Oct. 22 may be the day millions of Americans suddenly won't be able to afford their prescription drugs anymore.
On that day, Customs and Border Patrol plans to stop allowing prescription drugs to cross borders duty-free and with little to no paperwork, Zonos, an importer of record on these shipments, said on its website. Instead, these packages will have to go through an automated process that requires documentation, tariffs and other specific product details the Food and Drug Administration requires.
Neither CBP, the White House nor the FDA have responded to USA TODAY's request for comment.
The change effectively means the more than 4 million Americans who buy cheaper prescription drugs directly from pharmacies in other countries, including Canada,
Australia, New Zealand and the United Kingdom, will no longer have easy access to necessary medications at affordable prices, pharmacy experts say.
Seniors will be particularly affected, with 89% of those who purchase drugs from Canadian pharmacies being age 65+, according to the nonprofit Campaign for Personal Prescription Importation (CPPI) which advocates for Americans' access to affordable and safe prescription drugs.
"This is something where people are not just saving $20 per month (by buying abroad) but hundreds and thousands of dollars per month," said Ken Hunter, CPPI executive director. "People may be retired with a limited income, and maybe get $2,000 per month in Social Security. If they have to pay another $500 or $1,000 month for their prescription, they can’t afford it."
Why is the administration making the change?
On Aug. 29, 2025, President Donald Trump suspended indefinitely the de minimis rule that allowed low-value shipments of $800 or less to enter the country freely and tax-free. Initially, Trump said he aimed the closing of the loophole at China to counter the illicit flow of synthetic opioids into the U.S., but the changes soon expanded to all countries.
All packages must now go through a stricter entry process that will require more documentation and if they are drugs, more FDA scrutiny.
Americans ordering drugs themselves would now basically have to become professional importers, Hunter said. They would need customs bonds, a bill of sale, 10-digit classification numbers and they'll have to complete these forms and pay duties online monthly, he said.
"It's not practical for someone who may be immobile or 89 years old or with dementia," he said. "For someone like that, this is a ban (on their medications) that could jeopardize their lives."
How much cheaper are medications from overseas?
U.S. consumers can save 52% to 89%, with an average of more than 64%, by ordering 90-day supplies from licensed Canadian pharmacies instead of paying higher cash prices to U.S. GoodRx or Amazon, CPPI estimates.
For example, online consumer health watchdog The People's Pharmacy compared the cost of the antidepressant Wellbutrin XL 300. The retail price for a month’s worth of Wellbutrin XL 300 was at least $2,500 in the U.S., compared to less than $200 for a three-month supply from an online Canadian pharmacy.
"Give that price differential more than a 5-second consideration," wrote Joe Graedon, a pharmacologist and co-founder of The People's Pharmacy, in a blog. "That is a lot of money, even for someone who is well off financially."
What can people do?
In 2020, Trump praised Canadian medicine imports for lowering costs for Americans in his America First Healthcare Plan executive order, which allowed states, wholesalers and pharmacies to import medications from Canada for the first time.
"The American people pay an average of over — listen to this — three times more for medicine than Canadians," Trump said then. "So you could be two feet away on each side of the border — three times more. And that’s the way it is. Canada is far more than many other countries ... We will finally allow the safe and legal importation of prescription drugs from Canada."
Now that those imports will entail new requirements for individuals, Hunter said he's encouraging Americans to flood their Congressional representatives with emails, letters and phone calls asking the administration to at least pause this action. He hopes that message will get to the White House and Trump can tell CBP not to implement this plan.
"Maybe this is an unintended consequence (from closing the de minimus loophole), and the White House is not aware of the issue or not aware of the damage it could do to people in this country," Hunter said. "So that's why we have been doing a significant campaign with Congress and customers calling and writing their Congressional person and calling it out."
In the meantime, people should "not wait to order resupply," Hunter said. "Ask your doctor to get an additional prescription and your pharmacy to order them. Medication has to be in your mailbox by October 22, not ordered by then. You should also ask your doctor if there's another drug you can afford in the U.S., or you can travel to another country to get your medication."
Those are only temporary solutions, though, and likely unsustainable. Lawmakers should address unaffordable health care for the long-term, said Mary Johnson, an independent Medicare and Social Security policy analyst.
"While many people have taken this route of purchasing drugs from Canadian pharmacies, the bigger issue is that U.S. insurers are allowed to offer plans that can have poor or complete lack of coverage for some drugs and expensive co-insurance, here in the U.S.," she said. "When people feel forced to go to Canadian pharmacies to afford their prescriptions, that means private U.S. insurers don’t foot the bill and the companies and their stockholders pocket the profits."
Pay attention during open enrollment
These changes come just as Medicare open enrollment for 2027 coverage begins Oct. 15. Starting then, through Dec. 7, people can join, switch, or drop a Medicare Advantage plan or Part D prescription drug plan.
"Medicare beneficiaries can certainly benefit from comparing their Part D or Medicare Advantage plan choices and switching if they find a better plan," Johnson said. "My Part D plan had zero premium in 2026 but is going up to more than $19 per month in 2027. I’m just waiting until October 15, and I’ll be comparing my choices as I do every year."
Medora Lee is a money, markets and personal finance reporter at USA TODAY. You can reach her at mjlee@usatoday.com and subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday morning.
This article originally appeared on USA TODAY: Millions may face prescription drug price surge on Oct. 22
