As the cost of prescription drugs escalates, interest in buying cheaper medicines from other countries—such as Canada or Mexico —has risen. This practice, known as drug importation, is illegal under federal law.

Though the number of Americans who import medication for personal use cannot be accurately determined, a few states— mostly along U.S.borders—are making it easier for residents to import drugs through state laws that, for example, allow citizens who visit Canada to bring back drugs. And, federal lawmakers are considering legislation to legalize drug importation.

The American Pharmacists Association (APhA) and other medical groups are concerned about this activity. Ensuring the safety of imported drugs and preventing counterfeit drugs from entering the country are the APhA's primary concerns. An imported drug may not meet FDA specifications for manufacturing, proper drug strength, labeling and storage, and shipping conditions necessary for the drug's integrity—or may not be the drug the physician prescribed. These circumstances make it impossible for pharmacists to fill a professional obligation to counsel patients about all their medications.

Even worse, patients often do not tell their primary care practitioners or pharmacists about medications they are getting outside the U.S. The pharmacist then cannot identify potential drug interactions or maintain a complete patient profile, putting the patient's health at risk and placing the pharmacist at legal risk for not providing appropriate counseling. Therefore, it is important to educate your patients about the dangers of drug importation and, according to the APhA, encourage them to use a single reputable local pharmacy to fill their prescriptions.

You also should ask whether the patient has obtained any drugs from outside of the country. Explaining that this knowledge helps you to identify potential drug interactions and complications is one way to elicit a truthful answer. Advise patients about the potential risks of imported drugs to safeguard their health while protecting yourself from potential liability. Documenting all discussions with patients about imported drugs also is vital, especially as a reference in the event of a lawsuit.