Many patients with pain justifiably want to purchase prescribed medications online, for convenience and/or to save money. However, the Internet can be a hazardous place to buy medicines unless the source is legitimate and follows high standards for product quality and delivery. There are a number of resources available to help select suitable online pharmacies that healthcare professionals and patients should know about.
In a recent UPDATE [here] we noted that, as access to prescribed opioid analgesics and other pain medications is becoming more difficult in some areas, patients are turning to Internet-based pharmacies of questionable caliber and reputation. Many of these operate outside the laws of the United States, or even regulations of the countries in which they operate, and their products can be of low quality and harmful in some cases. Patients need to be warned of the hazards and steered in the direction of more reliable sources.
Writing in the December edition of the Pain Advocacy Community e-Newsletter from In the Face of Pain® [PDF here], Kristi R. Dover, Pharm D, says, “the number of available outlets is mind boggling, making the task of choosing a safe Internet pharmacy nearly impossible. To complicate this further, the options for safely saving money can be confusing and sometimes even misleading.”
Dover, who is a Senior Area Director in Purdue Pharma’s Medical Liaison Department, notes that this past summer the National Association of Boards of Pharmacy (NABP) in the United States alerted the public that many online pharmacy outlets are fake, dispensing counterfeit and unapproved drugs. The NABP reviewed more than 8,000 Internet drug outlets through their accreditation program, VIPPS® (Verified Internet Pharmacy Practice Sites), and found that more than 96% of them were not in compliance with state or federal laws and/or NABP patient safety and pharmacy practice standards. Making matters worse, more than one-third of those sites reviewed offered medications not approved by the U.S. Food and Drug Administration. [Additional information on this NABP monitoring program was provided in an earlier UPDATE here.]
Another online monitoring service, LegitScript, currently reports that of 93,675 pharmacy websites in its database only 328 are legitimate. So, when casually searching online, it seems much more likely to stumble upon a rogue pharmacy than a reliable and trusted one.
What can you do?
A number of online resources that evaluate Internet pharmacy sites and offer additional advice for both professionals and their patients are available. Some of these also are accessible at Pain-Topics.org [here], and recommended by Dover in her article.
- Internet Drug Outlet Identification Program — Progress Report for State and Federal Regulators: July 2011 — [Full report PDF here].
- Patient Education: Buying Medicine Online — advice from the NABP — [available here].
- PharmaHelper® — provides information and price comparisons on medications at Internet pharmacies meeting NABP-recognized standards — [online here].
- LegitScript — is a leading source of information regarding Internet pharmacies acting in accordance with the law and accepted standards of ethics and safety — [online here].
- Buying Medicines Over the Internet — this site from the U.S. FDA provides a variety of information about risks identified by the agency and offers tips for how to avoid falling victim to scams or being injured by dangerous medications and devices offered over the Internet — [access here].
Any legitimate online pharmacy will require a valid prescription provided to the purchaser by a duly licensed healthcare professional. Furthermore, the NABP warns persons in the U.S. that Canadian online pharmacies promoting cheaper prices actually may be getting their products from other countries where quality standards are lax and counterfeit medications more widespread.
Therefore, the NABP states that they cannot recommend any Canadian site selling drugs to Americans because U.S. FDA regulations prohibit this activity. In fact, any prescription drugs imported from other countries are not considered to be FDA-approved and their safety and effectiveness cannot be ensured.
Disclosure: In the Face of Pain® (http://InTheFaceofPain.com) and the Pain Advocacy Community e-Newsletter are projects of Purdue Pharma, which also is a supporter in part via an unrestricted medical education grant of Pain Treatment Topics. However, the company had no role whatsoever in suggesting this UPDATE topic or its contents. Furthermore, Pain Treatment Topics is not responsible for the contents or accuracy of the informational Websites linked above.