Jardiance price increased

[Klondike Kat]

Just picked up my Jardiance prescription - $588 for a 90 day supply. That was an increase of about $250. At this rate I won't be afford it much longer.

[rog]

1. Price from a Canadian pharmacy.

Generic equivalent for Jardiance Empagliflozin 10mg Tablet = $56.99 for 90 tabs
Brand Name Jardiance 10mg Tablet = $147.99 for 90 tabs

Generic equivalent for Jardiance Empagliflozin 25mg Tablet = $70.99 for 90 tabs
Brand Name Jardiance 25mg Tablet = $167.99 for 90 tabs

I am using generic Apixaban (Eliquis) from a Canadian pharmacy. Service is great, blood lab tests show levels exactly equal to name brand. Current retail in USA for brand name (generic not available here) = $531.55 per month. My cost for Apixaban from Canada = ~$25 per month. US price for Eliquis has been as high as $600+ per month.

I don't think I want to contribute actual pharmacies, but look for pharmacies certified by CIPArx. If they're certified by other associations such as Pharmacy Checker, that's good too, but at least CIPA.

https://www.cipa.com/verify-a-website

Edited to add that prices at various Canadian pharmacies vary widely, so it pays to shop and compare. Many of the pharmacies will also match lower prices from a competing pharmacy as long as they are CIPA certified.

[Jacson6]

3. How do you pay the CANRx companies for your medications?

[rog]

4. The pharmacy I use ...

... does not accept credit cards (they may accept one ... 'maybe' AmEx, I'm not sure). The reason is interesting ... if you'd like to know just mention it.

But they will set up a program to take the purchase amount from your bank account. Yes ... that made me nervous, but what I did was to set up a 2nd account, like a sub-account, and only transfer the amount I needed to complete the transaction. It's seamless, and I've never had a problem. The account has a discrete account number and routing number.

They also take: Personal check (which is processed electronically so there is no delay when you order), International money order, and Cashier's check (Note: this is just my pharmacy - others may have different policies.)

As long as I'm here, this is what CIPA (Canadian International Pharmacy Association) ... https://cipa.com ... says about credit cards.

VISA and MasterCard are now trying to address problems associated with illegitimate online pharmacies using VISA and MasterCard accounts. Unfortunately, a number of legitimate, safe pharmacies, including CIPA members, have been impacted by VISA and MasterCard’s unusually broad-brush approach. This is very frustrating, as we believe VISA’s and MasterCard’s policy is having a negative effect on consumers trying to purchase medications from trusted CIPA Member pharmacies with a perfect safety record and long history of serving U.S. residents.

And always check to see if your pharmacy is CIPA-certified by checking to see if they're actually listed on the CIPA web site ... some of the fake outfits have been known to counterfeit the CIPA logo.

https://www.cipa.com/verify-a-website

[Jacson6]

5. I remember in Salem, OR 20 years ago.

A business set up a system to order Rx from Canada. You would pay them and then they would pay the Rx fees. They were raided by US Customs, DEA and FBI. They received 5 yrs in club fed for the illegal importation of controlled substances and money laundering.

[rog]

6. I'm sure that's true, but I'd be interested in hearing the details.

I'm not talking about shady outfits. The pharmacy I deal with is completely visible and transparent. Canada has several regulatory organizations that certify Canadian online pharmacies.

Yes, personal importation of prescription medications is technically illegal, but despite the law, the FDA has a long-standing "Personal Importation Policy." This policy allows the agency to exercise discretion and not take enforcement action against individuals importing small quantities of medication under specific conditions. This is not a law that makes it legal, but rather a policy of looking the other way for personal use.

I don't know, but I wonder if the folks in Salem got in trouble because they were 'importing with intent to distribute'? That's never a good idea, and it's a lot different than offering a referral service from the US side or ordering small quantities of a medication for personal use internationally from a reputable pharmacy. The money laundering part wasn't a great idea, either.

Both of my parents, now deceased, ordered meds from Canada 25-30 years ago - the referral service was called Canada Drug Service (CDS). They seemed to have branches everywhere, many times advertising in local small town newspapers throughout the mid-west.

But a good place to start getting a feel for this service is the website of the Canadian International Pharmacy Association. I'm not going to make any recommendations, but searching for CIPA-certified businesses is a good place to start. I researched for the better part of a year before I decided to do this.

Here's a link to a good article -- I'll include a few excerpts.

CIPA Celebrates 20 Years Online

The Canadian International Pharmacy Association (CIPA) recently achieved a major milestone: We celebrated our 20-year anniversary, serving millions of customers around the world who otherwise would not afford, access or trust ordering their daily maintenance medications where they live. Founded in 2002 by a group of Canadian pharmacists who recognized the potential of the Internet to provide safe and affordable access to medications, CIPA has grown to become the world's foremost online pharmacy association. CIPA maintains a comprehensive set of Standards of Practice that all member pharmacies must adhere to. These Standards cover a wide range of areas, including patient safety, medication quality, and financial transparency to address the needs of the patients we are committed to serve from licensed pharmacies.

-----

In the world of internet governance, CIPA is a long-term member of the ICANN Business Constituency, the Internet Infrastructure Coalition (i2C), and Internet & Jurisdiction Policy Network, where we join with the world's greater business and technical communities in the commitment to promoting a safe and trusted internet.

-----

Our participation over the years at RightsCon and the Internet Governance Forum (IGF) has been productive in sharing and broadening understanding of the growing demand for ordering prescription maintenance medications from online pharmacies. We have collaborated with academics, activists, internet policy experts, NGOs and human rights advocates in the creation of the Brussels Principles on the Sale of Medicines over the Internet, which sets out a framework for the creation of transnational pharmacy access protocols.

-----

CIPA looks forward to continuing its collaboration toward a compassionate, trans-national approach that provides online access to safe and affordable medications for those in need.

[Jacson6]

8. Yes, The person would go to them to order the Rx and they imported them at a profit.

Then the person would get the pills delivered by a delivery person.

[rog]

9. So it sounds like 'distribution', right? That's ...

... not a real good idea.

I thought the info I discovered about the actual legal landscape, re: the language in the Medicare Modernization Act of 2003 and the non-implementation of the personal importation provision was interesting and depressing. I'm going to guess that the main reasons this part of a LAW ... which is on the books ... has not been instituted by any HHS Secretaries (D or R) are: "the logistical challenges of implementation (laziness), and opposition from the pharmaceutical industry.(lobbyists)" ... especially the latter. I don't imagine RFK is going to be any better - likely worse. I have my fingers crossed that the FDA policy of non-enforcement for personal importation continues. There are a lot of us out here who depend on it. I'm relatively lucky - I'm only on one $600+/mo drug. A large percentage of ppl my age are on multiple such drugs.

[rog]

7. re: the law, I just found this that I had not seen before, concerning personal importation.

Last edited Sat Mar 14, 2026, 11:56 PM - Edit history (2)

When you look at the lengthy legislation, search the word 'personal'. It only appears 8 times in the document (the first couple of hits are in a different context).

And then, see below for some added nuance, apropos why this is not in effect, despite being settled law.

MEDICARE PRESCRIPTION DRUG, IMPROVEMENT, AND MODERNIZATION ACT OF 2003
https://www.govinfo.gov/content/pkg/PLAW-108publ173/html/PLAW-108publ173.htm

Excerpt, re: personal importation of prescription medications. [CIPA certification checks all these boxes.]

(3) Drugs imported from Canada.--In
particular, the Secretary shall by regulation grant individuals
a waiver to permit individuals to import into the United States
a prescription drug that--
``(A) is imported from a licensed pharmacy for
personal use by an individual, not for resale, in
quantities that do not exceed a 90-day supply;
``(B) is accompanied by a copy of a valid
prescription;
``(C) is imported from Canada, from a seller
registered with the Secretary;
``(D) is a prescription drug approved by the
Secretary under chapter V;
``(E) is in the form of a final finished dosage that
was manufactured in an establishment registered under
section 510; and
``(F) is imported under such other conditions as the
Secretary determines to be necessary to ensure public
safety.

The excerpt shows that Congress explicitly created a legal framework to permit individuals importing prescription drugs from Canada for personal use.

However, as the text itself indicates, this authority is contingent on the Secretary of Health and Human Services (HHS) first establishing regulations to put the program into effect. This is the critical point where the law on paper meets the reality of implementation.

The Law vs. The Reality: Why the Waiver Isn't Active

The section, specifically (j) Waiver Authority for Importation by Individuals, does several things:

1) It declares Congressional intent: Congress states that the Secretary "should exercise discretion" to permit personal importation that doesn't pose a public health risk.

2) It grants authority: It explicitly gives the Secretary the power to grant waivers, either through a general regulation or on a case-by-case basis.

3) It specifically mandates a regulation for Canadian imports: Paragraph (3) is the key. It says the Secretary "shall by regulation grant individuals a waiver" to import a 90-day supply from a licensed Canadian pharmacy, provided specific safety conditions are met (e.g., a valid U.S. prescription, the drug is FDA-approved, etc.).

This language is mandatory ('shall by regulation'). So, why isn't this program up and running? The answer lies in the actions (and inactions) of subsequent HHS Secretaries.

Despite this law being passed in 2003, no HHS Secretary has ever issued the final regulations needed to implement Section 1121. This is often referred to as the law being "on the books" but not "in effect." Successive Secretaries from both Republican and Democratic administrations have declined to move forward, citing concerns about the safety and security of the pharmaceutical supply chain, the logistical challenges of implementation, and opposition from the pharmaceutical industry.

Still (so far), FDA chooses not to enforce the law for personal use..

[Brainstormy]

2. My prescription for Trelegy went from

45 dollars to six hundred a month! Needless to say, I didn't pick it up and the pharmacist told me that many others were doing the same.