Cost of drugs from Canada to soar

Millions of Americans set to pay more due to de minimis rule

Millions of Americans who buy cheap drugs from Canada could soon lose access when a customs rule goes into effect later this month, a change that has sparked opposition from Democrats and some Republicans with the cost of living a top issue for voters ahead of midterm elections.

The rule applies to a swath of goods beyond drugs and is intended to collect tariffs and prevent illegal drugs from coming into the U.S. It comes as President Donald Trump has made lowering drug prices a top target in addressing soaring healthcare costs, and critics say the rule will hurt patients seeking affordable medicine.

"The issue is a matter of life and death for me," said Susan Hooper, a 75-year-old Toledo, Ohio, resident who has been on oxygen for 14 years and takes two daily medications purchased through a Canadian pharmacy that are not available in the U.S.

The U.S. Customs and Border Protection rule targets the de minimis exemption, which previously allowed shipments valued under $800 to pass through customs more easily. As of Oct. 22, that exemption will be indefinitely suspended, and medications mailed from outside the U.S. will require additional data and a bond guarantee.

Many medications have already increased in price since customs rules went into effect in August 2025. However, the Oct. 22 compliance date includes importation rules that could eliminate the ability to import personal prescriptions.

The rule puts added fees and registration requirements on low-value shipments that previously entered the U.S. duty-free -- on everything from textiles to toys -- but the people who could see the most significant impacts are those who buy their cheap drugs from across the border.

And while the rule doesn't specifically target Canadian drugs -- it applies to international mail generally -- the practical consequence could be delays, refusals or substantially more difficulty getting their medications delivered.