According to statistics, in 2013, in the U.S. alone people spend over $300 billion on prescription drugs. So, it’s no wonder more and more people are looking for a way to save money spent on medications. For this purpose they navigate the Internet searching for the best offer. On the one hand, thousands of online vendors offer drugs at fair prices. On the other hand, it may be difficult to navigate through a huge number of websites and find reliable and trustworthy online pharmacies.
How do online pharmacies work
Online pharmacies are prescription drugs vendors operating through the Internet. Their advantage is the opportunity to sell the medications cheaper than regular local pharmacies, because they have no need to pay the rent of the premises. Working from one location and using Internet for business, they are able to attract and serve great numbers of customers.
Sometimes foreign online pharmacies have even more advantages: they can provide greater savings, as government agencies in their countries regulate medications prices, unlike in some other countries. Thus, in America the prices for many drugs are higher than that somewhere else.
Difficulties of online pharmacy shopping
As mentioned above, high prices in U.S. and some other countries make customers navigate through the Internet in search of maximum savings on prescription drugs purchasing. But it’s not always an easy process, as pharmacies can be both legitimate and illegitimate. The illegitimate ones are not controlled and checked to ensure they comply with regulations and laws and send the correct products to the customers. Such fraudulent pharmacies are often based (or claim so) in other countries.
It’s always frustrating to run into frauds in the Internet and realize that you’ve just wasted your money. But in case of being cheated by some online store and having not received the goods ordered or having received the goods of improper quality, one can still live with it. But shopping in online pharmacies - it's another thing. Dealing with fraudulent pharmacies is fraught with danger. Receiving fake medicines or placebos (pills of sugar or starch without active ingredients) can may have a negative impact on one’s health and even be life threatening.
When dealing with unreliable vendors one can also receive a generic instead of an ordered branded medication, an incorrect dosage, a drug with incomplete or missing label, even a completely different medication than the one originally prescribed. Hardly anyone wants to buy a pig in a bag and risk his life.
FDA concerning online pharmacies
Food and Drug Administration agency’s mission is to regulate products, so that the consumers are protected against unfair vendors. Importing medications from abroad is not explicitly forbidden by any law, so long as these are not prohibited substances and the order is made according to a licensed physician’s approval. Anyway, it is recommended by the FDA to refrain from buying medications from abroad, because their safety can hardly be confirmed, and in case of adverse reactions the consumers won’t be able to sue the manufacturer.
A numbers of medications ordered through the mail by illegal online pharmacies have been seized and intercepted by the FDA since 2008. These Operation Pangaea annual crackdowns were carried out through INTERPOL in collaboration with more than a hundred other countries. During Operation Pangaea VII more than 19,000 packages were seized worldwide, which had been ordered from illegal domestic and foreign online pharmacies. In the U.S.A. alone about 2,000 websites based in the country were identified and shut down by the FDA for illegal medications sale.
The FDA also struggles against promotion of illegal websites. Thus, in 2011 it sued Google for placing advertisements of illegal Canadian online pharmacies, and settled for $500 million. The American companies are prohibited to post ads of Canadian pharmacies, which are so trusted by consumers, because buying medications from abroad is not always lawful.
Where drugs can be legally purchased online
Prescription drugs can be legally purchased in an online pharmacy based in U.S. and having a certificate of the National Association of Boards of Pharmacy. The FDA recognizes the NABP as one of the leading pharmacy authorities. The NABP is a professional (and impartial) organization, and it supports and prefers state pharmacy.
Another independent organisation is LegitScript, which is also entitled to certify online pharmacies and has verified a number of websites. Only online pharmacies based in U.S.A. are approved by LegitScript, and such compliance with federal law is welcomed by the NABP. But while the NABP requires an application or fee from pharmacies to be verified, LegitScript does not. LegitScript therefore can certify online pharmacies that haven’t paid the fee to NABP and for this reason lack NABP’s certificate.
Illegal online pharmacy shopping
As mentioned above, the FDA’s strong recommendation is to avoid buying medications from other countries. However, there are a number of specific laws that are not clear enough. But there are some definitely illegal things related to online pharmacy shopping, such as:
- Purchasing medications in the U.S.A., which are not approved by the FDA (even if they are legal in any other countries).
- Purchasing substances that are controlled, without a written licensed doctor’s prescription, including all prescription stimulants, sedatives, anabolic steroids and narcotic painkillers. These drugs are offered by a lot of online pharmacies without asking for a prescription.
- In case of importing prescription drugs by mail, the patient is obliged to provide the contact information of his physician to customs authorities.
If you’re able to meet these requirements, you may try to save money and order medications from foreign pharmacies. You should remember that you must also act in accordance with another country’s laws. For example, to legally buy a controlled medication from an online pharmacy in Mexico, besides the prescription from your local physician, you’ll need another one from a licenced Mexican doctor.
Specificity of Canadian online pharmacy
Standards and pharmacy practices in Canada have a lot in common with American ones. To be able to sell to American customers, many Canadian online pharmacies follow Canadian and U.S. rules. Legitimate Canadian pharmacy websites allow patients from U.S. to verify prescriptions when ordering medications online, without requiring a separate prescription given in Canada. And they don’t sell substances that are controlled to patients from U.S., in order to provide compliance with American laws.
But according to reports of the FDA, a number of online pharmacies that are actually Canadian, operate from abroad. It is stated on the website of Canadian International Pharmacy Association certifying Canadian pharmacies, that pharmacies certified by it abide to the same safety and confidentiality procedures as the American ones. Pharmacies certified by CIPA have Canadian license and are legitimate, but it is hardly possible for pharmacy bodies to verify them. And the FDA advises to avoid purchasing on Canadian pharmacy websites even despite the fact that legitimate medications can be bought at cheaper prices from legitimate Canadian online pharmacies, according to some researches.
Online pharmacies and research results
For assessment of online pharmacies two studies were conducted: the last one of them – in September 2013, by NABP. It showed that almost 97% of online pharmacies having U.S. customers didn’t comply with American regulations and laws, in other words, were rogue. More than 10,500 pharmacies were covered by this report, among which only 90 turned out to be legitimate and about 260 were considered potentially legitimate.
Another study was made by the National Bureau of Economic Research in 2012. In order to assess drug integrity and cost, 5 common branded drugs were acquired by researchers: Zoloft, Viagra, Lipitor, Nexium, and Celebrex. The medications were from various online pharmacies. And here are some findings:
- Prescription verification was required by all of the U.S. online pharmacies, which could not not be said about the Canadian (90%) and foreign (67%) pharmacies.
- 10% of the medication samples turned out to be not the ordered ones, for example, some branded medicines were replaced by generics. The matter concerns 18% of pharmacies without certificates, 9% of Canadian pharmacies with certificates and 3% of certified pharmacies from U.S.
- The claim of the FDA that shipping by some “Canadian” pharmacies was actually made from other countries, turned out to be true.
- Of the medications matching the prescriptions, only 89% of those delivered by uncertified pharmacy websites contained the correct active ingredients, in comparison with 100% delivered by certified U.S. and Canadian pharmacies.
- All fraudulent prescriptions were for Viagra.
- According to researcher’s conclusion, banning all certified Canadian online pharmacies isn’t justified, even though there’re many rogue websites. Such blanket ban may prevent consumers from saving their money, since prescription drugs from abroad are almost 50% cheaper than those bought in U.S.
Security issue and foreign online pharmacies
The idea of ordering cheaper drugs from abroad can be alluring. But lax regulation of medications production and e-commerce in foreign countries is a significant disadvantage. India and Mexico are very popular among customers, because many medications can be bought much cheaper from these countries.
In India, many drug laws there seem incomplete, ambiguous and complicated, especially when it comes to medications sold via Internet. A lot of India-based online pharmacies don’t comply with their local regulations and laws. And the absence of laws on e-commerce means that your personal information is not protected. So, purchasing medications from India is risky and undesirable.
As for Mexico, many prescription drugs are not considered controlled and can be purchased over-the-counter, including antibiotics, blood pressure medicines and acne creams. According to the FDA’s data, up to 40% of pharmaceuticals from Mexico are counterfeit and therefore dangerous.
Recommendations for safe online pharmacy shopping
Here are some tips on how to protect yourself and your personal data when buying online:
- Look for pharmacies that are NABP- or CIPA-certified, to make sure they follow stringent quality and safety standards.
- Do not believe the word if the website claims being certified – check it on CIPA and NABP websites.
- Don’t trust the pharmacies selling medications without prescriptions or offering to prescribe the medications for you on their own.
- Make sure there are a phone number and a physical address of the online pharmacy on the website.
- Make a call and talk to a pharmacist, ask him questions and find out whether the pharmacy is licensed. You can verify the license online afterwards.
- Read the security and privacy policies, make sure you understand them well. It is important, because illegal pharmacies may sell your persona data to a third party.