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March 7, 2005

Internet Drugs

By Tait Trussell

As the demand for -- and cost of -- prescription drugs in America soar, the Internet marketplace for medications grows.  Seniors, especially, are being taken in and blinded by their desire for more and cheaper drugs.

In addition, hospital emergency room visits have increased 153% since 1999, as one out of ten high school students admits abusing powerful pain relievers, such as Percocet, OxyContin, and Darvon -- many acquired through the Internet, according to the Drug Enforcement Agency.  Many adolescents don't consider these potent drugs risky, says DEA Administrator Karen Tandy.

Investigators with the U.S. Government Accountability Office (formerly General Accounting Office) report buying samples from Internet providers selling pharmaceuticals including Celebrex for arthritis, Lipitor for cholesterol, Percocet for pain, and Viagra for male sexual dysfunction.

Drugs were bought from pharmacies that purported to be located in the U.S., Canada, and other foreign countries.  The investigators found some of the drug providers required purchasers to provide prescriptions, while some wanted only a medical history form, and the majority required no prescription.

A controversy swirls over drugs from Canada.  Many Americans send away for them or ride on buses to Canada where many drugs can be bought at a fraction of the price they'd pay in their local pharmacy.  The AARP has pushed for government approval for drugs from Canada.  But the GAO task force found a host of dangers in Internet purchases of drugs many of which were ostensibly from Canada.  They ranged from drugs containing an inadequate amount of the medicinal ingredient to those with a different chemical composition from the product ordered and drugs shipped in improper containers or with inadequate directions for use.

About one in five of the Internet pharmacies that sent purchased samples were found to be under investigation by the Food and Drug Administration or the Federal Drug Agency.  "Reasons for the investigations included allegations of selling adulterated, misbranded, or counterfeit drugs and providing prescription drugs where no valid doctor-patient relationship exists," the GAO report declared.  "Nine of these pharmacies were from the United States, one from Canada, and four from other foreign countries," it added. A draft of the task force report was presented to the full FDA last summer.

Citizens young and old should know that to dispense a prescription drug legally, a licensed pharmacist, working for a licensed pharmacy, must be presented a valid prescription from a licensed healthcare professional.  This helps ensure that the purchaser gets the right medicine in the proper dosage, has instructions on taking the medicine correctly, and is informed about possible side effects and other aspects of the drug.

The Medicare Prescription Drug Improvement and Modernization Act of 2003 directed the Secretary of Health and Human Services to set up a system for importing drugs from Canada if it is certified that the program would pose no risk to the public's health and safety and would result in a "significant reduction in the cost" of the drugs to Americans.  Although many drugs available in Canada are relatively cheap, not all are.  In fact, some were found to be as cheap or cheaper in the U.S.  And not all drugs sought are available in Canada.  The 2003 Act directed the Secretary of HHS to conduct a study on drug importation from Canada within a year.

FDA guidelines indicate that the agency may use its discretion to allow importation if a drug is for a non-serious condition and is not itself a health threat or is intended to treat a "serious condition for which effective treatment may not be available domestically."

Some sixteen of eighteen sample drugs from Canada Internet pharmacies were not approved for sale in the U.S. according to the GAO report, with some, for example, having "unapproved labeling and packaging, although comparable in chemical composition." 

The FDA added, "It is easy to design a fraudulent Canadian website that looks completely legitimate."  But who knows?  The drug could come from any county, and there is little assurance of its purity. 

Tait Trussell won a Loeb Award "for distinguished reporting of business and financial news" and a Benjamin Fine award for columns on education.  He was vice president of the American Enterprise Institute for Public Policy Research (AEI) and served on the Bicentennial Commission on the U.S. Constitution.

 


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Founded in 1978, ACSH is a consumer advocacy organization directed and advised by over 350 physicians, scientists and policy advisors. ACSH promotes the use of sound, peer-reviewed science in the formation of a full  spectrum of  public health policies, including those related to food, pharmaceuticals, environmental chemicals, lifestyle factors, consumer products and terrorism preparedness and response.