Stressing the potential danger to patients, NABP expressed its opposition to legislation introduced in Maine that would allow the dispensing of drugs from mail-order pharmacies located around the world. Maine Legislative Document 449 proposes to amend the definition of the “practice of pharmacy” to allow mail-order pharmacies located in Australia, Canada, Israel, Japan, New Zealand, Switzerland, South Africa, and the European Union to dispense drugs to patients in Maine. In a letter (PDF) to Maine Senators John L. Patrick and Douglas Thomas, and Maine Representative Erin D. Herbig, NABP notes the concern that this action, by effectively circumventing the federally regulated United States medication supply chain, would open the door to unapproved, substandard, and counterfeit drugs and pose a significant risk to patient safety. The letter highlights the fact that medications dispensed by foreign mail-order pharmacies are not approved by the US FDA, or, in many cases, by any public health authority. Since such drugs are dispensed outside the tightly regulated US drug supply chain, there is no way of knowing whether the products are substandard, adulterated, contaminated, or even toxic. As indicated in the letter, the distribution of fake cancer medication purchased from foreign sources in February 2012 serves as a prime example. The Association also expressed its concern that the proposed legislation would condone and foster violation of federal law, placing residents of Maine who might use such mail-order pharmacies in jeopardy, both legally and from a public health standpoint. Organizations providing testimony in opposition to the proposed legislation included the Partnership for Safe Medicines and Rite Aid Corporation, and both entities presented NABP’s letter to Maine legislators.