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The Risks Of Buying Drugs Online

Everyone loves a good deal. And the Internet provides several sources of deals and discounts. If you seek deals on prescription drugs, there are several things you should know so you don't get "mugged" by a rogue online pharmacy website.

Earlier this year, the National Association of Boards of Pharmacy (NABP), which accredits online drugstores, released the results of a study where it reviewed more than 9,600 online pharmacies. Key results:

  • Most are rogues sites: 96.6% (or 9.349 of 9,677 online pharmacies reviewed) operated out of compliance with existing laws and standards
  • Only 2.7% (259 online pharmacies) to be legitimate websites, and 0.7% (69 sites) were accredited through an NABP verification program
  • Of these 9,349 online pharmacies, 8,122 don't require a valid physician's prescription
  • 4,648 offer foreign or drugs not approved the U.S. FDA
  • 3,363 have internet servers outside the USA
  • 1,523 don't have secure web sites

The problem is intensified by drugs that are in short supply. Fraudsters know this and try to take advantage of the situation:

"The most critical shortages involve cancer, antibiotic, nutrition, and electrolyte-imbalance medicines, according to the FDA. For many community pharmacies, health-system pharmacies, and patients the lack of availability of needed -- and often life-saving -- medications through official, authorized supply channels means resorting to unconventional and more dangerous means of obtaining the medications, sometimes turning to unknown sellers online. The unfulfilled demand for these medications has created a lucrative market for counterfeiters..."

The results: several risks to consumers. One risk is that you may not get what you paid for:

"... health care facilities and patients have no assurance that the substances they receive are what they are purported to be. Many of the replacement drugs purchased online are unregulated, meaning there are no safeguards in place to ensure their identity, safety, efficacy, where and under what conditions they were made, or how they were handled."

A second risk is to your health. Counterfeit drugs can fail to address your medical conditions, make you sicker, or kill you:

"... two-thirds of the online drug sellers discovered in this study are represented on the NABP list of Not Recommended sites. These illegal online drug sellers pose serious risks to patient health. The risk is especially high with vaccines..."

A third risk is identity theft or fraud at those online pharmacies that operate unsecured sites.

Earlier this year, the U.S. Congress House Committee on Oversight and Government Reform investigated "gray market" companies, that operate outside of authorized drug distribution networks to provide short-supply drugs at hugely inflated prices. In July 2012, the committee released its report (Adobe PDF), which found:

"... a growing number of prescription drugs sold in the United States have experienced supply shortages. Because these shortages have been most severe among a group of injectable drugs used to treat patients with cancer and other serious illnesses, they have had a particularly serious impact on hospitals... During drug shortages, hospitals are sometimes unable to buy drugs from their normal trading partners, usually one of the three large national “primary” distributors... some short-supply injectable drugs do not reach health care providers through the manufacturer-wholesaler distributor-dispenser chain that policymakers and industry stakeholders present as the typical model for drug distribution. Instead, these drugs “leak” into longer gray market distribution networks, in which a number of different companies – some doing business as pharmacies and some as distributors – buy and resell the drugs to each other before one of them finally sells the drugs to a hospital or other health care facility. In more than two-thirds (69%) of the 300 drug distribution chains reviewed in this investigation, prescription drugs leaked into the gray market through pharmacies. Instead of dispensing the drugs in accordance with their professional duties, state laws, and the expectations of their trading partners, these pharmacies re-sold the drugs to gray market wholesalers..."

The investigation also found:

"... a number of businesses holding pharmacy licenses that do not dispense drugs, but instead appear to operate for the sole purpose of acquiring short-supply drugs that can be sold into the gray market.... Some gray market wholesalers gain access to shortage drugs by recruiting pharmacies to act as their purchasing agents..."

The impact is far higher drug prices than otherwise for health care facilities, hospitals, and consumers.

The NABP operates several online pharmacy accreditation programs, including the Verified Internet Pharmacy Practice Sites (VIPPS), the Veterinary-Verified Internet Pharmacy Practices Sites (Vet-VIPPS), and the e-Advertiser Approval Program. The NABP has appllied to the Internet Corporation For Assigned Names and Numbers (ICANN) for a specific domain-name to help consumers recognize accredited online pharmacies.

To protect yourself online, experts advise consumers to:

  1. Buy drugs online from reputable stores you already know
  2. Look for NABP VIPPS and Vet-VIPPS symbols when shopping
  3. Visit AwareRX.org, which maintains lists of both NABP-recommended and not-recommended online pharmacy websites
  4. Visit SafeMedicines.org operated by the Center for Safe Internet Pharmacies (CSIP), which contains a tool for patients to check if doctors in their state purchased counterfeit cancer medications
  5. Watch this public service announcement produced by the CISP:

Download the full NABP report: "Internet Drug Outlet Identification Program Progress Report for State and Federal Regulators: April 2012" (Adobe PDF).

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