Would you—or do you—purchase pharmaceuticals from an online pharmacy? As would be expected, a new study has found that most of those websites don’t meet basic laws and regulations for dispensing pharmaceuticals to consumers.


However, I did find the sheer scope interesting. The National Assn. of Boards of Pharmacy study found that 97 percent of the 10,758 websites investigated and reviewed by the organization don’t meet basic laws and regulations for dispensing pharmaceuticals to consumers. Furthermore, there are widespread violations on those rogue websites. For example, 88 percent of them don’t require a valid prescription; 49 percent of them offer foreign or non-FDA-approved drugs; 23 percent of the sites have an address outside the U.S., and most post no address whatsoever; and 16 percent of the sites aren’t secure, which puts consumers’ financial and identity information at risk.


The hazard also is worldwide. Recently though, to tackle the issue, nearly 200 enforcement agencies across 111 countries took part in Operation Pangea VII to target criminal networks behind the sale of fake medicines via illicit online pharmacies. The operation led to 237 arrests worldwide and the seizure of nearly U.S. $36 million worth of potentially dangerous medicines, Interpol reports.


Coordinated by Interpol, the operation involved law enforcement agencies, industry associations and private sector companies—including G2 Web Services, LegitScript, MasterCard, Microsoft, PayPal and Visa. The operation focused on social media channels, and took down more than 19,000 ads for falsified and otherwise illegal medicines on channels such as Facebook, YouTube and Twitter, and also closed approximately 10,600 websites.


As well as raids at physical addresses linked to the illicit pharmaceutical websites, some 543,000 packages were inspected by customs and regulatory authorities, of which nearly 20,000 were seized. Among the 9.4 million fake and illicit medicines seized during the operation were slimming pills, cancer medication, erectile dysfunction pills, cough and cold medication, anti-malarial, cholesterol medication and nutritional products.


As part of the operation, the U.S. Food and Drug Administration and the U.S. Customs and Border Protection conducted extensive examinations at U.S.-based international mail facilities, where many packages containing prescription drugs enter the U.S. The agencies found that most of the examined packages contained illegal prescription drugs that had been ordered from online sources.


One of the problems, notes the FDA, is that many American consumers order medicines from online sources believing they will receive the same medicine as the U.S. approved version. These medicines, however, are often unapproved or counterfeit, and come from countries with less stringent manufacturing standards or regulatory controls. Many illegal online pharmacies purport to sell drugs identical to the U.S. approved versions to attract consumers, but they actually send consumers unapproved, counterfeit or substandard versions.


“When consumers buy prescription drugs from outside the legitimate supply chain, they cannot know if the medicines they receive are counterfeit or even if they contain the right active ingredient in the proper dosages,” says Douglas Stearn, director of the FDA’s Office of Enforcement and Import Operations. “Consumers have little or no legal recourse if they experience a reaction to the unregulated medication or if they receive no therapeutic benefit at all. In addition to health risks, these pharmacies pose other risks to consumers, including credit card fraud, identity theft or computer viruses.”


One of the most important steps to help protect consumers is public education. Toward that end, NABP’s VIPPS (Verified Internet Pharmacy Practice Sites) accreditation program is helpful. The FDA also gives consumers information about ways they can identify an illegal pharmacy website and advice on how to find a safe online pharmacy through BeSafeRx: Know Your Online Pharmacy.


What do you think of these international efforts to close illicit online pharmacies? What role do you think consumer education should play in these efforts? What else can be done?