Buying Prescriptions Online

Internet pharmacies

• Four in ten American adults say they skipped a prescription, cut pills in half or skipped doses in the past year because they couldn't afford their medicine.

♦ Many online pharmacy sites are legitimate businesses, but you must use caution to avoid those who use the internet to sell unapproved, outdated or illegal products.

Online prescription sales run into the billions of dollars every year. Part of that is convenience, but in many cases it is also cheaper than retail.

Outside the U.S.

Buying prescription drugs from other countries is one way Americans cope with rising drug prices.

The cost of life-saving drugs can be prohibitive in America. Some drugs cost many times more than what people in other countries pay for the very same drugs.

Online pharmacies operating outside of the U.S. can offer some very significant savings. However, they also pose the greatest risk of running into counterfeit drugs.

• Buying drugs from internet pharmacies that do not provide a street address and telephone number may pose serious health risks.

You have no way of knowing where these companies are located, where they get their drugs, what is in their drugs, or how to reach them if there is a problem.

• Buying drugs on the internet may also pose financial risks. In some cases, the product may not be shipped at all. If it is coming from another country, it could be stopped at the border by customs.

♦ Technically, it's illegal to import prescription drugs from Canada. Many Americans do it anyway because of the government's unofficial "non-enforcement policy" for personal imports (up to a 90-day supply).

♦ The vast majority of foreign online pharmacies that sell to Americans pretend to be Canadian when they are not. That's because Canada is known for safe and inexpensive prescription medicines.

Knowing which pharmacies are legitimate requires some effort. See the verification sites below.

Big pharma conspiracy

There are plenty of theories that pharmaceutical companies are sinister and only care about making more money.

♦ For years, pharmaceutical companies have fought efforts to make it easier for Americans to import cheaper prescription drugs for personal use. To that end, they have promoted, and in some cases financed, online pharmacy watchdogs.

• The Alliance for Safe Online Pharmacies (ASOP) was set up with one main goal: controlling the story.

It includes the world's largest drug manufacturers. Other members include the online shopping monitor LegitScript, the National Association of Boards of Pharmacy and the National Association of Chain Drug Stores.

ASOP pushed industry ideas to the Obama administration. In the end, the White House went along with most of them and agreed to rules limiting access to online pharmacies.

• The Obama administration agreed to the creation of a separate group called the Center for Safe Internet Pharmacies (CSIP). It would be a nonprofit built around what ASOP and the drug industry wanted. A gatekeeper, basically.

The plan was for internet companies such as Google, domain registrars and credit card companies to "voluntarily" crack down on online pharmacies that didn't have a U.S. license. Payments would be denied and websites shut down.

Domain registrars would help shut down rogue pharmacy sites. Credit card companies would refuse payments to online pharmacies that weren't verified by companies like LegitScript or were flagged by manufacturers.

• Search engines would no longer run online pharmacy ads, including ads from legitimate overseas pharmacies.

You can still search for "Canadian Pharmacy" and get some hits.

ASOP was also reported to have paid a consulting firm $675,000, most of which went to fighting Senator Bernie Sanders' (I-Vt.) bill to legalize personal prescription imports.

♦ Conspiracy theories aside, drug manufacturers do have legitimate concerns about counterfeit drugs. But their efforts to shut down all overseas pharmacies, the legitimate ones right along with the rogue websites, do give the appearance that their main goal is protecting profits.

Verification sites

Use caution when buying drugs on the internet. As a rule, do not buy medications from unlicensed online sellers or from anyone who sells medications without a prescription.

Several organizations have sprung up to point consumers to legitimate online pharmacies. The big ones focus on U.S. pharmacies and steer people away from international pharmacies.

♦ The National Association of Boards of Pharmacy (NABP) runs what used to be called VIPPS. It dates back to 1999. In 2020 they renamed it Digital Pharmacy Accreditation.

NABP hands its seal of approval to sites that go through their verification process, buy a special ".pharmacy" web address and pay some hefty fees.

♦ NABP also runs a consumer site called Safe Pharmacy with a Safe Site Search Tool. Type in a pharmacy's web address and it tells you whether NABP has verified the site or put it on their "Not Recommended" list. Keep in mind NABP is a member of ASOP, so international pharmacies don't tend to fare well here.

♦ If you want to dig a little deeper, you can check a pharmacy's license through your state board of pharmacy (or equivalent state agency). The FDA keeps a list of states that have a searchable database searchable database of licensed pharmacies.

♦ PharmacyChecker has been around since 2003. It does not appear to be tied to credit card companies or drug companies. It has been featured by a number of large news organizations.

PharmacyChecker lists verified and licensed pharmacies in Canada, the U.S. and other countries. It even includes pet pharmacies. The site has a handy prescription price check feature too.

They say they put sites through a verification process before giving them the PharmacyChecker seal of approval. They also say they do some onsite inspections and have some purchases tested to confirm the drugs are what they're supposed to be.

♦ In Canada, there is a similar accrediting organization called the Canadian International Pharmacy Association (CIPA). It was founded in 2002 and is made up of licensed Canadian retail pharmacies.

You can search by pharmacy name. There are currently 50 accredited pharmacies listed. A complete list with web addresses can be found here.

Canadian pharmacies often sell the identical drug for much less than U.S. pharmacies. A lot of that comes down to price controls. Canada's government puts a ceiling on what drug companies can charge for patented drugs. In the U.S., pharmaceutical companies charge as much as the market will bear, until consumers cry foul.

♦ Most Canadian pharmacies are blocked from accepting VISA and MasterCard. A few take American Express and almost all take checks.

Looking ahead

States are still trying to do what Washington won't. Florida and Colorado both have FDA approval to import drugs from Canada. Neither has gotten a single pill onto pharmacy shelves yet. You can read the whole saga in our article Importing from Canada.

Consumer groups will keep pressing for the freedom to import legally. Pharmaceutical companies will keep working to stop them.

As drug prices keep soaring and insurers push more costs back onto patients, millions of generally law-abiding Americans will have no choice but to break the law. They'll buy their prescriptions outside the U.S. and have them shipped home.