Internet Pharmacies Is the convenience worth the risk?

by David Orenstein freelance writer

Buying medication over the Internet can be a great convenience for patients, but medications and the Internet aren't always a good mix. The Internet is replete with illegal sources of prescription and unapproved drugs. In the Internet age, patients might benefit from advice on how to avoid unscrupulous online drug peddlers and how to discern legitimate online options.

Of course there always will be self-destructive patients who buy medications illegally while in Mexico. They will be just as unrepentant about doing it online. But the problem posed by many Internet pharmacies is more insidious than such brash risk-taking. In many cases such pharmacies present themselves as legitimate ways to get drugs, when in fact they are skirting critical safeguards. Well-meaning patients can easily be duped.

In an October report to Congress by the US General Accounting Office, investigators revealed alarming statistics about a sampling of 190 online pharmacies. First, only 111 (55%) sites required a prescription from a licensed physician. Of the remaining 79 sites, 54 would write a prescription based on a "questionnaire" filled out by the patient, and 25 ignored the legal and ethical need for a prescription. Of the 54 that wrote their own prescriptions, only one would tell the GAO the name of the "physician" reviewing the questionnaires.

Even among the sites that required a prescription from a real physician based on a real office visit, widespread problems exist. The GAO checked on the licensing status of 64 such pharmacies and found that 22 (34%) were not licensed in at least one of the states in which they claimed to be licensed.

Another startling statistic was that only 44 of the 190 pharmacies (23%) had a privacy statement posted on the site. This is of potential legal concern nationally as federal medical privacy laws fall into place, and 21 states have laws protecting the privacy of pharmacy information, the GAO found. Patients who consort with these sites may find that some of their medical information has been sold.

The dangers of unregulated pharmacies are many. Patients run the risk of buying ineffective or dangerous imitation pills, buying unapproved medications with unknown side effects, or suffering harmful drug interactions. To prevent these possibilities, federal and state agencies have engaged in scores of lawsuits and prosecutions. But, especially with pharmacies outside the United States, there is little our government can do.

To combat this, patients must be educated about the dangers and the safe alternatives. The home page of a potentially life-saving program by the National Association of Boards of Pharmacy is at vipps.nabp.net. The organization has certified 15 online pharmacies as legal and responsible purveyors of medicine under its Verifiable Internet Pharmacy Practice Sites program. The list includes the industry's heavy-hitters such as Drugstore.com, PlanetRx.com, and Merck-Medco. It also includes Accurate Medical Equipment & Supply Co, Inc, based in Fort Worth.

When Accurate's accuratepharmacy.com won the certification in September, owner Robert M. Ritter Jr said, "By meeting the high standards set by VIPPS . . . we will establish the trust needed in the Internet community." Trust certainly is needed because all the evidence points to one sad fact: Mr Ritter is in a tiny minority of Internet pharmacists who understand that endangering patients and skirting the law is not a convenience to patients.

David Orenstein is a technology and business writer in Silicon Valley. If you are interested in learning more about a technology topic in Computing Care, e-mail him at davealli@earthlink.net.