A new US mail rule could send a Dallas woman's prescription from $10 per week to $1,100. Could your meds be next?

“I’m extremely upset,” she told the WSJ.

Cavazos is one of millions of Americans who currently use foreign mail-order pharmacies to access more affordable medications. The practice has existed for decades but operates in a legal gray area. Now, Washington will enforce a set of rules that will make it harder for foreign pharmacies to ship medication to the United States.

The crackdown

Foreign mail-in prescriptions are technically barred under FDA rules but importers told the WSJ it’s rarely enforced since customs agents typically do not check low-value, individual packages.

Starting Oct. 22, that will change. Imports will be required to meet the FDA’s standards for personal drug imports. Previously, qualifying drugs valued at $800 or less could enter the U.S. through an exemption without entry procedures and import duties.

Under the change, prescription drugs will need to go through a formal entry process and a company or person will have to legally be on the hook if a shipment does not qualify for entry. Medications mailed from abroad will need both a customs broker and a financial guarantee — a standard most mail-order prescriptions will not meet, according to the WSJ.

Zonos, a Utah-based company that handles much of the mail moving through Canada and other countries, will essentially have to decide which packages go through the border by checking them against the FDA’s criteria for drug imports.

“There will be just a full stop of anything coming into the States,” Tim Smith, general manager of the Canadian International Pharmacy Association, a trade group of licensed Canadian pharmacies, told the WSJ. “These are cash-strapped, uninsured or underinsured people; many senior citizens on fixed incomes.”

According to the WSJ, the FDA generally won’t stop personal shipments if it’s treating a serious illness with no good domestic options, isn’t marketed to Americans, carries no unusual safety concerns and comes with a doctor’s note. A spokesperson for the Department of Health and Human Services told the WSJ the FDA will continue to evaluate imports on a case-by-case basis.