The Public Policy

Of Rats and Meds

Online pharmacies can be poisonous.

By 2.5.09

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Picture a typical morning. If you're like me, you head into the kitchen, pour yourself a cup of coffee, scan the newspaper, and take your vitamins and prescription drugs. Imagine if, after washing down those pills with your coffee, you were to cough out a rat.

Sound far-fetched? It shouldn't. That's the storyline in a new commercial being aired in British movie theaters, alerting moviegoers to the very real fact that most online pharmacies sell counterfeit drugs. And counterfeits are sometimes laced with rat poison.

The hard-hitting advertisement, created by Pfizer in collaboration with several U.K. patient advocacy groups and Britain's government drug regulator, is quite disgusting. But it's an important message. And it's a message that Americans, too, need to see. That's why the Food and Drug Administration (FDA) should join up with drug firms to launch a similar public awareness campaign here in the United States.

According to the World Health Organization, about 10 percent of the global drug supply is counterfeit. Many of these dangerous pills are sold online by fly-by-night pharmacies. Patients often go online to illegally purchase pills because they want to save money, skip the doctor, or get a drug for recreational use.

Counterfeit online outfits are very effective at hiding where they're actually based. A few years ago, for instance, the FDA purchased several popular prescription drugs from an online pharmacy claiming to be headquartered in Canada. What they found was startling. Not only were none of the drugs manufactured in Canada, but they all failed to meet the FDA's standards for purity and strength.

In 2007, the respected Internet fraud expert MarkMonitor looked at 3,160 online pharmacies claiming to sell legitimate drugs. Virtually all of the online pharmacies, though, were selling fake medicine. In fact, only four of the sites were accredited by Verified Internet Pharmacy Practice Sites, the drug industry's "Good Housekeeping" seal of approval.

So when customers get bilked after buying drugs online, regulators often can't even determine the perpetrator's physical location, making it effectively impossible to enforce existing drug safety laws.

What's more, when compared to the United States, most nations are quite lax when it comes to drug safety. So even the drugs sold from legitimate online foreign pharmacies pose a health threat.

The European Union's drug market, for instance, operates under a "parallel trade" ordinance, which allows for legal, unfettered importation between all member countries. Among other things, this means that the independent wholesalers along the chain of supply are allowed to open and repackage drug shipments before passing them along. So if American consumers go online and purchase drugs that have passed through the European Union, they could end up with a mislabeled, expired, or otherwise subpar product.

Online pharmacies based in Canada are largely supplied by European manufacturers -- so their pills, too, can be dangerous.

It's imperative that American patients be made aware of the dangers of making online drug purchases. The FDA can give them the information they need by following its British counterpart and launching a public awareness campaign.

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About the Author

Peter Pitts is partner/director of global health at Porter Novelli, a senior fellow at the Center for Medicine in the Public Interest, and a former FDA associate commissioner.