This chapter explores how relatively simple changes in the technology of communication can influence policy and regulation in a specific policy area. In particular, we examine how the introduction and expansion of internet marketing of pharmaceuticals by Canadian firms changed pharmaceutical policy in North America. The primary and most obvious change is in the regulation of drugs sold by Canadian firms to Americans based on internet transactions. In addition, we show other, derivative policy changes in the realms of: professional regulation, protection of drug supply, drug safety, intergovernmental relations and, to some extent, public and private coverage of consumer drug purchases. Thus, this chapter shows how change in communications and marketing technology can alter the commercial, regulatory and political environment in a policy area that has previously been dominated by the rhetoric of scientific professionalism and concerns for proper commercial returns on scientific and technological innovation. We first consider the basic story of how Canadian internet pharmacies began. Then, we consider the American response, in its various dimensions. Next, the Canadian policy response is examined. Finally, we comment on the present state of play in the relevant policy environments and likely future developments.