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In a world of lots of small middlemen, sure. But in a world where you only have a handful of middlemen that can all collude with eachother to fix prices high? looks pointedly at several entire markets
Sure, you could have a cartel, but cartels only really work in industries that have very high barriers to entry, like oil production. Non-members have every incentive to undercut the cartel, and if it's reasonably easy to enter the market, someone will do that.
It's not particularly hard to buy stuff from Canada and re-sell it.
Any random stuff from Canada, yes. But as I understand it there are a few extra hoops at the border for large quantities of prescription medications.