INTERNET DRUG PURCHASES: SUBSTANDARD DRUG RISKS
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A ProMED-mail post
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http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
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http://www.isid.org>
Date: Mon 17 Aug 2009
Source: Africa Fighting Malaria [edited]
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http://fightingmalaria.org/pdfs/interne ... st2009.pdf>
For the most part, drugs bought over the Internet are safe, but
website pharmacies lacking a physical location often sell fake drugs,
concludes a study published today [17 Aug 2009] by Africa Fighting
Malaria, a non-profit advocacy group.
Prescription drug spending in the US hit USD 216.7 billion in 2006.
While the lion's share is still spent in large chain stores like CVS
or RiteAid, more and more consumers are turning to the Internet to
purchase their drugs. In 2009, 30 percent of prescription drug users
reported buying drugs online, and the market is now at least USD 12
billion. But are all drugs safe to procure over the Internet, or are
some drugs more dangerous than others? How can consumers separate the
good websites from the bad websites?
The study examined drug purchasing over the Internet by assessing 5
popular drugs for price, conditions of purchase, and basic quality.
Celebrex (arthritis), Lipitor (cholesterol), Nexium (acid reflux),
Viagra (erectile dysfunction) and Zoloft (depression) were purchased
from a selection of 26 websites. Some were approved by ratings
agencies, including the National Association of Boards of Pharmacy
(NABP) and the independent group PharmacyChecker; others were
considered to be legally compliant according to PharmacyChecker, and
some were disapproved by these ratings agencies.
The conditions of purchase, the price and the quality of products
varied enormously. Some websites advertised single pills while others
only permitted the purchase of large quantities. Many websites
delivered incorrect drugs; some delivered no drugs at all; many
websites shipped from multiple international locations and from
locations that were different from those advertised on the websites.
Some drugs manufactured in India were marked-up over 2000 percent in
price, while other drugs from the EU, possibly stolen, were deeply
discounted from their cover price.
Drugs were tested for basic quality using the TruScan Raman
spectrometer, comparing spectral readings from the purchased drugs
against those of approved U.S. brand formulations. Some websites sent
substitute drugs in place of the requested brand-name drugs. These
drugs, comprising roughly 20 percent of the total sample, could not
be assessed accurately due to unobtainable reference standards
required for spectrometry testing. Of those which could be assessed,
all drugs except 2 Viagra samples, one of which was almost certainly
counterfeit and originated in China, passed spectrometry testing. But
even assuming that all of the substituted drugs were bioequivalent
generics, which may not have been the case, risks remain.
The study found that there is ample opportunity for prescription drug
abuse. The lead author was able to procure several drugs from
non-NABP-approved websites without a prescription or by using
photocopies or faxed versions. He was also able to procure several
drugs from 26 website pharmacies under the same consumer name within
just a few months. For the websites that required prescriptions, the
lead author was able to use the same prescriptions multiple times
because of the lack of insistence on original versions.
"Our findings suggest that purchasing drugs over the Internet is not
necessarily dangerous. The danger appears to come from drugs shipped
from unknown overseas locations," said Dr. Roger Bate, Legatum Fellow
at the American Enterprise Institute and lead author on the study.
"Nevertheless, many of the drugs were illegally sold and hence raise
questions about the traders involved. Most importantly, the World
Health Organization reports that drugs from websites that conceal
their physical address are counterfeit in over 50 percent of cases;
our findings are consistent with WHO reports, since all the drug
failures came from websites lacking a physical address. Even
brand-name drugs from non-approved websites that had a physical
address passed quality tests."
The study concluded that consumers may be able to reduce their risk
by purchasing drugs only from NABP-approved websites and by using
common sense when examining packaging and pills.
--
Communicated by:
Kimberly Hess
Africa Fighting Malaria
<
khess@fightingmalaria.org>
[The study highlights problems with drug purchase over the Internet.
Even though few samples of counterfeit drugs were found, the study
shows that the buyer has few opportunities to control quality when
buying over the net. - Mod.EP]