The scene is becoming increasingly common in the United States: Consumers are replacing a trip to the corner drugstore with a click onto the Internet, where they find hundreds of websites selling prescription drugs and other health products.
Many of these are lawful enterprises that genuinely offer convenience, privacy, and the safeguards of traditional procedures for prescribing drugs. For the most part, consumers can use these services with the same confidence they have in their neighborhood druggist. Some of these sites are familiar large drugstore chains, while others are local "mom and pop" pharmacies, set up to serve their customers electronically.
But consumers must be wary of people who are using the Internet as an outlet for products or practices that are illegal in the offline world. These rogue sites sell unapproved products, or — if they deal in approved ones — often sidestep established procedures meant to protect consumers. For example, some sites require customers to fill out only a questionnaire before ordering prescription drugs, bypassing any face-to-face interaction with a health professional.
Skirting the system this way sets the stage for problems, including dangerous drug interactions and harm from contaminated, counterfeit, or outdated drugs.
For some people, buying prescription drugs online offers advantages not available from a local drugstore, including:
Greater availability of drugs for people confined to their homes, or for those who live far from the pharmacy
The ease of comparative shopping among many sites to find the best prices and products
Greater convenience and access to a wide variety of products
Easier access to written product information, and references to sources other than what you would typically find in traditional storefront pharmacies
The ability for consumers to order products and consult with a pharmacist in the privacy of their homes.
Internet drug shopping also claims to save consumers money. In some cases this is true.
Consumers seeking health products online can find dozens of sites that FDA officials say are legally questionable. A number of them specialize in providing drugs such as Viagra, the baldness therapy finasteride, or the weight-loss treatment orlistat. Others, based in foreign countries, promise to deliver prescription drugs at a much cheaper price than their domestic cost, but the drugs may be different from those approved in the United States or may be past their expiration dates. Still other sites make fraudulent health claims or blatantly advertise that a customer can buy drugs with no prescription. Online drug sites can now be located in nearly any state or country having phone lines.
Whether new legislation will improve oversight of online pharmacies remains to be seen. State medical boards regulate medical practice, while state pharmacy boards oversee pharmacy practice. The FDA and the Federal Trade Commission ensure that drug sellers make legal, scientifically proven claims for their products. Numerous other agencies, such as the U.S. Customs Service and the U.S. Postal Service enforce laws regarding the shipment of drug products.
The FDA regulates the safety, effectiveness, and manufacturing of pharmaceutical drugs, as well as a part of the prescribing process.
Though regulating Internet sales of health products is still fairly new, the FDA has successfully taken action in the past against illegal sites.
In general, legitimate online pharmacies operate this way:
Users open an account with the pharmacy, submitting credit and insurance information. The pharmacy is licensed to sell prescription drugs by the state in which it operates and in those states to which it sells, if an out-of-state license is required.
After establishing an account, users must submit a valid prescription. Doctors can call it in, or users can deliver it to the pharmacy by fax or mail.
Some online pharmacies send products from a central spot, while others allow users to pick the prescription up at a local drugstore. Prescriptions usually are delivered quickly, often with no shipping charge. For an extra fee, many sites will deliver overnight.
Sites typically have a mechanism for users to ask questions of the pharmacist, either through email or a toll-free number.
With hundreds of drug-dispensing websites in business, how can consumers tell which sites are legitimate ones, especially when it's very easy to set up a site that is professional looking and promises deep discounts or a minimum of hassles?
The FDA offers these tips to consumers who buy health products online:
Check with the National Association of Boards of Pharmacy to determine if the site is a licensed pharmacy in good standing. The NABP can be reached at (847) 391-4406 or go to its website.
Don't buy from sites that offer to prescribe a prescription drug for the first time without a physical exam, sell a prescription drug without a prescription, or sell drugs not approved by FDA.
Don't do business with sites that do not provide access to a registered pharmacist to answer questions.
Avoid sites that do not identify with whom you are dealing and do not provide a U.S. address and phone number to contact if there's a problem.
Beware of sites that advertise a "new cure" for a serious disorder or a quick cure-all for a wide range of ailments.
Be careful of sites that use impressive-sounding terminology to disguise a lack of good science or those that claim the government, the medical profession, or research scientists have conspired to suppress a product.
Steer clear of sites that include undocumented case histories claiming "amazing" results.
Talk to your health-care professional before using any medication for the first time.
If you suspect a site is illegal, you can report it to the FDA on its website.