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Sourcing Canadian-Registered Medicines for US Clinical Trials and Expanded Access

For US sponsors, CROs and institutions: the IND and expanded-access contexts in which Canadian-registered medicines are lawfully imported, what the importer needs, and why Canada is a practical comparator source.

Two lawful contexts

US law does not permit commercial importation of unapproved drugs for general sale. There are, however, two contexts in which a Canadian-registered medicine is routinely brought into the United States by a sponsor or institution:

1. Investigational use under an IND. A drug used in a clinical investigation is imported under the sponsor's Investigational New Drug application; comparators and background therapies used in the trial are covered by the IND and its labelling requirements in 21 CFR Part 312 [1].

2. Expanded access. FDA may permit an investigational drug to be used outside a trial for a patient or group with a serious condition, through an expanded-access IND or protocol [2].

Separately, FDA has stated a personal importation enforcement policy for individuals; that policy is not a supply route for institutions and is outside this guide [3].

What the US importer of record needs

Why sponsors look to Canada

Bilingual labelling, Health Canada licensing of every establishment in the chain, and a large generic market mean a comparator that is single-source or short in the US often has several marketed Canadian DINs. The molecule's [supply graph](/molecule/adalimumab/suppliers) shows those DINs alongside every other market's registrations.

How Nexara Health supports US sponsors

Nexara Health (Health Canada DEL #3-002896) exports Canadian-marketed product to the sponsor's designated US importer or depot with the documents above. We supply sponsors, CROs and institutions under an IND or expanded-access authorization only; we do not ship to US patients or pharmacies for commercial use. [Request a quote](/contact) or see the [trial comparator supply index](/trials/comparator-supply).

Sources

[1] 21 CFR Part 312, Investigational New Drug Application (incl. § 312.6 labelling, § 312.110 import and export) — https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-312

[2] U.S. FDA, Expanded Access — https://www.fda.gov/news-events/public-health-focus/expanded-access

[3] U.S. FDA, Personal Importation — https://www.fda.gov/industry/import-basics/personal-importation

[4] Health Canada, Drug Product Database — https://health-products.canada.ca/dpd-bdpp/

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