Protecting Our Drug Supply: Internet Pharmacies, Fake Drugs and the Debate Over Imported Medicine

By Dr. Bryan Liang VP of the Partnership for Safe Medicines What you should know about the public health threat posed by phony online pharmacies and the possible new risks of opening the US drug supply to foreign sources.

Posted on | By Dr. Bryan Liang

High school student Ryan Haight’s tragic death in 2001 awakened the nation to the dangers of rogue online pharmacies dispensing fake medicine, including counterfeit and diverted forms that were dispensed without any physician oversight. Congress responded by passing the aptly named  Ryan Haight Online Pharmacy Consumer Protection Act in 2008, a law that was intended to stop illicit practices by online pharmacies in the US.

While Ryan’s story brought attention to the very serious public health threat posed by phony online pharmacies, many Americans do not realize that the problem is even worse today. Nor are they aware of the new risks we would face if Washington opens our drug supply to foreign sources.

Online Pharmacy Counterfeit Risks

Nearly three years after the Haight Act, a new study conducted by the National Association of Boards of Pharmacies (NABP) has found that nearly 80% of purported online pharmacies still do not require a valid prescription for any medicine. The report also finds that:

  • 96% don’t meet the necessary certification established by the Verified Internet Pharmacy Practice Sites.
  • More than 3,000 pharmacies dispense medicines in the US that are not FDA-approved.
  • Most online pharmacies fail to identify a physical address.
  • Of those who do, roughly two-thirds are located outside the US.

These illegal online drug sellers have now infiltrated the social media space as well. As my work has noted, they have adapted quickly to any opportunity to make illicit sales, and there is little if any regulatory means to address related patient safety risks.

Threats Outside the US

Illicit online pharmacies offer a worldwide gateway for criminals to market and sell counterfeit or tainted products under the guise of legitimacy. Even when the arm of US law can reach them, which is increasingly uncommon as these online drug pushers are located outside the US, criminals still have every incentive to make and sell counterfeit prescription medicine, as they consider it “low risk.” First, it’s rare that they get caught. Second, the penalties in virtually every area of the world for trafficking licit drugs are far less than those associated with the distribution of illicit drugs – often resulting in no more than a fine.

Fortunately, the closed regulatory system in the US does an excellent job of keeping fake or tainted medicines out of supplies sent to legitimate pharmacies, clinics and hospitals. But that is not the case in Europe or other countries that have more open trade systems for medicine, and where counterfeit or otherwise tainted medicine is turning up more and more throughout the delivery system and outside of it.

These dangerous and deadly “medicines” are not just limited to lifestyle drugs (if they ever were). They involve medicines for cancer, heart disease, schizophrenia and diabetes; they include medicines we all depend on to fight infections – even medicines we give our children to fight their coughs.

Policy Debate in Washington

Unfortunately, some federal policymakers want to open up our own trade in medicine, believing that drug importation would lower the cost of some medicine and make it more affordable. The Pharmaceutical Market Access and Drug Safety Act of 2011 proposed in the US Senate aims to allow drug importation, even though experts and government regulators continue to warn about the safety risks associated with opening the closed and tightly regulated US system. Importation would bring the world’s problems of fake and tainted drugs into our own medicine cabinets. Criminals like those behind the phony online pharmacies would exploit a more open US system the very same way they already take advantage of more open systems abroad.

Clearly, these risks would be unintended consequences. No one in Congress is trying to put you or your loved ones at risk. It is simply a matter of limited knowledge. Legislators need to know that opening our borders to foreign drugs under an “importation rule” would be dangerous based on experiences around the world. It would also create the potential for online drug sellers to peddle fakes directly to anyone with a credit card and Internet access, claiming they are legal importers. These situations create tremendous risks to patient safety.

Steps You Can Take to Stay Safe

  • First and foremost, partner with your doctor to understand how any medications will help you reach your health-care goals, and what to expect from these drugs – both as a treatment and for any side effects.
  • Use only medicine that has been prescribed by your doctor or another trusted health-care professional who is licensed in the US to write prescriptions for medicine.
  • Ask your doctor if there are any special steps you need to take to fill your prescription.
  • Use the SAFE DRUG checklist from the Partnership for Safe Medicines (PSM) to ensure you are familiar with your drugs and know what to do if there are questions.
  • If you do choose to buy online, make sure the pharmacy meets standards set by the National Association of Boards of Pharmacy’s Verified Internet Pharmacy Practice Sites program. Simply paste the online pharmacy’s web address into NABP’s verification checker (located at the very bottom of the page).
  • Patients unable to afford medicines they need can also find safe, affordable drugs through patient assistance programs. Click here for more information about these programs and other ideas for saving money while staying safe online.

Nothing can replace the time and quality of life that is taken by fake and tainted drugs. As patients, all of us are our own last barrier to harm. We need to educate ourselves and our loved ones, so no one has to ever bet their life on the safety of our drug supply.

Article written by Dr. Bryan Liang
VP of the Partnership for Safe Medicines