Canadian pharmacists are not allowed to dispense drugs to Americans with just a prescription from an American physician. 
The National Association of Pharmacy Regulatory Authorities (NAPRA), which represents pharmacy regulators across Canada, says that “pharmacists in Canada are not legally allowed to fill prescriptions from physicians that are not licensed to practice medicine in Canada.”

Some Canadian online pharmacies circumvent this law by having a Canadian physician co-sign prescriptions written by foreign doctors, but they are violating medical standards of care by dispensing prescriptions for patients they have never met.

Why should we put our health safety in the hands of someone who we know is breaking the law?

Canada does not have enough medicine to supply even a fraction of America’s patients.
The United States’ population is nine times the size of Canada‘s, and Canada is already having trouble meeting demand for medicines their own citizens desperately need. A peer-reviewed research paper from PSM Board President Marv Shepherd estimated that if 10% of America’s patients started ordering from Canada, Canada would exhaust their supply in 224 days.

In recent years, patients have faced serious shortages of chemotherapy, painkillers, antibiotics and anti-seizure medicines. Canadian patient groups are adamant in their opposition to the idea of Americans raiding their drug supply. In 2016, arthritis patient advocate Linda Wilhelm wrote:

“We urge Americans not to raid Canada’s pharmacies to try and buy cheaper medicines. Our mothers, fathers, siblings, and kids will all be further harmed by this.

Her sentiment has been echoed by representatives in Canada’s asthma, cancer, epilepsy, hemophilia, kidney, lymphoma and Parkinson’s communities.

Packages from Canada are not necessarily from the Canadian drug supply.
Orders placed on so-called “Canadian” websites have yielded products that came from Turkey, India, Egypt and elsewhere. In 2005, FDA investigators found that nearly half the illegally imported drugs they seized from four foreign countries were falsely labeled Canadian. 85% of seized medicines came from outside Canada, and some of those drugs were counterfeit. Industry practices haven’t changed. Since 2012, medical practices and individual Americans have ordered prescription drugs from Canadian online pharmacies and have received substandard, contaminated and counterfeit medicines from other foreign countries that weren’t approved by the FDA or its Canadian counterpart, Health Canada.

Moreover, Health Canada does not inspect packages Canadian web pharmacies are selling to Americans. As one Canadian official put it, “Health Canada does not assure that products being sold to U.S. citizens are safe, effective, and of high quality, and does not intend to do so in the future.”

It’s not just the drugs, but the way those drugs were stored and shipped, that needs to be inspected. Biologics, sterile injectables, infusions and other fragile drugs are susceptible to degradation during transit. If they aren’t shipped under tightly controlled temperature, humidity and light conditions they won’t work. From unrefrigerated insulin in 2003 to chemotherapy drugs shipped without dry ice during a heat wave in 2012, fake Canadian pharmacies and distributors have a long history of shipping sensitive drugs unsafely.

No one can tell if their medicine is genuine by looking at it.
Not even trained pharmacists can determine whether a real medication is fake without lab tests. Criminals have access to blister packs, litho printing, and even security holograms. They will use any compound from floor wax to road paint to make pills appear genuine. Some counterfeits contain a small amount of active ingredient to fool chemical screens, but they won’t contain enough to treat your disease.

Our own health experts say importation is not safe.
Since 2000, every head of the FDA and the Department of Health and Human Services has refused to sign off on the safety of importing drugs from outside the licensed supply chain. As former FDA head Dr. Andrew C. von Eschenbach told Congress in 2008, imported drugs are “often coming from places other than Canada that we have absolutely no control or confidence in, or when analyzed are found to either not contain the active ingredients or to contain ingredients that are in fact harmful.”

Criminal penalties don’t ensure foreign companies’ compliance.
In 2015, executives from were indicted for a $78 million conspiracy to sell non FDA-approved medications, including cancer drugs, to Americans. The FDA intercepted some of their medications and lab-tested them. They were fake. These executives remain at large in Canada today, operating their fake internet pharmacy site selling to Americans.

Remote pharmacists cannot safely dispense drugs without access to the rest of your healthcare records.
Pharmacists are responsible for our safety. They check that each new medication will not interact with other medications you are taking and that your doctor has chosen an appropriate medication and dose for your condition. They discuss how the medication should be taken and potential side effects to watch out for.  A remote pharmacist with no access to your records and no access to you cannot ensure your safety: drug interactions they miss can harm you by making medicine less effective, causing unexpected side effects, or increasing the effects of a particular drug.

Canadian web pharmacies don’t participate in safety communications about drugs in the United States.
The safety of American drugs is ensured by a wide range of communications (including, for example, adverse event reporting, recalls, letters to healthcare providers and consumers) between the FDA, pharmacies, pharmaceutical companies and patients. Foreign sellers are not required to participate in those communications, which means that adverse effects from their products may be missed.