Leading US Retail Drug Prices Increased Over $165 on Average in 2021, Canadian Prices Dropped $1

Sept 2021 US Vs CA Price Comp

Americans find Savings of 50% – 90% at Online Canadian Pharmacies Compared to Best Coupon Prices at Amazon, GoodRx & Leading U.S. Competitors

Washington, D.C. –  A September price comparison of leading brand name prescription drugs shows average U.S. retail prices have climbed over $165 in 2021.  Comparatively, online Canadian pharmacies’ prices for the same prescription drugs haven’t changed and offer savings 50% to 90% lower than the best U.S. coupon prices. The analysis by the Campaign for Personal Prescription Importation (CPPI) compares prices at leading U.S. pharmacy competitors including AmazonPharmacy, CVS, GoodRx, and Walgreens against online Canadian pharmacies

This month, Congressional efforts to pass prescription drug pricing reform have stalled despite topping Americans’ legislative priorities. Meanwhile, an estimated 18 million Americans are unable to pay for at least one prescription for their household over the last three months. A 

“50 to 90 percent savings on drug prices at online Canadian pharmacies can literally mean life or death for many U.S. patients.  Congress and the Administration should be fighting to ensure Americans access,” says Jack Pfeiffer, Executive Director of CPPI. “Online Canadian pharmacies place critical medications back in the reach of American patients, allowing patients to directly recoup the savings.”

Year over year analysis shows that U.S. retail prices on top-selling name brand prescription drugs have increased by an average $165 from 2020 to 2021. For example, a 90 day Spiriva inhaler prescription, ​​used to improve breathing in people with respiratory conditions such as asthma and COPD, increased $444 in U.S. retail price from $1,309.90 in December 2020 to $1,754.09 in September 2021. U.S. coupon prices for Spiriva rose $97 from $1,306.05 to $1,403.36 during the same period. 

Comparatively, average prices for top name brand prescription drugs at online Canadian pharmacies have dropped in price by an average of $1 (U.S. currency) between December 2020 and September 2021. The same 90 day Spiriva inhaler prescription averaged $283.92 in December 2020 and $287.09 in September 2021 at online Canadian pharmacies. 

Figure 1

Table 1: USA vs CDN Dec. ’20 to Sept. ’21 (Price Side By Side of 10 Leading Prescriptions)

Figure 2: Sept 2021 Price Comparison
Table 2: Price Comparison SpreadsheetIncludes non-Prime and retail price comparisons


Purchasing prescription medications for importation from licensed and certified online Canadian pharmacies is safe and easy. Annually, Americans receive over 1 million prescriptions from online Canadian pharmacies. For decades, FDA guidance has helped people safely import medications. Online pharmacies recommended by CPPI like those certified by the Canadian International Pharmacy Association (CIPA) report a 100% perfect safety record while serving millions of American customers since 2002.

CPPI survey data released in February 2021, shows that Americans importing prescription drugs save an average of $228 a month ($2,736 a year) on medication from online Canadian pharmacies. People who spend more than $300 a month on prescriptions reported saving $755 a month, up from $648 in 2019. For years, CPPI tracking has shown that Canadian drug prices offer savings on leading name brand prescription drugs of over 50%. 


This comparison reflects prices for 90-day supplies of top-selling brand-name medications using the most common strengths prescribed to patients. Prices recorded as of September 28, 2021. Pricing and discounts do fluctuate day by day. The recorded percentages reflect savings offered by certified online Canadian pharmacies over the lowest U.S. discount price, be those from Amazon Prime or a traditional U.S. pharmacy as reported by GoodRx. All prices are in U.S. dollars. This comparison reflects prices without insurance. 

Canadian mail order prescription pricing was calculated using the average price of pharmacies certified by Canadian International Pharmacy Association (CIPA). Canadian product pricing is for Health Canada approved brand name products, dispensed by a pharmacy licensed in Canada. Over 60 websites have CIPA certification, prices vary. Certified online pharmacies do not sell controlled substances, narcotics, pseudoephedrine products, or highly temperature sensitive products including Botox, Insulin, Victoza, Saxenda.

Amazon Pharmacy is not yet available in all regions of the U.S. Figure 1 displays prices at the discounted Amazon Prime rate, non-Prime prices and discount percentage are included in Table 1.  
Prices for traditional pharmacies were compared through GoodRx, and the lowest discount/coupon prices are reflected in the U.S./GoodRx column. GoodRx gathers current prices, coupons and discounts from leading traditional pharmacy operators including CVS, Walgreens, Rite Aid, Costco, Safeway, Albertsons, Publix and others.