It couldn't be easier—ordering prescription drugs online with a few clicks of the mouse and having them delivered right to your door, without ever having to see a doctor. People living with chronic illnesses depend on prescription medications. But many have trouble affording the drugs they need; while other elders can't easily get to the doctor. The lure and appeal of internet pharmacies is obvious: cheaper drugs that are easy to get. But is it safe? In many cases, they are not.
Around the world, however, criminal rings have turned the business of counterfeiting medicines into a $75 billion global enterprise, according to a report by the Partnership for Safe Medicines (www.safemedicines.org). These fake pharmacies are prevalent online. A report from the National Association of Boards of Pharmacy (NABP), gleaned from examining more than 8,000 online pharmacy sites found that:
- 40% of medicine may be fake in some countries
- 96% of online pharmacies are not following state and federal laws and regulations
- 85% don't require a prescription
- 43.9% sell non-FDA approved medicines
- More than 4,000 do not provide a physical address
Counterfeit medicines claiming to treat cancer, diabetes, asthma, heart disease and other serious illnesses all have been discovered on these sites, the report says.
These online drug sellers who are peddling prescription medications are unlicensed, operating illegally or coming from foreign countries where medications shipped to the United States are unregulated. They are not regulated by the FDA and the drugs are not tested, not verified, and not deemed reliable by any regulatory agency in the US or abroad.
Fake drugs might contain too little or too much of an active ingredient, they may contain the wrong medicine, or no medicine at all. Investigations have found these drugs being made with dangerous ingredients including sugar, floor wax and paint. "People can die. Fake drugs are a dangerous threat to consumers," Kumar Kibble, deputy director at Immigrations and Customs Enforcement (ICE), told CBS News.
How big is the problem of counterfeit drugs?
How many people are ordering drugs illegally in the U.S.? In 2010, U.S. Customs and Border Protection seized three million fraudulent medications from international mail parcels that contained fake drugs used to arthritis, high cholesterol, depression, AIDS and other chronic conditions.
"Counterfeiters do not take a patient's overall health or immune system into consideration when selling fake or sub-standard forms of life-sustaining medicines," says the Partnership for Safe Medicines report. "They are not interested in whether the patient is taking other medications or if the combination of medications will result in an adverse reaction. Nor are they concerned that the products sold to treat potentially deadly diseases aren't effective."
The traditional method of getting meds
When patients go to a pharmacy and pick up their medicines, they can be confident that what they're getting is effective, safe, and precisely what the doctor prescribed. FDA-approved and regulated medicine has been through an extensive regulatory and oversight process before entering the market, including steps to ensure secure transit from factory to wholesaler, then to the pharmacy, and ultimately into our homes.
There are many websites that operate legally and offer convenience, privacy, and safeguards for purchasing medicines. There are reputable websites that are online entities of legitimate pharmacies, such as Walgreens or CVS. The Partnership for Safe Medicines urges consumers to who are using online pharmacies do their homework and know who they are buying from before purchasing medications online.
Consumers can visit the National Association of Boards of Pharmacy website to get a list of safe online pharmacies that have been investigated, verified and accredited.
What about Canadian pharmacies?
And that Canadian online pharmacy with the cheaper prices that you hear so much about? It may be calling itself a "Canadian pharmacy," but it may actually obtain its medications from countries in Asia, South America, or Eastern Europe, where quality standards are more lax and counterfeit medications more widespread, says the report.
A call to action
While FBI, DEA and FDA fight to find, shut down and prosecute counterfeit pharmacies, Congress is again considering proposals that would permit Americans to purchase medicines from pharmacies outside the U.S., legislation known as "drug importation" saying the policy will save consumers money.
The Partnership for Safe Medicines says the risks of counterfeit drugs far outweigh any cost savings. "Only a tiny fraction of the global supply of counterfeit drugs ever makes it into the U.S. drug supply," the report says. "All that could change rather quickly, however, if federal policymakers open up the closed system that has protected our medicines well, and allow importation from foreign-based pharmacies. That is why chronic disease communities should understand the very real public health risks that a change in importation policy would pose."
The report goes on to say "the U.S. should take further steps to crack down on fake online pharmacies by banning any online drug sellers from transacting business in this country unless accredited by the NABP's Verified Internet Pharmacy Practice Sites."