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Buyer Beware: New Study Shows Pitfalls of Internet Pharmacies
Sept. 29, 1999 (Washington) -- Filling prescriptions through the Internet might seem like a convenient way to keep the family medicine cabinet stocked, but there are a number of dangers associated with buying medications through Web sites, say researchers at the University of Pennsylvania in Philadelphia.
A study of 46 Web sites that sell prescription medications found that some would not reveal where they are based or where their medications are manufactured. Internet pharmacies may use physicians from outside the U.S. to provide online consultations to people without prescriptions. And despite the common belief that the Internet can provide bargains, the researchers found the medications and physician services cost more when they are purchased online than they would if obtained the conventional way.
The study, which was released early due to its public health implications, is scheduled to be published in the December issue of the Annals of Internal Medicine and was conducted by Bernard S. Bloom, PhD, and Ronald C. Iannacone, BS. Their search of Internet pharmacies, conducted in February and March, yielded 37 sites that required a prescription or an online physician consultation to dispense pharmaceuticals and nine -- all based outside the U.S. -- that did not.
For consumers, the greatest risks come from sites that don't require a prescription or physician consultation, or that market medications that are not approved by the FDA. But even with an online consultation, there is potential for harm because the quality of the physician is generally not known, Bloom and Iannacone write.
"Let's hope to God it is a physician. It could be your Aunt Mildred. You just don't know," Bloom tells WebMD. And as for those "sites that offered physician consultants, there was a disclaimer that said the physician may not be in your country." Bloom is a research professor in the department of medicine at the University of Pennsylvania.
Bloom says it's not practical to suggest that consumers stay away from ordering all prescription medications without a physician visit. "It's remarkable how accurate people are in doctoring themselves," he says, adding that there should be some physician involvement. "It seems to me, certainly for most prescription medications, you want to have a physician have some input, to know the patient, know something about other medications they might be taking."
The list of the commonly sold medications reads like a "who's who" of the most popular and heavily advertised medications today: Viagra (sildenafil) and Propecia ( finasteride), Claritin ( loratadine), Celebrex (celecoxib), Valtrex ( valacyclovir), and Zyban (bupropion). Many of the medications are not covered by insurance plans because they are so-called "lifestyle" drugs. Some sites existed only to sell specific medications, and little information was available about them, according to the authors.
The authors also reviewed the costs of medications and consults. "Among the 37 sites selling Viagra, the median per pill price was $4.50 (range, $4.30 to $4.65). Among the 16 Internet sites offering Propecia, the median per pill price was $1.94 (range, $1.55 to $1.95). On average the two medications were about 10% more expensive when they were obtained from a web site than from a local pharmacy," the authors write.
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