Pros and Cons of Online Prescriptions
Every choice comes with pros and cons, and the decision to utilize a mail-order pharmacy is no different. Thorough consumers will consider both sides.
- Lower Prices: Online pharmacies inherently cost less than your typical drugstore, due to lower overhead costs. Further savings can be found through wholesalers or discount pharmacies, and some pharmacies based outside the United States offer lower prices as a result of national policies varying from country to country.
- More Convenient: Injuries and other forms of incapacitation make it difficult for some to visit a local drugstore. Others simply live too far away or don’t have the time due to scheduling conflicts. In any case, ordering from a respected online pharmacy offers a level of convenience unavailable through local stores.
- Purchase Anonymously: Shopping online removes the potential embarrassment involved in purchasing medications or medical supplies over the counter. Policies put into place by the online pharmacy will further protect your privacy if you are careful to choose one that offers such protections.
- Online Resources: Detailed information that may not be available in a traditional store setting will be right at your fingertips when you order online. Drug interaction guides, disease reports, drug facts, and more can be found through certain pharmaceutical websites.
- Fluctuating Prices: Prices found on online pharmacies change often and without notice. Some mail-order pharmacies offer special introductory pricing to lure new customers, but those low prices vanish after a single order. The pharmacies listed on DrugPricer always show the current pricing available.
- Hidden Fees: Before you finalize an order with an online pharmacy, check to be sure they haven’t tacked on any additional fees after the prescription price. Things like higher-than-average shipping costs, account fees, ordering fees, consultation fees, and many others are standard methods of overcharging a consumer.
- Disreputable Actions: If you find an online pharmacy that doesn’t require a prescription, one that lacks any sort of contact information, or one without an adequate license, more than likely you have found a shady store. These disreputable pharmacies sell substances that are both unauthorized and potentially addictive, and they distribute highly dangerous drugs that are easily misused without a doctor’s help. Some of these drugs, like Accutane, Lotronex, and Clozaril should never be bought from an online pharmacy.
Pharmacies of such repute are barred from being listed on DrugPricer, eliminating the threat of dangerous drugs endangering any patient.
Different Varieties of Online Pharmacies
One of the main factors in determining the trustworthiness of an online pharmacy is to consider the prescriptions they take. They can be broken down into three standard levels:
- Traditional: The most reliable and safest types of online pharmacies require the original prescription acquired from a doctor after a face-to-face appointment. This category primarily consists of large providers that always have a full stock of medications ready to be shipped. Traditional online pharmacies tend to offer the lowest prices as well, due in part to the high amount of volume they deal with.
- Remote-Consultation: This type of pharmacy doesn’t require an existing prescription, but instead collects relevant information from their customers in order to ensure the prescription is necessary. Once a physician determines that the prescription is valid, the store fills the order. Remote consultation pharmacies are excellent for milder medications that don’t fall under the controlled substances category. Addictive substances can not be prescribed using a remote consultation in the United States, and some states don’t allow for remote consultations of any sort. Research must be done on local laws regarding prescription medications before utilizing a remote consultation pharmacy.
- None Required: The Unite State Drug Enforcement Agency, or DEA, issues specific licenses to pharmacies that sell controlled substances. Only pharmacies with this license can legally sell controlled substances. Additionally, In 2008 the Ryan Haight Act began requiring in-person exams for patients who wish to fill their controlled substance prescriptions through a mail-order or online pharmacy. However, ‘rogue’ pharmacies exist online that will fill drug orders with no prescription or consultation.
Online pharmacies that don’t require prescriptions of any sort are unethical and dangerous. Not only do they distribute controlled substances without the proper licensing or medical advice, but the patient does not know for sure that they are receiving what they need. The drugs could be counterfeit, or an incorrect dosage.
Other Classifications for Online Pharmacies
Beyond the prescriptions accepted by online pharmacies, another way to verify the quality of a mail-order service is to consider the types of drugs offered by them. These classifications include:
- Specialized: These pharmacies offer only a specific set of products that are meant to focus on a single medical issue.
- Popular: The most sought after medications are available from this type of pharmacy. While the selection may be limited to 10-50 drugs, they will be some of the most commonly purchased available.
- Lifestyle: Lifestyle pharmacies tend to carry elective medications like birth control, weight loss, anti-smoking, hair growth, and many others.
- 250-499: These pharmacies carry a majority of the drugs prescribed through standard prescriptions.
- 500+: These stores provide many of the same prescriptions that you may find at your local drugstore.
- Full Service: A full service pharmacy offers all sorts of prescriptions, as well as over-the-counter items, supplies, and non-medical products like beauty and health supplies.
Online pharmacies that deliberately distribute inferior medication that is either unlicensed or outright fake are called rogue pharmacies. In some cases these rogue pharmacies will also sell medications that are regulated and seem legitimate, but they don’t protect the health of their patients through certain necessary precautions. Taking medication from a falsified or non-existent prescription can put a patient at risk for illness or even death. Genuine, legitimate prescriptions must be attained.
A common practice of rogue pharmacies is to try to appear legitimate by offering remote consultations at a premium for the customer. A substandard consultation is completed to create a veil of legitimacy for an otherwise unethical procedure, and the drug is sold under the guise of a prescription from a physician. It’s important to note that some reputable pharmacies do offer legitimate remote consultations, but those done by rogue pharmacies only serve to create a false sense of security for the patient.
How to Spot a Rogue Pharmacy
It can be easy to see the warning signs of a rogue pharmacy if you are looking for them. If an online pharmacy does NOT do any of the following things, it could be considered rogue:
- Hire licensed pharmacists
- Securely hold medical and financial records of their patients
- Require prescriptions
- Provide contact information
- Distribute legitimate medications
- Fill prescriptions through licensed pharmacies
Online Verification for Pharmacies on DrugPricer.com
Unlike consumers who choose to use rogue web-based pharmacies, consumers who utilize only pharmacies that have been certified by websites like DrugPricer.com will receive legitimate medicine, based on findings from the National Bureau of Economic Research. By researching the pharmacies verified as legitimate on DrugPricer.com you can avoid potential hassles from purchasing from a rogue pharmacy. There are other organizations that provide information about online pharmacies, like the Canadian International Pharmacy Association, or CIPA, and the Canadian Anti-Fraud Centre, or CAFC. The National Association of Boards of Pharmacy, or NABP, operates another fine resource for researching legitimate pharmacies as well, the Verified Internet Pharmacy Practice Sites, or VIPPS.
While an invaluable resource, VIPPS only provides credential checks on pharmacies based in the United States. Foreign and domestic pharmacies alike are verified through DrugPricer.com, as the majority of consumers buy the lower priced drugs from foreign sources.
Verifying Online Pharmacies
Controlled substances will never be shipped by legitimate pharmacies or foreign countries to residents within the United States. DrugPricer.com uses a strict set of validation guidelines to determine whether an online pharmacy should be listed on the site. Pharmacies not only must hold licenses from their own country, but a set of third party associates will also offer accreditation to those who earn it. Only those online pharmacies that require traditional prescriptions are listed on DrugPricer as well.
Web-based pharmacies are given further legitimacy by third-party verification. Several U.S. and Canadian institutions offer accreditation, including the Canadian International Pharmacy Association, or CIPA, the National Community Pharmacists Association, or NCPA, the Better Business Bureau Online, or BBBOnline, the Manitoba International Pharmacists Association, or MIPA, and VIPPS, or Verified Internet Pharmacy Practice Sites.
Legal Issues of Ordering Medications Online
While United States federal law prohibits residents from ordering prescription drugs from other countries, customs officials don’t intercept packages coming from Canada that contain prescription medications. There are also some states that will help residents order from foreign countries. In order to ensure that your order is successful, there are some guidelines you should follow when ordering:
- Use only legitimately obtained prescriptions
- Do not order controlled substances or anything classified as a Schedule IV drug
- Order no more than three months worth of your medication at once
A full list of the guidelines provided by the FDA for personal drug importation can be found here. It should be noted that the FDA hasn’t once prosecuted someone following the approved guidelines.
In this video Marcia Crosse, PhD explains the FDA’s personal drug importation policies. Marcia is the director for the Health Care Team at the U.S. Government Accountability Office (GAO).
Foreign Pharmacies Versus Domestic
Foreign mail-order or online pharmacies can be appealing to those with no insurance for prescription medications, but residents of the United States who order from foreign pharmacies will lose out on several potential benefits of ordering from a domestic web-based pharmacy, including:
- Lower shipping rates
- Lower prices for generic medications
- Insurance acceptance when covered for prescription drugs
- Less legal hassle
By using DrugPricer before a purchase to compare pharmacies you might avoid losing out on the best deal possible. DrugPricer offers what you need to know to be confident in your purchase.
Pharmacy Regulation in the United States
Online and mail-order pharmacies are susceptible to the same controls that maintain prescription drug safety in all of the United States.
- The FDA grants approval after clinical trials, takes feedback after the market has been exposed to a drug for a certain time, and recalls dangerous drugs after evidence of their danger is found.
- The DEA oversees all controlled substances, and they are responsible for issuing licenses that allow pharmacies to sell those substances.
- Licenses of the pharmacists and pharmacies are regulated on a state-to-state basis. Each state has a slightly different set of regulations, but it is common to have licensed pharmacists working with controlled substances within a licensed pharmacy all throughout the United States.
With so many levels of control keeping patients healthy and pharmacies dispensing the correct drugs, there is no comparison between purchasing from home and abroad. Foreign countries might offer slightly lower prices, but that’s not a good reason to ignore safety. Learning how foreign countries control their medications will shed light on which online pharmacies can provide the same level of safety as the United States.
Don’t forget that it is illegal to order foreign prescription drugs. Personal use is typically allowed by the FDA in small amounts, but international packages are seized from time to time. The FDA primarily targets packages from developing countries and essentially anywhere other than Canada, but less than one percent of all drug imports from online pharmacies are seized.
How to Properly Choose an International Online Pharmacy
The international market for prescription drugs has grown tremendously, and several countries are able to sell to the United States. Strict regulations must be kept in order to ensure safety, but there are various ways each country can regulate their industry. To be legitimate, each online pharmacy should be clearly evident of the following:
- Regulation by an agency similar to the FDA that monitors the safety of all drugs and approves new drugs for distribution after appropriate clinical trials.
- Labeling and distribution standards for pharmaceuticals on a national scale.
- Individual regulation on a province or state level of pharmacies with routine inspections and strict drug distribution guidelines.
- Laws should be in place that require pharmacists to have exceptional education and thorough training.
- Prescriptions should be legally required for drugs not available over-the-counter.
- Good Manufacturing Practices, or GMP, should be followed when manufacturing medications.
International Practices for Pharmaceuticals Overview
Prescription drugs are regulated in Australia through the same policies as they are in the European Union. Pharmacists are registered by each territory or state, as are pharmacies, and the Therapeutic Goods Administration regulates pharmaceuticals on a national scale.
Policies and regulations are controlled through the Pharmaceutical Society of Australia, and the state boards make up the organization, ensuring safe practices throughout all pharmacies.
The Pharmacy Guild of Australia accounts for over 80 percent of all pharmacies. Members of the Guild are kept up to date on current issues, and the organization supports positive workplaces and superior education. The Guild also helps deliver a safe health care system by working closely with the government, pharmaceutical manufacturers, and all other involved.
- Therapeutic Goods Administration, Department of Health and Aging
- The Pharmacy Guild of Australia
- The Pharmaceutical Society of Australia
In Barbados a pharmacy may sell their products online or through mail-order if they meet the following requirements:
- A passed inspection from the Barbados Drug Service, or BDS, which operates under the Barbados Ministry of Health, or BMH.
- The Pharmacy and Drug Services Act regulations must be met.
- Pharmaceutical distribution is handled onsite by a licensed pharmacist.
A free-trade zone exists for the online pharmacies in Barbados, but they still must follow the regulations set forth by their local laws. Be that as it may, often times the drugs distributed by free-trade pharmacies are obtained outside the regulated drugs within the country.
Online pharmacies and mail-order services are only verified by DrugPricer after meeting several regulations, and these approved pharmacies potentially include wholesalers who provide goods to free-trade pharmacies.
Perhaps the most popular source for international prescriptions is Canada, due to the fact they operate so similarly to U.S. pharmacies. On a national scale, all drugs are overseen by the Therapeutic Products Directorate, and each province is left to regulate their own pharmacies. Each province requires:
- Pharmacy board licensing
- Licensed pharmacists onsite
- Specific standards for the distribution and storage of drugs
Online and mail-order pharmacies in Curaçao operate in nearly the same way as they do in Barbados. The Inspectorate of Public Health and the Inspector of Pharmaceutical Affairs regulate the pharmacies the get approval to operate internationally, and all distribution must be handled by a licensed pharmacist.
A free-trade zone exists for the online pharmacies in Curaçao, but they still have to follow the regulations set forth by their own laws. Even with that being the case, the drugs distributed by free-trade pharmacies are often obtained outside the regulated drugs within the country.
Online pharmacies and mail-order services are only verified by DrugPricer after meeting intense regulations, and these approved pharmacies potentially include distributors who sell goods to free-trade pharmacies.
Indian regulations are close to those used in the United States. They also require a licensed pharmacist onsite, as well as standard practices for safe storage and protection of controlled substances. The main governing body of the pharmaceutical industry is the Central Drugs Standards Control Organization, and it is responsible for the following:
- Regulation of existing drugs and approval of new ones.
- Ensure safety by following the use of prescription drugs.
- Protection of the actual drug supply.
- Inspecting, licensing, and enforcing policies through the State Drug Control Offices.
The drug supply in India is somewhat below the U.S. standards in terms of regulation, despite the fact the FDA inspects manufacturing facilities within India. India is still responsible for a decent percent of the world’s active drug compounds, and as such the country is susceptible to higher levels of counterfeit medications. DrugPrice will only approve those Indian sellers who pass the same intensive standards as all other pharmacies listed on this site.
Pharmacies and pharmacists as well as all prescription drugs in Israel are regulated by the Israeli Ministry of Health’s Pharmaceutical Division. Israeli practices closely follow those of the EU and United States, including GMP for pharmaceutical production and FDA or similar standards. Most prescription drugs manufactured in Israel are approved for distribution in both the EU and the U.S. Generic drugs in the U.S are often supplied from Israel.
The Italian Drug Regulatory Authority is responsible for maintaining the high pharmaceutical standards set forth by the EU in Italy. Only after new drugs pass clinical testing are they approved for sale. Another EU agency known as the European Medicines Evaluation Authority, or EMEA, is also responsible for evaluating the safety of all medications in the EU.
Italian pharmacies are strictly regulated when it comes to prescriptions, and only licensed pharmacists can legally own a pharmacy within the country.
The approval and monitoring of medications in New Zealand is overseen by Medsafe, an FDA equivalent organization. Pharmacies are also licensed by Medsafe, and they are held to standards similar to pharmacies in the United States. Pharmacists are regulated and licensed by the Pharmacy Council, and the education and training of pharmacists is guided by the Pharmaceutical Society of New Zealand.
Singapore has rigorous regulations that give it equal stature with the United State and EU when it comes to pharmaceutical practices. Pharmacies are regulated by the Health Sciences Authority, which guarantees the safety of equipment and storage facilities. All pharmacies must be owned by a pharmacist licensed with the Singapore Pharmacy Council.
If a new drug has already been approved in the EU, Australia, or the United States it can be expedited for approval in Singapore, but all other drugs must go through a nine month approval process by the Health Products Regulation Group. Once approved, all drugs are regulated by the Therapeutics Products Division.
Pharmacies in Singapore can also function as exporters, but those exports are not guaranteed by the Therapeutics Products Division. Only those pharmacies who meet high safety standards are approved by DrugPricer.
Approvals for new drugs in South Africa must go through the Medicines Control Council after clinical trials. Pharmacies and pharmacists are licensed by the South African Pharmacy Council, or the SAPC. The organization also requires pharmacies to employ licensed pharmacists to distribute prescription medications as well as store them safely.
All pharmaceuticals in Switzerland are regulated by an organization called Swiss Medic. The EMEA is also responsible for drug approvals in Switzerland as with all other EU countries. Switzerland uses standards that are equal to those in the United States.
Instead of states, Switzerland is broken into cantons. Pharmacies are regulated in each region, and all pharmacies are required to have a licensed pharmacist employed to oversee all pharmaceutical practices.
Turkey’s Drugs and Pharmacy General Management agency is responsible for the approval of new drugs, and a second agency known as the Advisory Commission for the Registration of Medicinal Products for Human Use helps the process along. It has been reported by the World Health Organization, or WHO, that Turkey’s pharmaceutical practices are equivalent to the EU’s.
Pharmacies in Turkey are required to have a licensed pharmacist onsite while open to the public. There are prevalent issues with unregistered drugs in some areas of Turkey, and as such DrugPricer will not condone the purchase of prescription drugs from pharmacies in those areas.
The EMEA regulates and approves new prescription drugs in the UK, and the Medical and Healthcare Products Regulatory Agency oversees the approval process. The practices used by the UK pharmaceutical industry are equivalent to those in the rest of the EU and the U.S.
Both pharmacies and pharmacists are licensed and must be registered by the General Pharmaceutical Council. Only licensed pharmacists are legally allowed to operate pharmacies.
There are a myriad of ways in which counterfeit medications can pose a threat. Ingredients in counterfeit drugs may be either ineffective or completely incorrect. Some counterfeits contain no active drugs of any sort. Packaging can also be done insufficiently, allowing for further contamination.
Countries with inadequate regulations for their online pharmacies only further raise the risk for the distribution of counterfeit drugs. Pharmacies that omit contact information should be avoided, as they may be attempting to avoid feedback. No online pharmacies will be posted to DrugPricer without contact details of some sort, or a physical address.
Intellectual Rights for Pharmaceutical Manufacturers
When a new drug is brought to the market in the United States the company that produces it owns exclusive rights to that drug for twenty years. After the initial twenty year period, other companies are then allowed to produce generic versions. Foreign countries are only allowed to hold ten year rights, or in some cases none at all. Due to the variety of property rights laws, some foreign manufacturers have been known to begin making generic forms of still patented U.S. medications. These unauthorized products are considered illegal in the United States.