The Alliance for Safe Online Pharmacies (ASOP Global) has conducted a statistically sound survey of 500 US consumers to assess how well they understand the regulation of online pharmacies. The result: it doesn’t look good. While 55% of respondents say that they have, or are willing to buy drugs online, 95% don’t know about certification programs like the “dot-pharmacy” top-level internet domain registration or the Verified Internet Pharmacy Practice Sites (VIPPS) program, both managed by the National Assn. of Boards of Pharmacy, NABP). “This is especially timely because as millions of Americans face the prospect of changes in their healthcare coverage should Congress repeal or replace the Affordable Care Act, or legalize prescription drug importation from Canada, people may turn to the Internet to access prescription medicines,” said ASOP Global’s Executive Director, Libby Baney, in a statement.
It is known anecdotally that millions of American consumers associate “Canadian pharmacy” with legitimate sources of pharmaceuticals, to be purchased at prices substantially below those offered in the US; the problem is, the categorization of “Canadian pharmacy” is relatively unregulated, and many of them are known to be operating from other countries and to be completely outside any regulatory oversight. NABP is the designated authority to manage any legitimate online pharmacy that would use “.pharmacy” as part of its internet address, but the survey indicates that most consumers are unaware of the importance of the designation.
ASOP Global has held two meetings recently with work groups involving parties like the Canadian Pharmacy Assn. to address the lack of control; back in April the National Assn of Pharmacy Regulatory Authorities (NAPRA), Canada’s association of provincial and territorial pharmacy regulatory bodies, wrote to the US Congress that “Even if an online pharmacy claims to be from Canada, there is no system currently in place to ensure medicines sold to US patients from foreign sources will be safe and effective.” Meanwhile, ASOP Global has posted a factsheet that points to sites certified by a group called the Canadian Internet Pharmacy Assn.; in fact at least one such site has been indicted for selling counterfeit medicine.
ASOP also cites a recent Purdue University study that even pharmacists themselves have a hard time differentiating legitimate from illegitimate pharmacies (only 4% of the 80 pharmacists who responded say that they are “very confident” that they can identify illicit online pharmacies). It also notes that at any given time, there are some 33,000 illegitimate pharmacies operating online—far more than the number of “.pharmacy” sites. For the past three years, FDA, Interpol and other international law-enforcement agencies have run the Pangea program, an annual event to shut down and arrest illegitimate or outright-illegal online pharmacies. And while thousands of sites are shut down each year, thousands more spring up in their place.
Allowing consumer purchases of pharmaceuticals from abroad has been reluctantly permitted by FDA (which has the authority to prevent this); and re-importation of drugs has been proposed in Congress as a way to address skyrocketing drug prices. So far, pharma industry lobbyists have been able to hold the line with Congress and the White House against re-importation, but the topic is, to say the least, fluid at this time.