The National Assn. of Boards of Pharmacy (NABP; Mt. Prospect, IL) has just updated its ongoing survey of online sellers of drugs, finding that of 10,082 sites surveyed through April, just under 97% of them fail one or more criteria for legitimate pharmaceutical dispensing in the US. Nearly 9,000 of them do not require a valid prescription; almost 5,000 offer foreign or non-FDA-approved drugs, 2,347 have a physical address outside the US (NABP requires those dispensing ethical products to be located in the US) and—amazingly—1,123 dispense controlled substances, which violates a host of DEA and other regulators’ rules. Currently, there are 82 sites accredited by NABP as Verified Internet Pharmacy Practice Sites (VIPPS) or the related Vet-VIPPS for veterinary practices.
Last June, NABP applied to the Internet Corp. for Assigned Names and Numbers (ICANN) to own and manage a new “generic top-level domain” (gTLD), .pharmacy. (TLDs are the phrase following the dot in a website URL, such as .com, .gov, .org, etc.; ICANN is in the process of allowing thousands of new TLDs to be specified.) gTLD owners pay a licensing fee to ICANN and need to be vetted by that organization. According to NABP, there has been some grumbling that NABP is taking on a global responsibility that might lead to US-based online pharmacies getting preferential treatment—but the international ICANN organization is itself amply represented globally (and would therefore be expected to account for multinational concerns). Moreover, NABP itself has affiliate relationships in other countries (notably Canada), and has sought and received support from several non-US organizations. Eli Lilly, Merck and about a dozen other pharma companies have ponied up several hundred thousand dollars to support NABP’s effort.
“Mindful of the international spread of unapproved, substandard, and counterfeit medicine, and the contributing role that illegal online drug sellers play, NABP it taking steps to establish an online space exclusively for legitimate Internet pharmacies and other trustworthy prescription drug-related organizations,” the group says in its latest report. The ICANN evaluation process is intricate and deliberate; NABP expects a decision this summer. Owning .pharmacy won’t put illicit sellers out of business, but should provide better clarity to consumers. It remains to be seen how NABP might regulate legitimate online pharmacies globally.