PORTLAND — Maida Uhlig said she’s been purchasing anxiety medication from Canada for about 20 years, and would have to pay thousands more per year if a new U.S. Customs and Border Protection rule goes into effect later this month that would ban people from buying medicines internationally by mail.

Uhlig, 81, of Portland, said she takes Lexapro, which her insurance doesn’t cover because there’s a generic equivalent available. Uhlig said she’s tried the generics, but for her they’re not effective. She said only the brand name medication alleviates her anxiety.

She pays about $675 per year out-of-pocket for the brand name medication, purchasing by mail through Canadian pharmacies. If she had to purchase that same drug in the U.S., Uhlig estimates the cost would be about $6,300.

“I couldn’t do it. I don’t have that money,” said Uhlig, a retired administrative assistant. “It would be debilitating if I couldn’t take this medication.”

The rule is set to go into effect Oct. 22, eliminating an exemption that previously allowed importation of prescription drugs through the international postal system.

U.S. Rep. Chellie Pingree, D-1st District, said in an interview last week that she signed onto a letter from dozens of House members asking the Trump administration to abandon the rule.

“People have been doing this for a long time, and it shouldn’t be taken away from them,” Pingree said. “We need to make sure people who are getting their prescriptions this way don’t get caught in this trap.”

A 2020 University of Florida study found that about 2 million Americans purchase prescriptions from international pharmacies.

Ken Hunter, executive director of the Campaign for Personal Prescription Importation, a New Jersey-based advocacy group, said in an interview Friday that many countries, including Canada, regulate drug prices more than the U.S., which leads to many prescription medications being cheaper when imported.

Hunter said for decades, the federal government has allowed drugs for individual prescriptions to be imported through the U.S. mail, through the Medicare Modernization Act of 2003. In the era before drugs could be purchased internationally over the internet, the federal government allowed people to drive over the Canadian border to purchase personal prescriptions.

“Drug prices, when buying internationally, are much less than what they are in the U.S., typically half the price to one-fifth the price,” Hunter said. “This is going to price people out of the ability to use these drugs. We are heading toward a significant healthcare crisis.”

Hunter pointed to Eliquis, a blood thinner often prescribed to prevent strokes, as a commonly imported medication. When purchased from Canada, it costs about $550 for a three-month supply, but in the U.S. it’s priced at over $1,000, he said. Hunter said while generic drugs are often inexpensive in the U.S., it can sometimes take years for a new medication to have a generic equivalent. Or, he said, there may be generics available in other countries, but not the United States.

CBP said on Friday that it would respond to questions about the new rule. The agency had not responded by Tuesday.

According to the published rule, CBP cited the potential of “illicit-drug importations” as one of the reasons.

Hunter said banning the importation of personal prescription medications is not going to be effective in reducing the flow of illicit drugs into the U.S., which occur in much larger volumes.

Ann Woloson, executive director of the Maine-based nonprofit Consumers for Affordable Health Care, said in an interview Friday that the impacts of the new rule would be devastating for many who already have difficulty affording their medications.

Many people have high-deductible insurance plans or those where the patient has to pay a certain percentage of drug costs. In those cases, insurance would not protect people from paying thousands in out-of-pocket costs, Woloson said.

“It’s another sad example of how our current administration is going to make it harder for people to afford the healthcare they need,” she said.

Thirty-two percent of Maine residents surveyed this year by Consumers for Affordable Health Care reported that they took fewer pills than prescribed to save money.

Uhlig said she has a supply of anxiety pills that will last about a year, but after that she would have to take a 10-hour, round-trip bus to Montreal to purchase the medications directly from Canadian pharmacies. Hunter said the new rule doesn’t prohibit people from personally crossing the border to buy drugs from Canadian pharmacies, but making people travel long distances to get medications they need would be a hardship for many.

Uhlig said people shouldn’t be forced to pay exorbitant costs for medicine they need.

“It’s so unfair, because people rely on these drugs to live,” she said.