Published Online: Sunday, April 1, 2007

Community pharmacists concerned about growing competition from cheap mail-order pharmacies in Canada may soon have another worry: competition from the Cherokee in North Carolina. Like other Native American tribes around the country, the Cherokee are developing plans to cash in on their status as a "sovereign nation" to market prescription drugs by mail to patients across the United States. The Mashantucket Pequot—a tiny, 650-member tribe in Connecticut—currently operate a mailorder pharmacy that generates >$15 million in revenue a year.

Whereas the Pequot tribal nation sells only US drugs through its mail-order dispensary, the Cherokee are considering plans to buy pharmaceuticals for their pharmacy from Canada. A Canadian mail-order drug service operated by Native Americans in North Carolina would draw immediate attention from both federal and state regulators, who have taken the position that commercial importation of prescription medications is illegal.

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