Consumer Guide to Online Pharmacies

The Upside

• Low-cost prescriptions: Without the overhead of brick-and-mortar stores, online pharmacies can offer better prices. Discount pharmacies and wholesalers reduce prices even further, and pharmacies in Canada and other countries often have better prices than the U.S. does due to differing national health care policies.
• Convenience: Many people find it difficult to visit the local pharmacy. Whether they are incapacitated with an injury or illness, reside far from business centers or simply don’t have time due to busy schedules, ordering online is often more convenient.
• Anonymity: Health is a very personal subject, and some people feel more comfortable when minimizing face-to-face interaction. This makes online ordering very appealing. However, it’s extremely important to choose online and mail-order pharmacies that protect you with strong privacy policies and safeguards.
• Medical Resources: Some online sites may offer detailed drug facts, drug interaction guides, reports about diseases and links to authoritative agencies with additional information.

The Downside

• Changing Prices: Introductory prices may not apply to repeat customers, and online pharmacies often change rates as a matter of practice. eDrugSearch always has the most current price information for all the pharmacies we list.
• Additional Fees: Be sure to check online and mail-order pharmacies for additional fees added on top of attractive prescription prices. These might include ordering fees, account fees, consultation fees and, of course, shipping costs.
• Shady Practices: Some online pharmacies don’t require prescriptions; they don’t provide contact information, such as an address or phone number; they don’t have adequate licensing; and they sell unauthorized controlled substances that can be harmful or addictive. They also sell other drugs that can be highly dangerous without a doctor’s supervision. These restricted-distribution drugs include Clozaril, Accutane and Lotronex, among others, and should never be purchased online.

eDrugSearch prequalification procedures help eliminate disreputable pharmacies that endanger patient health.

• Traditional Prescriptions: Mail-order and online pharmacies that insist on traditional prescriptions are the safest, most reliable choices. They require an original doctor’s order issued after an in-person patient visit. These are often large, national providers or mail-order centers that carry a full stock of prescription drugs, and they usually have the lowest prices due to their high volume of business.
• Remote-Consultation Prescriptions: Online pharmacies that conduct remote consultations can be equally safe and reliable, especially for milder, lifestyle medications. Individuals submit relevant medical information, and a physician associated with the pharmacy reviews it to determine whether or not a prescription is appropriate. If so, the pharmacy fills the order. U.S. federal law forbids prescriptions for addictive, controlled substances through remote consultation. Additionally, remote prescriptions are entirely illegal in some states while others allow them only for non-controlled drugs. It’s important to know local laws before choosing this type of pharmacy.
• No Prescription Required: Pharmacies in the U.S. that sell controlled substances must have a specific license to do so from the U.S. Drug Enforcement Agency (DEA). Furthermore, the Ryan Haight Act of 2008 requires patients to have an in-person exam before prescriptions for controlled substances can be filled through online and mail-order pharmacies. Yet there are “rogue” pharmacies that fill orders for any type of drug without a prescription or even a consultation.

These unethical businesses can be dangerous not only in providing addictive substances without a license or a doctor’s guidance, but also because the drugs they provide may be counterfeit; patients never know if what they receive will be the correct strength or if it is even what they actually ordered.

• Full service: Carries all types of prescription medications, over-the-counter products, testing supplies, and non-medical supplies such as health and beauty items.
• 500+: Carries most prescription drugs that a local pharmacy carries.250-499: Carries drugs requested in the majority of prescriptions.
• Lifestyle: Carries drugs that might be considered optional, including contraception, sexual enhancement, weight loss, hair growth and smoking control drugs.
• Popular: Carries only the most-requested prescription medications; may be limited to 10 to 50 different drugs.
• Specialized: Carries medications intended for very specific conditions rather than a wide range of products.

Rogue Online Pharmacies

Rogue online pharmacies are websites that deliberately sell inferior, fake or unlicensed medication. These Fake Rogue Web-based pharmacies may also sell legitimate, regulated medications; however, these pharmacies do not use certain safeguards to protect patients’ health. Anyone who takes unsuitable prescription medication puts themselves at risk of serious illness or death. Therefore, it is imperative to only fill genuine prescriptions.

Pharmacy Consultations

Numerous rogue online pharmacies disguise themselves as legitimate pharmacies by offering substandard consultations. These consultations, which come at a cost to the patient, are conducted in order to fill a prescription that the pharmacy claims is written by a licensed physician. Although there are some websites that offer safe and secure remote consultations, rogue pharmacies use
supposed consultations to create the illusion of patient safety.

Indicators of a Rogue Online Pharmacy

There are several warning signs that a pharmacy is considered rogue. The main indicators of a rogue pharmacies are those that do not:

• Require a prescription.
• Sell genuine medications.
• Use licensed pharmacies to fill prescriptions.
• Hire a licensed pharmacist to dispense prescriptions.
• Keep patients’ financial and medical information secure.
• Publish pertinent, verifiable contact information on their site.

Verify Online Pharmacies on eDrugSearch.com

According to the National Bureau of Economic Research, consumers who used Web-based pharmacies certified by sites such as eDrugSearch.com always receive legitimate medications, unlike those who choose to use pharmacies deemed as rogue. Only use pharmacies that are verified by eDrugSearch.com in order to avoid filling prescriptions with rogue pharmacies. You may also research an online pharmacy through reputable organizations like the Canadian International Pharmacy Association (CIPA), in partnership with the Canadian Anti-Fraud Centre (CAFC), which continues to aggressively monitor and pursue rogue online pharmacies. VIPPS, or Verified Internet Pharmacy Practice Sites, which operates through the National Association of Boards of Pharmacy, or NABP.

However, VIPPS only checks the credentials of U.S.-based pharmacies. Since consumers tend to use pharmacies in foreign countries, which often offer the lowest prices, eDrugSearch.com verifies the credentials of not only U.S. pharmacies, but also foreign pharmacies.

Also, a handful of states have initiated programs to help residents order prescriptions from other countries. However, there are still a few guidelines to help prevent penalties and make sure an online order goes through:

1. Provide an original prescription.
2. Don’t attempt to order controlled substances or drugs designated as Schedule IV medications.
3. Only order a three-month supply or less.

Here is the FDA’s personal drug importation guidelines. It’s important to know that the FDA has NEVER prosecuted anyone for uses the guidelines above for their personal drug importation.

Watch Marcia Crosse, PhD — the director for the Health Care Team at the U.S. Government Accountability Office (GAO) — explain the FDA’s personal drug importation policies:

• Lower generic prices
• Lower shipping charges
• Easier legal recourse if needed
• Prescription drug insurance acceptance

Using eDrugSearch to compare online pharmacies and their prices is always smart. It provides the kind of information that lets you purchase online prescriptions in safety and confidence.

• The Food and Drug Administration (FDA) oversees the U.S. drug supply, granting initial approvals after controlled clinical trials; taking feedback once drugs are on the market; and issuing recalls where evidence comes to light of unsafe medications.
• The Drug Enforcement Agency (DEA) regulates controlled substances and issues licenses to pharmacies that sell them.
• Individual states handle the regulation and licensing of both pharmacists and pharmacies. Though state regulations differ slightly, having a licensed pharmacist on-site and having controlled storage and drug-dispensing practices are common in all U.S. pharmacies.

All of this input helps ensure that U.S. pharmacies dispense drugs correctly and that patient health is protected. The lower cost of prescriptions from other countries isn’t reason enough to abandon safety. Knowing a bit about how other countries regulate medications will help you determine which international online and mail-order pharmacies are likely to equal the safety of U.S. pharmacies.

Remember, it’s technically illegal to import prescription medication of any kind. The FDA generally allows personal use in limited supply, but seizure of international orders does occur. Prescriptions from non-Canadian countries and especially from still-developing nations are targeted most frequently; however, order seizures from online and mail-order pharmacies equal less than one percent of all personal drug imports.

• An overseeing agency equivalent to the FDA that requires scientific results from clinical trials prior to approving drugs and that also monitors drugs for ongoing safety.
• National standards and laws related to labeling and distribution of pharmaceuticals.
• National, state or province systems that oversee pharmacies, inspecting them regularly and requiring strict safety guidelines for handling and dispensing drugs.
• Laws that ensure pharmacists have superior education and training.
• Laws that require a doctor’s prescription for medications not sold to the general public.
• Following Good Manufacturing Practices (GMP) when producing prescription drugs.

Buying prescriptions from online and mail-order pharmacies in developing countries, or from those with inadequate safety regulations, increases the risk of receiving counterfeit products. Sites that don’t publish contact information are more likely to be unethical and should be avoided. eDrugSearch will not approve pharmacies that don’t post a physical address or other contact details.

Pharmaceutical Companies Intellectual Property Rights

In the U.S., companies that bring a drug to market have exclusive sales rights for 20 years; only then can other companies create generic equivalents. However, other countries may only protect patented drugs for 10 years or less, or they may not protect patents at all. Due to differing property rights, some international online and mail-order pharmacies sell generic medications that are still under brand patents in the U.S. The FDA considers these generic drugs to be unauthorized for use in the U.S. This may or may not contribute to seizure when importing generic prescriptions.