Improving Value

Drugs - Importation

Wholesale drug importation programs authorize states to function as licensed wholesalers, allowing them to purchase lower-cost drugs from Canada and make them available to state residents through pharmacies and administering providers. States need approval from the federal Department of Health and Human Services before implementing these programs, ensuring that minimum quality standards are met.

While critics have expressed concerns that drugs from Canada may be unsafe, more than 30 Canadian manufacturers are registered to produce drugs for U.S. markets.1 Moreover, approximately 40 percent of drugs currently available in the U.S. are manufactured in other countries.

Vermont was the first state to create a wholesale drug importation program in 2018. Other states are increasingly considering this approach.2 For example, Florida’s importation law3 creates two prescription drug importation programs: The Canadian Drug Importation Program focuses on lowering the cost of drugs to state-funded programs (like Medicaid and the state prison system) and The International Prescription Drug Importation Program allows medicines to be imported from Canada and other countries. The drugs would be available to consumers through wholesale distributors and pharmacies.



1. "Is It Safe for States to Import Drugs from Canada? Yes, Here's Why," National Academy for State Health Policy (September 2017). 

2. "Vermont First in Nation to Approve Rx Drug Importation from Canada," National Academy for State Health Policy. 

3. Bunis, Dena, "Florida Governor Signs Prescription Drug Importation Bill," AARP (June 11, 2019).