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
The next time your doctor writes you a prescription, consider this: The
medication may not be approved for your specific condition or age group.
But you probably shouldn't call the medical board. The practice, called
"off-label" prescribing, is entirely legal and very common. More than one
in five outpatient prescriptions written in the U.S. are for off-label
"Off-label" means the medication is being used in a manner not specified in
the FDA's approved packaging label, or insert...
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
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."
"If a site makes claims or promises that you don't need
a prescription or that their doctors will view your comments or questionnaire,
that's a definite warning sign to avoid those sites," Catizone says.
"Some of these medications, especially from overseas, are from dubious
sites. We're not sure if they're counterfeit medications or outdated or expired
Legitimate Web sites will ask for a valid prescription and
verify it with your doctor, Catizone notes. Look for sites that call customers
to provide advice whenever filling new prescriptions.
Find out whether the site's pharmacy, physicians and
pharmacists are licensed in the state where you live. It is illegal for doctors
to prescribe medications for patients in a state where they are not licensed to
practice. Not all prescriptions bought over the Internet will be covered by
your insurance, so check beforehand. Do not buy prescriptions over the Internet
unless the company lists its phone number and address to contact if there are