffs and prevent illegal drugs from coming into the U.S.
The rule does not target Canadian drugs specifically because it applies to international mail generally, but the practical consequence could include added fees and registration requirements for low-value deliveries that previously entered the U.S. without duties.
Susan Hooper, a 75-year-old Toledo, Ohio resident who said she has been on oxygen for 14 years, described using Canadian pharmacy purchases for two daily medications that she said are not available in the U.S., and said, “The issue is a matter of life and death for me.”
The rule would place additional requirements on medications mailed from outside the U.S., including the need for more data and a bond guarantee.
According to the reporting, about 2.3 million Americans buy prescription drugs abroad, citing a 2020 study by JAMA Network.
Opponents are pressing the Trump administration for assurances about access to affordable care for people who obtain medications through import channels.
Ken Hunter, executive director of the Campaign for Personal Prescription Importation, said some people may not benefit from the administration’s broader drug-pricing efforts, arguing in part that costs can vary by medication.
Hunter cited his organization’s August study of 10 commonly prescribed medications imported from Canada and said examples include Eliquis: he described a three-month supply of 180, 5-mg pills costing $565 from a mail order Canadian pharmacy, compared with roughly $1,017 from Amazon’s pharmacy arm or $1,029 from GoodRx.
In a statement, White House spokesperson Allison Schuster said President Donald Trump “remains dedicated to lowering the cost of prescription drugs,” pointing to most-favored-nation drug deals and saying the administration is working to ensure Americans have access to “low-cost pharmaceuticals across the board.”
Lawmakers on both sides of the aisle have also sought answers about how the rule would affect patients, including Florida Republicans who wrote to the administration and said Floridians would not be able to easily travel to Canada.
The reporting said Customs and Border Protection representatives did not respond to requests for comment.
The rule is also coming as some patients say tariff changes have already increased prices for medications they buy from Canada.
Hooper said her medications have increased in price since the Trump administration imposed additional tariffs on Canada in August, and she described theophylline rising from $85 with shipping to $141, and Foradil rising from $151 to $273.
Hooper said she will “find a way to manage through the change” and, until then, has been “in a rush to stockpile.”
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