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NABP Findings Underscore Dangers of Purchasing Prescription Medicine Online and from Foreign Sources
With the number of visitors to Internet drug outlets nearly tripling in the last year, the risk to patients’ health is higher than ever. Based on its assessment of more than 1,000 Internet drug outlets selling medicine online, the National Association of Boards of Pharmacy® (NABP®) finds that 97% of these sites appear to be operating out of compliance with state and federal laws or established patient safety and pharmacy practice standards. Most of these sites appear to violate several criteria for legitimate pharmacy practice. For instance, 93% do not require a valid prescription, 25% do not secure patients’ personal information, and 61% offer foreign drugs, which are not approved by the US Food and Drug Administration (FDA), and which, according to federal law, are not legal to sell in the US.
“NABP understands the need for many patients to consider cost in regard to their prescription medications,” says NABP President Rich Palombo, RPh. “Our hope, however, is that no one should have to sacrifice safety in the interest of saving money.”
NABP historically has viewed the use of medications obtained from foreign sources cautiously for two reasons: (1) federal law prohibits it, and (2) proponents have yet to develop provisions to ensure patients receive safe, effective medications. Currently, no safeguards exist to protect shipments of foreign medications entering the US from infiltration by counterfeit and substandard drugs. Until such provisions are in place, use of foreign medicines will present a risk.
Foreign medicines are often purchased from Internet drug outlets, the majority of which have been found to be operating outside of the regulatory framework established to protect patient health. “Buying drugs online continues to be fraught with fraudsters,” MarkMonitor reports in its summer 2008 Brandjacking Index™. In its survey of nearly 3,000 Internet drug outlets, MarkMonitor “found numerous examples of con artists who hijack well-known brands for their own profit and continue to thrive by selling illicit drugs, endangering consumers’ health and well-being.” Meanwhile, the number of visits to Internet drug outlets continues to rise. The report cites 99,000 visitors to Internet drug outlets by the second quarter of 2008, compared to 32,000 visitors by the same time last year.
Depending on the country of origin, the likelihood of foreign medications being counterfeit may be significant. The World Health Organization estimates that counterfeit drugs range from less than 1% in developed countries to more than 30% in some developing countries. Drug counterfeiting occurs less frequently in the US than in other countries due to the strict regulatory framework that governs the production of drug products and the distribution chain, and enforcement against violators.
Web sites that sell medicine over the Internet may not be legitimately licensed pharmacies in any country, or they may dispense medicine obtained from anywhere in the world. When patients do choose to purchase medicine over the Internet, FDA advises them to use Internet pharmacies that are accredited through the Verified Internet Pharmacy Practice Sites™ (VIPPS®) program. These sites, displaying the VIPPS seal of approval, have undergone and successfully completed the rigorous NABP accreditation process, which includes a thorough review of all policies and procedures regarding the practice of pharmacy and dispensing of medicine over the Internet, as well as an on-site inspection of facilities used by the site to receive, review, and dispense medicine. Unless medications have been purchased from a state-licensed Internet pharmacy in the US, the safety and efficacy of these medications cannot be guaranteed.
To educate and empower patients to make informed decisions when buying medicine online, NABP monitors Web sites that sell prescription medicine and distinguishes those sites that do, and do not, appear to comply with state and federal laws and established patient safety and pharmacy practice standards. As of October 2008, NABP has assessed more than 1,000 Internet drug outlets, 999 of which appear to be operating in conflict with pharmacy laws and standards and have been named as Not Recommended on the NABP Web site. MarkMonitor states in its Brandjacking Index, “[w]e strongly urge consumers to check this listing before they purchase any medications online.”
Larissa Doucette
