Mail-Order Prescriptions From Canada Could Face Delays or Refusals When a Customs Rule’s Grace Period Ends October 22

Nearly 1 Million HealthCare.gov Enrollees in 30 States Are Getting $500 Treasury Checks That Require No ApplicationNearly 1 million HealthCare.gov enrollees who paid full price are getting $500 checks. See who qualifies and how to avoid scams tied to the payments. Parents Should Check Amazon Bath Seats and Dressers, Giant Bike Lock Keys, and Avengers Medals in New RecallsNew CPSC recalls cover Amazon baby bath seats and dressers, Giant LED bike lock keys, and Avengers medals. See what you own and how to get refunds. Chicago Marathon’s Record Field of More Than 55,000 Faces a Yellow-Flag Day with Highs Near 71 DegreesThe Chicago Marathon starts under a yellow flag with a forecast high near 71, above the 65-degree normal. Heat illness signs and when to stop. Records Detail Immediate Jeopardy Citation After Charlotte Nursing Home Resident in Wheelchair Was Fatally Struck in 2023Records show inspectors cited a Charlotte nursing home at the immediate jeopardy level after a resident in a wheelchair was fatally struck on a busy road. Mental Health Four Deaths in Evenamide Trials Prompt FDA Concern Over a Possible Fatal Heart Rhythm Signal in Schizophrenia DrugThe FDA flagged a possible fatal heart rhythm signal after four deaths in evenamide trials. What a safety signal means for people with schizophrenia. Frequent Mental Distress in Adults 18 to 29 Climbed From 12.7% to 21.3% Since 2012 Despite Recent DeclinesCDC data show 1 in 5 adults 18 to 29 report frequent mental distress, up from 2012 but down two years straight. Where to find help today. Veterans’ PTSD and Depression Relief After Ibogaine Largely Held for a Year in Small Stanford Study of 30Most veterans in a small Stanford ibogaine study kept their PTSD gains at 12 months, but the study had no control group, and heart risks remain. Hymns and Childhood Songs Topped the Phantom Music 81 Patients Heard, and Hearing Loss Was Often Not the CauseA Dutch study of people who hear music that isn’t playing found that half had no documented hearing loss, and most found the music a burden. Innovation Leeches Dipped in Guinness Turned Erratic, and the Ones Placed on Garlic DiedA 1994 BMJ experiment tried beer, garlic, and sour cream to make medical leeches bite faster. Beer backfired, and garlic proved fatal. Weltruza Becomes the First Monthly Under-the-Skin Olanzapine Shot Approved for Adults with Schizophrenia, No Post-Injection Monitoring NeededFDA approves Weltruza, a monthly under-the-skin olanzapine shot for schizophrenia with no post-injection monitoring. Trial results and side effects. Gut Bacteria Protein Linked to Fever After COVID Vaccines in 171 Adults as Mouse Tests Point to DietA Science study links flagellin, a gut bacteria protein, to fever after mRNA COVID shots in 171 adults. Antibody responses were not affected. Google’s AMIE Chatbot Interviewed 98 Boston Primary Care Patients Under Doctor Supervision Without a Single Safety StopIn a Lancet study, Google’s AMIE AI interviewed 98 patients before urgent visits with no safety stops. What doctors measured and what it cannot prove. Healthy Living Doctor Who Christmas Episodes Were Tied to Fewer Deaths, and This Year There Won’t Be OneA BMJ study linked Doctor Who Christmas Day episodes to lower death rates. The BBC has scrapped its 2026 special. Here’s what the data showed. Peppa Pig’s Doctor Makes House Calls for a Rash, and a Real GP Says That Breeds Unrealistic ExpectationsA GP’s BMJ feature argued that Peppa Pig’s Dr. Brown Bear sets expectations that real doctors can’t meet. U.S. patients now wait about a month for appointments. Par Health Recalls Two Brevital Anesthetic Lots Over Cellulose Particles That Could Block Blood Vessels in the LungsPar Health recalled two Brevital anesthetic lots after cellulose particles were found. See the lot numbers and what surgery and ECT patients can ask about. Starfish Brand Cold-Smoked Salmon, Halibut and Trout Recalled for Possible Listeria in Six East Coast StatesStarfish Seafood Trio cold-smoked fish is recalled in six states for possible Listeria. Check lot D139149161-153 and learn who faces the highest risk. Covid – 19 FDA Proposes Requiring Companies to Report Food Additives That Now Reach Grocery Shelves Without Federal ReviewFDA has released its proposed GRAS rule requiring companies to notify the agency about food additives. Here is what the proposal does and does not do. Federal Regulators Warn Some Hair Dryer Brushes Lack the Part That Stops ElectrocutionCPSC warns hair dryer brushes sold on Walmart.com and TikTok Shop lack immersion protection. The seller has not agreed to a recall or refund. A Recalled Teething Toy Broke the Pattern Parents Were Told to Look ForA newly recalled pull-string teething toy has a different model number and design from earlier recalls, and one choking incident has been reported. Trying to Lower Blood Sugar, Cholesterol or Blood Pressure? Different Workouts Suited Different MarkersA pooled analysis of 53 trials found that different exercise types helped different metabolic markers. Most of the evidence was low certainty. William Thomas Cain | Getty Images Share on Twitter Share on Facebook Share on Pocket Americans who fill prescriptions through Canadian mail-order pharmacies have 10 days before a federal customs change could slow, complicate, or stop their deliveries. A U.S. Customs and Border Protection rule on international mail reaches a key compliance date on Oct. 22, and patient advocates warn that imported medicines could get caught in it.

The rule does not mention prescription drugs by name. It covers nearly everything arriving through the international postal network, from clothing to toys. But according to the Associated Press, medications mailed from abroad will need additional data and a customs bond once the change takes hold, and the practical result could be delays, refusals or added costs.

The stakes are highest for older adults and people with chronic conditions who rely on lower Canadian prices to stay on their medicines. About 2.3 million U.S. adults reported buying prescription drugs abroad to save money, according to a study in JAMA Network Open published in 2020 and cited by the AP.

CBP published the interim final rule in June. It indefinitely suspends the de minimis exemption that once let mail shipments worth $800 or less enter duty-free, and it creates a new informal entry process for mail shipments valued at $2,500 or less.

Under that process, only an owner, purchaser, or licensed customs broker can file the entry, and the filer must hold a customs bond. Each package must be reported with details that include a 10-digit tariff classification, country of origin, value, and tracking number.

The Oct. 22 date matters because of a grace period written into the rule. Until then, CBP has let goods subject to other federal agencies’ import requirements use the simpler postal process. After Oct. 22, those goods must go through formal entry, a more demanding customs filing. Prescription drugs are regulated by the FDA, which is why medicines appear likely to fall into that group even though the text never names them.

CBP said it would open a voluntary electronic option, called the Entry Type 13 test, as an alternative to formal entry for these shipments when the grace period ends. Whether Canadian pharmacies will use it, and how quickly, has not been made public.

In the rule, the agency said it wanted to prevent “the flooding of low-value merchandise into the United States,” including illicit drugs such as fentanyl. Congress has separately written an end to the de minimis exemption into law, effective July 1, 2027.

The price difference can be large. A study by the Campaign for Personal Prescription Importation found in an August study that a three-month supply of the blood thinner Eliquis cost $565 from a Canadian mail-order pharmacy, compared with roughly $1,017 through Amazon’s pharmacy or $1,029 through GoodRx, the AP reported.

Ken Hunter, the group’s executive director, said price-cutting efforts have not reached everyone. “There has been a lot of talk of lowering drug prices, but in many cases it doesn’t cover all drugs for all people for all conditions,” he told the AP.

Geography shapes the burden. People who live near the Canadian border can sometimes fill prescriptions in person, but many Floridians cannot easily travel to Canada. Three Florida Republican members of Congress, Aaron Bean, Gus Bilirakis and Scott Franklin, wrote to the administration urging CBP and the FDA to make sure constituents seeking lower prices are not swept up by the rule. Florida’s own federally authorized Canadian importation program has stalled.

Separately, 71 House Democrats led by Reps. Mark Pocan and Jan Schakowsky asked HHS, the Department of Homeland Security, the FDA and CBP to delay the new procedures for prescription medicines. A White House spokesperson told the AP the administration remains committed to lowering drug costs and pointed to its pricing agreements with drugmakers.

Much is still uncertain. The administration could drop the rule, change it or decide not to enforce it, the AP noted, and CBP did not respond to the AP’s requests for comment. Until officials say how mailed prescriptions will be handled, patients are planning around a moving target.

The legal backdrop matters too. Importing prescription drugs for personal use has generally been illegal for individuals, as the American Medical Association has noted, even though federal enforcement has historically been limited. The new rule changes customs paperwork, not the underlying FDA law.

Patients who travel to Canada in person face a different situation. The rule states that it does not affect the separate customs exemption for personal articles carried by travelers, although FDA rules on bringing medicines across the border still apply.

People who depend on a Canadian pharmacy should contact it now and ask how it plans to ship after Oct. 22, whether it will use a customs broker, and whether any new fees will be passed along. Ordering a refill early may help bridge a delay, but patients should confirm the pharmacy can still deliver.

It is also worth asking a U.S. doctor or pharmacist about backup options. Generic alternatives, manufacturer assistance programs, discount cards and Medicare drug-price negotiation may lower costs for some medicines. No one should stop or ration a prescribed drug without talking to a clinician, since gaps in blood thinners, inhalers or heart medicines can be dangerous.

Caution is warranted with websites that suddenly promise easy workarounds. Pharmacist associations in both countries have long warned that some sites posing as Canadian pharmacies sell counterfeit or unsafe products.

KFF Health News flagged the rule in its Oct. 9 briefing as a growing affordability concern. The next real test comes after Oct. 22, when patients begin to see whether their packages arrive on time.

A grace period in a CBP mail rule ends, and goods subject to other federal agencies’ import requirements must use formal customs entry. Prescription drugs, which the FDA regulates, appear likely to be affected.

Does the rule ban Canadian prescriptions?

No. The rule does not name medicines, but added filing, bonding and data requirements could cause delays, refusals or extra costs for mailed prescriptions.

About 2.3 million U.S. adults reported buying prescription drugs abroad to save money, according to a 2020 JAMA Network Open study. Not all of them use mail delivery from Canada.

Older adults and people with chronic conditions who rely on lower foreign prices are most exposed. Patients far from the border, including many in Florida, have fewer alternatives.

Yes. The AP reported that the administration could drop, alter, or decline to enforce the rule, and lawmakers from both parties have asked for assurances on personal-use prescriptions.

Contact the pharmacy about shipping plans, ask a U.S. clinician or pharmacist about backup options, and avoid unverified websites. Do not stop a prescribed medicine without medical advice.