The Warning Signs of Illegal Online “Pharmacies”
Why buy from a store when you can shop on the Internet? Unfortunately, there are numerous illegal Web sites that will sell you contaminated or counterfeit drugs, unapproved products, the wrong product, or simply take your money and never deliver anything in return.
The situation is very much "buyer beware." Patients can protect themselves by looking for suspicious characteristics that indicate thee "online pharmacies" may be selling illicit or counterfeit drugs. For example:
The site does not have a physical address or telephone number is listed.
The site does not have a licensed pharmacist available to answer questions.
There is no way to talk to a person if problems arise regarding suspect contraband or counterfeit medication.
The site does not ask for the name, address, or phone number of your current doctor.
The site does not require that a valid prescription issued by a physician be provided before filling the order.
The site offers to sell drugs without a prescription or only requires a buyer to fill out a questionnaire to receive drugs.
The site does not accept any insurance and requires that all payments be made with a credit card.
The site requires that you waive some rights before sending the drugs.
The site "advises" consumers about drug importation laws and why it is "permissible" to obtain prescription drugs from foreign countries via the Internet.
The site encourages buyers to have the drugs sent to post office boxes.
If you suspect a Web site is making illegal online drug sales or selling counterfeit drugs, report it to the FDA by sending an email to a webcomplaints@ora.fda.gov. This is just one of the 10 ways the Partnership for Safe Medicines recommends you can fight counterfeit drugs. Visit SafeMedicines.org to learn more about how you can help combat counterfeit drugs.
Getting Back to Basics: Use the Standard VIPPS Categories
When it comes to shopping, no retailer is as accessible to consumers as the Internet. With a few clicks of the mouse, this remarkable tool can connect you with almost anything you want—from rare collectables to inexpensive trinkets—and have it delivered to your doorstep. But it is a double edged-sword-the anonymity of the Internet allows the good and the bad to sell, including counterfeit drugs via online “pharmacies.” And, as my colleagues and I have warned, for prescription drugs, the Internet can be a prescription for disaster, since these drug pushers are anything but legitimate pharmacies.
Since the late 1990s, the National Association of Boards of Pharmacy (NABP) in its Verified Internet Pharmacy Practice Site (VIPPS) program have reviewed online drug sellers and placed them into two categories: recommended or not recommended. The "Recommended" sellers are legitimate online pharmacies. They are the 15 pharmacy Web sites that carry the VIPPS seal, have gone through rigorous assessment and inspection, and represent more than 12,000 actually verified pharmacies. The "Not Recommended Sites" are online drug sellers that do not appear to comply with state and federal laws, or NABP's patient safety and pharmacy practice standards—which indicates that they represent a greater risk of selling counterfeit drugs.
But recently, NABP began using a new category: "Reviewed Internet Pharmacy Practice Sites." Here, NABP reviews "public information" available for these online drug sellers and determine that they appear to or may comply with state and federal laws and NABP patient safety and online pharmacy practice standards.
This new "reviewed" category is not helpful. It is important to remember that these online drug sellers have not demonstrated compliance with the stringent set of criteria necessary for legitimate online pharmacies to qualify for VIPPS accreditation, and therefore could be distributing counterfeit drugs to buyers. Even NABP advises patients to use the "reviewed" sites with caution since the information needed to conclusively determine the legitimacy and legality of these sites isn't available.
That's why we at the Partnership for Safe Medicines continue to recommend that you only use full, "Recommended" VIPPS accreditation online pharmacies to avoid receiving counterfeit drugs.
Remember, you are the last barrier to harm. So keep visiting SafeMedicines.org to learn how to protect yourself and your family from contraband and counterfeit drugs.
Shabby Standards
Bryan A. Liang, MD, PhD, JD
Earlier this week, I talked about India's opposition to IMPACT's proposed definition of a counterfeit medicine. Indian "experts" claimed it would hurt their generic drug industry's exports, and I asked just who these "experts" were protecting if the IMPACT's focus was only non-legitimate producers.
Now we have a better idea. Ranbaxy Laboratories, India's largest pharmaceutical company and one of the world's largest producers of generic drugs, is facing allegations by the U.S. Justice Department and the Food and Drug Administration that it manufactured substandard generic drugs and forged documents to cover it up.
Investigations like this illustrate why it is so important that consumers purchase prescription drugs from a trusted pharmacy that only sells FDA-approved drugs. As the Financial Times pointed out, in countries such as India, there are different standards for the drugs made for domestic use than for those destined for export. Exported drugs are typically subject to far tougher regulatory scrutiny.
A true generic drug is a copy that is the same as a brand-name drug in dosage, safety, strength, how it is taken, and its quality, performance and intended use. It is regulated by appropriate government authorities. There are accountable manufacturers that stand behind these drugs.
A huge source of drugs that are not regulated and untrustworthy are those purchased online from non-accredited sources. Use only VIPPS accredited online pharmacies if buying over the Internet, as we have emphasized in the past. Drug forms that claim to be generic but are not regulated or are being sold by non-accredited pharmacies can result in no treatment for the disease, harm, or death.
Visit SafeMedicines.org to learn the safest ways to buy medications online and how to save money on your prescription drugs costs without increasing your risk of buying a counterfeit drug.
Who’s Accountable?
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Ryan Haight. Marcia Bergeron. They paid with their wallets for diverted and counterfeit drugs. They also paid with their lives.
These tragedies have highlighted a few important facts. Someone hosted the criminal Web sites that sold these “medicines.” Someone enabled them to appear in Web search results. Someone processed the payments online. Who are these someone’s—and will they be held to account?
The sad fact is that we have no accountability for those who enable Internet-based criminal activity with medicine. Here’s a simple policy agenda for Congressional action:
1. Create a List of Legitimate Internet Pharmacies: The U.S. government should define a list of legitimate Internet pharmacies that meet comply with appropriate state and federal standards—or who participate in the VIPPS program.
2. Publicize the List: The government should share this list with all search engine and financial service companies to indicate which pharmacies are legal and allowed to operate.
3. Enforce the List: Assess fines for companies that continue to enable sales to the U.S. by companies not on the list. Hold them and their Boards liable for the dangerous drugs they are selling.
At the present time, the only parties who gain by Internet drug selling are the illicit Web sites who sell and the search engines who profit. There needs to be a focus on accountability and safety.
To learn more about how you can help protect our supply chain, regulate online pharmacies and fight counterfeit drugs, please visit SafeMedicines.org.
Spammers Beware
Earlier this month, the Los Angels Times published a story that explored the extremely profitable relationship between spammers and drug counterfeiters. For some time now, spammers have made money by sending countless emails to the public and then charging the credit cards of those who responded for products which never existed. In some case, the spammers sold that credit card information to other criminals.
Now, spammers have paired up with overseas criminals to flood our inboxes with offers for cheap drugs. Of course, what all those emails neglect to say is that the package arriving at your door is very likely filled with counterfeit drugs or contraband medications. Often these supposed medications arrive without any instructions or, in some cases, with instructions printed in foreign languages.
Not only do spammers and drug counterfeiters defraud consumers, they threaten our health. At their worst, counterfeit drugs cause great harm and fatalities. At the least, the drugs these enterprising criminals sell deny ill patients from therapies that can alleviate suffering and save lives.
If you do order medicines online, make sure the Web site is part of the Verified Internet Pharmacy Practice Sites (VIPPS) program. Both the U.S. Food and Drug Administration and the Drug Enforcement Administration support VIPPS since no other accreditation or verification program for online drug sellers covers as many areas as VIPPS, or does so as thoroughly.
Remember, counterfeit drugs are unsafe at any cost and keep visiting SafeMedicines.org to learn how we can work together to protect the safety of our prescription medicines.
Partnership for Safe Medicines Supports Stronger Online Pharmacy Regulation
WASHINGTON (June 25, 2008) – The Partnership for Safe Medicines, a group of organizations and individuals dedicated to protect consumers from counterfeit medicines, issued the following statement regarding yesterday's House Judiciary Subcommittee on Crime, Terrorism, and Homeland Security hearing on “Online Pharmacies and the Problem of Internet Drug Abuse” and the proposed “Ryan Haight Online Pharmacy Consumer Protection Act of 2008” (H.R. 6353 and S. 980).
The Partnership for Safe Medicines commends the members of this subcommittee and Representatives Stupak, Smith and Bono Mack for addressing a major safety issue associated with online drug access—the sale of controlled substances over the Internet without a valid prescription.
Unfortunately, mandating prescriptions for drugs purchased online will not be enough to stop this public health threat. Internet drug peddlers will simply bridge the gap by creating and selling fake prescriptions. Rogue online drug sellers enable drug abusers to purchase their drug of choice and endanger consumers by passing off counterfeit medications.
One of the Partnership’s core principles for drugs safety is that we must regulate online pharmacies. We value the rigorous oversight and standards that govern traditional pharmacies in the United States and believe all online drug sellers should be held to the same standards. We advocate that no one should be able to purchase any type of prescription drug, not just controlled substances, over the Internet without a valid prescription. That is why we endorse the Verified Internet Pharmacy Practice Site (VIPPS) accreditation program created by the National Association of Boards of Pharmacy. All Internet drug vendors, regardless of which state or country they are based in, must comply with the pharmaceutical licensing and survey requirements for every state they send pharmaceuticals.
Unscrupulous online businesses will continue to sell whatever to whomever, as long as they are paid. If we truly want to avoid another deadly incident of failed Internet drug safety, we urge Congress to take this opportunity to further address the vulnerabilities threatening the safety of our prescription drugs. To learn more about how we can protect our supply chain, regulate online pharmacies, fight counterfeit drugs and other principles of drug safety, please visit SafeMedicines.org
About the Partnerships for Safe Medicines
The Partnership for Safe Medicines is a group of organizations and individuals that have policies, procedures, or programs to protect consumers from counterfeit or contraband medicines. To join us in our stand against counterfeit drugs or obtain your own copy of the Principles for Drug Safety doctrine, please visit SafeMedicines.org.
Principles for Drug Safety
After years of neglect, it’s refreshing to see Congress giving drug safety the attention it deserves. But as my colleague Dr. Shepherd said last month, policy makers must view these efforts as the beginning of improving our supply chain, not the end.
If Congress and the FDA truly want to avoid another deadly incident of failed drug safety, our policy makers must take this opportunity to address the other vulnerabilities threatening the safety of our prescription drugs.
The Partnership for Safe Medicines has developed three core principles to support quality assurance programs and establish a drug distribution system that is without compromise. These principles include:
1. Protect Our Supply Chain
2. Closely Regulate Those Selling Pharmaceuticals Online
3. Unify in the Fight Against Counterfeit Drugs
We believe the United States needs to be a leader in the global fight against counterfeit drugs. To join us in our stand against counterfeit drugs or obtain your own copy of the Principles for Drug Safety doctrine, please visit SafeMedicines.org.
Regulating Online Pharmacies
Bryan A. Liang, MD, PhD, JD
According to some sources, there are at least 1,000 Web sites selling prescription drugs. Of course, not all of which are legitimate. Considering the sheer number of hits an Internet search for "online pharmacy" returns, it's not surprising that the U.S. Senate has put the Online Pharmacy Consumer Protection Act of 2007 on its legislative calendar.
One provision in the Act will prohibit an online pharmacy from selling a controlled substance over the Internet without a valid prescription. This is not an isolated concern. In fact, recently a Utah couple was in the news for their role in an international counterfeit drug operation in which they received and distributed shipments of hundreds of drugs, sometimes thousands of tablets, without a license or doctor's supervision.
As I've noted elsewhere, by confronting the safety issues associated with online drug access, requiring a prescription is step in the right direction. But it needs to go much further. It should require online pharmacies to be certified so customers can recognize which pharmacies are legitimate.
Stories of people who've died after purchasing controlled substances through online pharmacies are tragic. For example, Ryan Haight, a straight-A, talented high school scholar and athlete died because of an overdose of Vicodin, a powerful painkiller that he'd purchased without a prescription through an unregulated Internet seller.
Unfortunately, online drug peddlers prey upon an increasing demand: the National Survey of Drug Use and Health found that 6 million Americans aged 12 or older had used prescription psychotherapeutic drugs nonmedically in the previous month, and 3.1 million had abused OxyContin in their short lives. The bulk of new abusers are in the 12- to 17-year-old age group.
Further, beyond selling drugs of abuse to children, unregulated online pharmacies also maim and injure patients by passing off fakes.
Patients who access drugs through the Internet, who often represent some of the most vulnerable patients including the elderly and minorities, don't know they are not getting the real thing because many diseases are "silent."
Drugs treating high blood pressure, elevated cholesterol, cancer, and other illnesses don't provide immediate or obvious clinical changes after being taken.
Unregulated online sellers represent a lose-lose situation—patients getting the drugs of abuse they want; and patients not getting the drugs of treatment they need.
However, mandating prescriptions alone is not enough. Unscrupulous online businesses will sell whatever to whomever, as long as they are paid. Just as they've embraced counterfeit drugs, they'll also sell fake prescriptions.
Regulating these pharmacies should include verification that consumers have a valid prescription. But these sellers should also be licensed in the state where they sell drugs just like normal pharmacies, and be subject to rigorous oversight standards, such as the VIPPS program--the Verified Internet Pharmacy Practice Site accreditation program created by the National Association of Boards of Pharmacy.
The idea of ensuring that pharmacies verify prescriptions is a good one. But it is only a start. Oversight must include assurances that they are legitimate, have a license, and verify the need for the medications they dispense.
For more information about buying safely online, go to SafeMedicines.org.
An Easy Prescription to Follow
If you're looking to purchase drugs online, here are a couple of simple ways to increase the possibility the website you're considering buying drugs from is a legitimate website, and to protect yourself from receiving counterfeit or contraband drugs.
- Make sure the website carries a VIPPS® Seal, which signals that the online pharmacy has the seal of approval by The National Association of Boards of Pharmacy.
- Check that the site requires a valid prescription by a licensed healthcare provider.
- Check to see if there's a licensed pharmacist available to answer questions about your medicine or your order, and valid contact information.
If any of the above isn't true for the website, be suspicious! There's a strong chance that the website is not legitimate, nor are the drugs that come from it. This is even the case for websites that appear to be American or Canadian.
Unfortunately, an FDA study released last month concluded that many purchasers of drugs online are people specifically trying to avoid needing a valid prescription. Others were trying to find drugs at cheaper prices. Here, too, the FDA found that people were misguided, since more than half of the prescription drugs the FDA looked at for its study had FDA-approved generic versions, likely sold at lower prices.
Taking medicines without a valid prescription presents inherent risks, which are then compounded when the drugs are bought from illegitimate websites. While the need to save money is understandable, no amount of cost savings is worth risking your family's health and possibly their lives.
This website offers tools to help you make sure the prescription drugs you're buying come from a legitimate, safe source. Click here. It also has a guide for ways to find safe drugs at cheaper prices. Click here.
Remember protect yourself and your family! You are the last barrier to harm!