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    Mayo Clinic's mission is to inspire hope and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education and research. Additionally, there are many more websites that claim to have some nexus to Canada – slap a maple leaf on a website – to dupe U. Like the other “Canadian online pharmacy” websites described above, these sites also do not source drugs that are approved by Health Canada. These sites have no real connection to Canada at all – do not work with a pharmacy or pharmacist licensed by a Canadian province and do not have physical presence in Canada. Indeed, Legit Script has approved a few that are solely targeting Canadian residents and that are operating legally under Canadian laws. Sometimes some of the drugs are, but never all of them. When a pharmacy is physically located in the United States, there is a built-in disincentive against supplying sub-standard drugs to U. residents: the risk of civil or criminal enforcement action. S., if they violate safety rules, the FDA, DEA, or a State Board of Pharmacy can exercise regulatory, even prosecutorial, authority over the pharmacy operators. That’s not just because of the laws prohibiting Americans from buying Health Canada-approved medicines; it’s because we have never seen a case where the website is shipping all or even most drugs from the Canadian pharmacy. government cannot effectively exercise cross- border jurisdiction to ensure that the drugs shipped into the U. Adding more resources, authorities, and penalties won’t change the fact that international criminals can evade U. law enforcement simply by operating off-shore in jurisdictions that don’t prioritize internet pharmacy crime and/or don’t cooperate with U. Simply put, the FDA and other regulatory boards, including Canadian ones, are rendered impotent to protect the public health as they cannot ensure the medicines supplied from online sellers are actually legitimate. Take, for example, the with smuggling $78 million worth of mislabeled, unapproved and counterfeit cancer drugs into the U. If a Canadian (or UK, or Indian, etc.) foreign national does the same, the FDA has no power to execute search warrants or arrest individuals in other countries absent extraordinary circumstances. In some cases, foreign jurisdictions cooperate with the U. on enforcement actions but many internet pharmacy criminals remain at large internationally. pharmacy knowingly swaps out FDA-approved medicine for toxic counterfeits and someone dies, the FDA can execute a search warrant, arrest the offender and protect the public health. Government can and does take action against illegal online pharmacy operators , our government’s power stops at our borders.

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