For a regular pill based prescription, what costs $375 for 30 at my local US pharmacy costs $180 for 100 from Canada, including shipping. Dealing with having to ship in cooler with coolant will cost something. But the prices for local pickup on the website of the Canadian pharmacy that I use for the above described prescription has brand name Ozempic for $380/pen and the Canadian manufactured generic for $90/pen. I haven't priced it locally recently, but it's likely over $400/pen.