Patients face shortages of prescription drugs for medical problems, including RSV and ADHD, and the costs of medicines are also skyrocketing. So to fill a prescription these days, where are some consumers turning to for solutions? Well, increasingly, they're going online.
Denver resident Ali Schroer took her doctor's recommendation for an online pharmacy that claimed to be from Canada. She ordered allergy medicines from the site. "It looked exactly like what I had been taking for years and years, and so I really didn't think anything of it," she said.
But pharmacists warn that buying medicine online can be dangerous.
"I've had the unfortunate circumstance to talk to many parents who have lost children because of one reason or another. They took a medication. They got online or via social media. It contained fentanyl, and they never woke up," says John Hertig, a professor of pharmacy at Butler University. "At any one given point in time, it's estimated there are about 35,000 illegal online drug sellers, and the vast majority of these are selling substandard or falsified medicines in some way."
Niamh Lewis, with the National Association of Boards of Pharmacy, says about 20 new illegal online pharmacies go active each day. "I almost hesitate to call them online pharmacies because really they're online drug sellers or illegal online drug sellers," says Hertig. "We estimate between maybe $1 to $2 million are made per website per month in this space, and now [it] has surpassed other criminal activities like human trafficking as well as illegal arms sales. In terms of financial benefit."
These drug sellers break laws in three ways, says Lewis. The first is selling prescription medicines without requiring a prescription. The second is failing to hold a pharmacy license in the area where the patient lives. The final one is selling medicines not authorized for sale in the patient's jurisdiction.
Law enforcement has battled these illegal online pharmacies for decades. A 2005 bust by the drug enforcement agency shut down roughly 4,600 web sites as part of Operation Cyber-X.
In 2011, Google agreed with the Department of Justice to forfeit $500 million of revenue made from ads for online Canadian pharmacies they say illegally exported prescription drugs into the U.S.
Investigations by Interpol, the international criminal police organization, have shut down scores of online sellers. In 2017, the agency's operation in Pangea arrested 500 people and confiscated $51 million in illegal medications.
The FDA, meanwhile, regularly issues warning letters that identify illegal medication sellers.
But experts say law enforcement can only do so much.
"It is extremely difficult. It is like whack-a-mole," says Lewis of NABP. "But the problem is significantly better than it was in 2011. If it's it, these actors are trying to find a home on the internet, and they are sort of being chased to the far reaches of the internet, which is a good thing."
Republican Senator Marco Rubio of Florida has proposed a new law, dubbed the DRUGS Act, that would empower the FDA to shut down websites selling medications illegally.
While public awareness campaigns are another strategy, including a recent ad with Danny Trejo.
Pharmacists say 5% of online drug-selling sites are legit.
"There are absolutely legitimate pharmacies that operate online. And that's a huge convenience for patients, especially since the pandemic. It has become more and more prevalent, more and more common. And it is something that really helps people in rural areas—people who are too busy to pick up their drugs," says Lewis.
There are ways to buy medicines safely online. First, check that the pharmacy you're buying hasn't been flagged as dangerous.
"NABP's Not Recommended List truly compiles the egregious actors. We have about 200 new websites being added per week for the last couple of years," says Lewis.
The FDA also offers a directory of state-licensed online pharmacies.
Accredited online sellers, like major retailers, can be a convenient and cost-saving way to obtain the drugs you need safely. As are smaller firms, like Alto Pharmacy.
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