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    The Online Pharmacy Phenomenon


    WebMD Feature

    Since 1998, there has been explosive growth in the number of Web sites offering to fill prescriptions or sell medications. But the proliferation of Internet prescriptions is sounding alarm bells for doctors, pharmacists and health authorities nationwide because of a lack of standards -- even illegal practices -- at some Web sites.

    The National Association of Boards of Pharmacy (NABP) estimates there are at least 400 Web sites dispensing prescriptions in the United States. No one knows how many of these online pharmacies exist worldwide.

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    More Regulation Needed

    The advantage of Internet prescriptions is convenience. With a few keystrokes on the computer, prescriptions are filled and delivered by mail or can be picked up at a local pharmacy. Internet prescriptions are especially useful for seniors and people with disabilities who may have difficulty leaving the house.

    But Web sites have offered the impotence drug Viagra, the allergy medicine Claritin and the anti-baldness pill Propecia without patients ever seeing a doctor, says Carmen Catizone, executive director of the NABP.

    For example, a California Web site was dispensing hundreds of Viagra prescriptions per week to people who filled out brief medical questionnaires but never saw a doctor. The patients' responses were supposedly forwarded to a doctor for prescription approval, but health authorities later discovered the "doctor" was actually a retired veterinarian in Mexico. The site has since been closed.

    "For us, that's a very dangerous situation," says Catizone, whose association members are state agencies that regulate pharmacies and pharmacists.

    The American Medical Association (AMA) recommends that before prescribing medication, doctors should take a patient's medical history and discuss the benefits, risks and side effects of the treatment. In most cases the AMA suggests that doctors physically examine a patient. Without a thorough consultation with a physician, taking a prescription drug like Viagra can be risky if a patient has heart problems or other medical risks, or is taking a medication with potentially harmful interactions.

    Research before Purchase

    If you want to get a prescription through the Internet, use a Web site affiliated with a pharmacy, Catizone suggests. Stay away from sites that offer to prescribe medicine if you just have to answer a few questions or undergo what he calls a "cyberspace consultation."

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