Some Internet drug store sites ignore any manner of medical review or prescription authorization. They boldly go where no law-abiding pharmacy would dare to go.
“Worse than the threat of anthrax,” one site warns, “is the threat that if a city is attacked, the demand for anthrax antibiotics will cause all pharmacies to run out of stock.”
No Prescription Required
The steady media attention given anthrax scares has turned Cipro into a household name, and dozens of Internet sites have come under investigation for illegally selling the antibiotic without a proper prescription.
Law enforcement officials and drug industry experts say the way the antibiotic is being sold is just the latest example of a growing threat to public health.
Online pharmacies selling medication without a prescription, or after only a brief online consultation, are violating U.S. laws meant to ensure the nation’s drug supply is safe for patients. Some sell the genuine product, but regulatory officials say many others substitute expired drugs, counterfeit drugs, or sugar pills.
The phony drugs can trigger allergic reactions or cause dangerous interactions with other drugs, health officials say. Internet sites often neglect to screen patients for health conditions that could be aggravated by certain drugs.
Even being cheated of a prescribed medication, substituted with sugar, can have serious repercussions for people who rely on it. In the case of anthrax, the consequences could be deadly if someone takes fake antibiotics.
Cyber Drug Traffic
Illegal sales of prescription drugs have increased over the past few years as the practice of buying medications online has gained acceptability.
Before the Internet, some drug hucksters ran small ads in newspapers or magazines offering toll-free numbers to order prescription drugs. But there really was no fast and effective way to reach a mass public with a scam.
The advent of legitimate online pharmacies unwittingly cleared the way for unscrupulous drug dealers eager to profit from the public’s demand for brand-name prescriptions.
Dealers can launch Web sites overnight and reach hundreds of thousands of people by spamming email addresses. They can use false names and addresses. They can shut down sites being investigated by U.S. authorities and quickly replace them with new ones.
Among the first drugs to be targeted by illegal dealers was Pfizer’s Viagra. In summer 1998, two months after Viagra was approved to treat erectile dysfunction, Pfizer learned Internet sites were selling the drug without requiring a prescription.
Online profiteers violated trademark and regulatory rules claiming to offer drugs “just as good as” as Viagra. Others capitalized on the name by marketing pills called Viagro or Vigra.
Customs officials have intercepted thousands of phony or expired Viagra pills en route to American customers.
“This was a new phenomenon for the industry,” said Geoff Cook, a spokesman for Pfizer. “Viagra was such a breakthrough and such a success that we have all these people trying to infringe upon it.”
Pfizer’s experience was only the tip of an iceberg. Internet sites soon began selling other popular lifestyle-oriented drugs. Over the years, the online pharmacies pushed Xenical for weight loss, Propecia for hair loss, Zyban to help quit smoking, and others.
Since the terrorist attack on America, Cipro jumped to the top of the list of medications sold illegally on the Internet. It is featured on many of the multi-drug Web sites and promoted more vigorously than Viagra. On other sites, it is the only drug sold, spawning a host of Web sites with the words Cipro or anthrax in their addresses.
Public health officials insist there is no reason to hoard Cipro. The government is creating its own stockpile to respond to emergencies. Bayer, the company that makes Cipro, is adding 200 million pills to the stockpile. Health officials say hoarding will only make a shortfall more likely. Moreover, taking Cipro unnecessarily can create strains of bacteria resistant to antibiotics.
A Global Challenge
Despite efforts to shut down illegal sites and pursue action against those who infringe on trademarks and patents, the problem of unauthorized pharmaceutical sales persists.
According to Tom McGuinnis, the U.S. Food and Drug Administration’ s director of pharmacy affairs, illegal sites operated within the U.S. are relatively easy to shut down, an effort that has fallen largely to state regulators and law enforcement. But many of the online pharmacies, even those claiming to have U.S. doctors or U.S. operations, are overseas. In those cases, U.S. regulators depend on assistance from foreign regulators. Some regulatory agencies, especially in developing nations, lack the authority to act.
Know Your Source
Legitimate online pharmacies, such as CVS.com and RiteAid.com, do not issue prescriptions based on online consultations. They operate much as regular drug stores do, accepting prescriptions phoned-in or emailed by doctors. And, they are licensed by state pharmacy boards.