Pharmacists Play a Critical Role in Protecting Patients From Illegal Online Drug Sellers

Actor Danny Trejo explains how fake meds bought online can put patients' lives in danger. Video Credit: Alliance for Safe Online Pharmacies (ASOP) Global

The Oath of the Pharmacist compels the more than 325,000 practicing pharmacists across the United States to prioritize the “welfare of humanity and relief of suffering.” As more and more patients are driven to look for cheaper and easier access to medications online due to ongoing drug access and cost challenges, pharmacists are called to play a critical role in the fight against illegal online drug sellers through educating patients on the risks before them in the current landscape for online drug retail.

Americans buy clothes, furniture, and almost every other product you can think of online, and increasingly, that includes prescription medications. The pandemic then accelerated that demand due to the immediate need for online access to convenient, lower-cost medications.¹ Now, with challenges in medication access and drug shortages, even more patients are turning to the internet for everything from an antibiotic such as amoxicillin (Moxatag; Fera Pharmaceuticals) and an ADHD medication like amphetamine/dextroamphetamine (Adderall; Teva Pharmaceutical) to the chemotherapy drug cisplatin (Platinol; Qilu Pharmaceutical) or the diabetes medication semaglutide (Ozempic; Novo Nordisk).^2,3

Yet, it has been found that approximately 95% of online drug sellers operate illegally, in direct violation of US state and federal laws.^2,4 These rogue websites may sell counterfeit or unapproved medicines, operate without the required pharmacy license, or fail to require a valid prescription. Further, unlike receiving a cheap copy of a brand-name consumer good, many consumers may never know that the medications they receive from online sellers are not what they claim to be. Even worse, medications sold by illegal online drug sellers have been found to contain harmful ingredients such as mercury and fentanyl, making them dangerous and, in some cases, deadly.⁵

These rogue websites may sell counterfeit or unapproved medicines, operate without the required pharmacy license, or fail to require a valid prescription. Image Credit: ASOP Global

These trends are alarming for patient safety advocates and for pharmacists alike. Because, as suggested by a national survey commissioned by the ASOP Global Foundation, most Americans think they know more than they actually do about the online pharmacies they find online, they may take risks that can elevate their exposure to potential harm.^1,6 In ASOP Global Foundation’s survey, the responses revealed that nearly half of Americans erroneously believe that all websites offering prescription services to Americans are approved by the FDA or state regulators. Further, nearly three-quarters of Americans think verified, safe websites selling prescription medications should appear first in search results or be clearly identified as legitimate.

As trusted resources for healthcare information, pharmacists are uniquely positioned to counter these misperceptions among patients head-on. Pharmacists are uniquely positioned at the frontlines helping to ensure patients understand how to buy medications safely, both online and offline.

Five things’ pharmacists can say to help protect patients from illegal online drug sellers:

1. Whether buying from online or brick-and-mortar pharmacy all prescription medications in the US require a valid prescription. Selling prescription medication without a valid prescription is not only illegal, but also dangerous. Patients cannot trust the quality of medicines sold outside the regulated supply chain via unlicensed “pharmacy” websites, on social media platforms, or in online marketplaces. As DEA reminds in “One Pill Can Kill,” the best way to stay safe is to buy medicines from licensed pharmacies.
2. Verify before you buy. Before buying from an online source, patients should go to safe.pharmacy or legitscript.com to verify that an online seller is safe and legitimate. Further, sellers whose website URL ends in .pharmacy have been verified as safe by the National Association of Boards of Pharmacy.
3. Learn how to steer clear of Bad Meds. Fake meds kill real people. Pharmacists can help patients protect themselves and their loved ones by teaching them how to distinguish safe meds from the bad. The Bad Meds public service campaign shows you how.
4. Use prescription services to save money and stay safe. Services like NeedyMeds and RefillWise can help patients access discounts and find the lowest prices on their medications.
5. Learn more at www.ASOPFoundation.pharmacy. Nonprofit ASOP Global Foundation offers free information and resources to providers and patients on how to stay safe and save on medicines.

Consistent with the Oath of the Pharmacist, it is important for all providers to recognize the growing public health threat of illegal online pharmacies and take proactive measures to protect patients. By understanding the risks associated with these illegal actors and effectively counsel patients, pharmacists can be the first line of defense for combatting illegal online drug sellers and keeping their communities safe.

About the Author

Libby Baney, JD, is a partner at Faegre Drinker LLP and senior advisor of the Alliance for Safe Online Pharmacies.

References

1. ASOP Global. 2021 Survey American perceptions and use of online pharmacies executives summary. July 9, 2021. Accessed July 31, 2023. https://asopfoundation.pharmacy/wp-content/uploads/2021/07/ASOP-Global-Foundation-2021-Consumer-Behavior-Survey-Key-Findings_Final-7.9.2021.pdf
2. Jewett C. How the shortage of a $15 cancer drug is upending treatment. The New York Times. June 26, 2023. Accessed July 31, 2023. https://www.nytimes.com/2023/06/26/health/cancer-drugs-shortage.html.
3. Loftus P. What is ozempic and why is it such a big deal right now? WSJ. May 22, 2023. Accessed July 31, 2023. https://www.wsj.com/articles/ozempic-diabetes-drug-weight-loss-c0e03c25.
4. National Association of Boards of Pharmacy. Rouge Rx activity report disrupting illegal online pharmacies: lock-and suspends as a tool to protect patients. 2022. Accessed July 31, 2023. https://nabp.pharmacy/wp-content/uploads/2022/10/Rogue-Rx-Activity-Report-Disrupting-Illegal-Online-Pharmacies-2022.pdf
5. Partnership for Safe Medicines. Do you know the 5 kinds of poisons that are found in counterfeit medicines? April 13, 2015. Accessed July 31, 2023. https://www.safemedicines.org/2015/04/do-you-know-the-5-kinds-of-poisons-that-are-found-in-counterfeit-medicines-4-13-15.html
6. ASOP Global. 2021 Survey American perceptions and use of online pharmacies executives summary. July 9, 2021. Accessed July 31, 2023. https://asopfoundation.pharmacy/wp-content/uploads/2021/07/ASOP-Global-Foundation-2021-Consumer-Behavior-Survey-Key-Findings_Final-7.9.2021.pdf
7. Staff SIB. Bad Meds. Los Angeles County Sheriff’s Department. December 14, 2022. Accessed July 31, 2023. https://lasd.org/badmeds/