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Online Pharmacies May Save Money and Time, but Beware: You Could Be Putting Your Health at Risk, U.S. Officials Warn

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If you’re brave enough to do a web search for the phrase “online pharmacy,” brace yourself: we just tried it and our search engine returned over two billion hits. One source estimates that the total sales volume for online pharmacies is expected to top $22.5 billion in 2022, with more than one U.S. prescription consumer in five ordering prescriptions online. This same source reports that the biggest gainer in dollar volume will be China, which now accounts for roughly one-quarter of total online prescription revenue.

When it comes to saving time and money, online pharmacies would seem to have the edge, promoting much lower costs, direct delivery, and complete privacy. What’s not to like? Well,   as this recent NextAvenue article suggests, the answer is, “Plenty.” In her article, New York-based writer and psychotherapist Barbra Williams Cosentino looks at recent consumer alerts from the U.S. Drug Enforcement Administration to warn readers that those cheap prices could be luring buyers toward impure, expired, or fraudulent drugs that have the dangerous potential to cause major health problems. It’s a classic case of “Buyer beware!”

Promises of Online Pharmacies are Enticing

The online pharmacy world seems too good to be true. Lower costs, free shipping, and no prescriptions or doctor’s visits needed? Wow! On top of that, the sites look so professional, and the selection of name brand drugs is amazing. Even the fine print seems to contain no red flags. No problem, right?

In her NextAvenue article, Cosentino warns readers not to be taken in by appearances. “If you don’t know what to look for, you could very well be purchasing fake prescription pills containing fentanyl or methamphetamine from an international or domestic criminal drug network,” she writes.

“According to the Drug Enforcement Administration’s 2021 Public Safety Alert,” Cosentino explains, “there is a huge surge in online sales of lethal counterfeit pills. Mass-produced in Mexico, smuggled into the U.S. and sold on popular social media and e-commerce platforms, they look just like their legitimate counterparts and are sickening and killing Americans at an unprecedented rate.”

Many Buy Prescription Drugs Online

Buying prescription drugs online isn’t a niche market. In fact, it’s far more common than you might think across all demographics and health conditions. Asthma and diabetes meds, drugs for cancer, and even pills like Adderall for ADHD can all be found online at far lower costs (apparently) than traditional retail. But the truth is, many buyers don’t really know what they’re getting.

In her NextAvenue Cosentino writes, “According to the National Association of Boards of Pharmacy (NABP), of the approximately 35,000 online pharmacies around the world, 95 percent are unregulated and rogue, selling products that may be substandard, tainted or expired. Operating out of compliance with U.S. pharmacy laws and safety standards, they won’t necessarily cure what’s ailing you, and in fact, they could even kill you.” 

Pandemic Boosted Online Sales

As with so many things, the COVID-19 pandemic saw a societal shift and a surge in online drug sales, since many people were unable to leave their homes to go to the pharmacy.

Libby Baney, senior advisor to the Alliance for Safe Online Pharmacies (ASOP) told Cosentino, “People use [online pharmacies] for convenience, cost and easy access to medications. It can often be less expensive to purchase medications there, even if you have health insurance and only are responsible for a co-pay. When they are legitimate and legal, providing you with the prescription medications that your doctor has ordered, online pharmacies can be a viable alternative to going to the pharmacy.”

The Problem: Separating Legit Pharmacies from Bad Actors

But as Cosentino puts it, the key word here is legitimate. It can be very difficult for the average consumer to tell the difference between a good site and a bad one, and even health care workers find it tough to tell the difference. “These digital drug dealers know what consumers want and they oblige, with their main objective being selling you pills for profit,” Baney said.

Cosentino explains the process: “Are you ordering from an online pharmacy because you don’t have time to get to the doctor’s office? If there’s not a ‘real’ physician or pharmacist for you to chat with online, you could decide on your own that you need a Z pack or Cipro (types of antibiotics) for that persistent sore throat or urinary tract infection. You will be prompted to fill out a questionnaire which is supposedly reviewed by a pharmacist, and your medicine will soon be on its way.”

However, she adds, “The problem is that it might not be the right medication or dosage for your self-diagnosed problem, and you have no way of knowing if the drug you’re getting is produced in a shoddy facility or if it contains a much smaller amount of active ingredient than it should.” The so-called “pharmacist review” is often bogus.

To add insult to injury, it’s not just your health at stake when you buy fraudulent drugs. These sites can also be rife with scams and identity theft schemes. They can take your personal and financial data, infect your computer with viruses, and sell your information on to other bad actors online.

Misconceptions About Online Pharmacies

Online pharmacies and mail order pharmacies behave very differently, too. Mail order pharmacies through your health plan require a certain type of insurance, while an online pharmacy may or may not accept your insurance.

But if all this sounds confusing to you, you’re not alone. ASOP’s May 2021 survey, called “American Perceptions and Use of Online Pharmacies”, revealed that many users of online pharmacies find the process confusing. A few tidbits below:

  • 45 percent of survey respondents believed that all websites offering health care services and prescription meds online are safe and verified by the FDA or some other regulatory body. Among those who have previously purchased medications online, that number jumped to 59 percent!
  • A whopping 25 percent of consumers say they would trade higher risk for the reward of lower costs and more convenience ordering drugs online. But Cosentino adds, “46 percent said they would be willing to purchase prescription medications from an online source that is not FDA approved if it gave them access to drugs they could not otherwise get or medicines at cheaper prices.” 
  • And finally, a strange belief that emerged from the survey is that many people believe (wrongly) that all medicines from Canada sold online are always safe and legitimate.

That’s an awful lot of dangerous misconceptions in one place!

Bottom Line: Be Safe, Not Sorry

Cosentino is quick to add that she’s not saying don’t use online pharmacies. Just to use them wisely. The savings and the convenience can definitely be worth it, as long as you do your homework. She provides a list of resources and sites, and we’ve included them here verbatim, as we feel they are very useful to have on hand:

  • The Alliance for Safe Online Pharmacies allows you to download a list of safe pharmacy websites or to search their site to see if one you’re considering is legitimate. There is also a Facebook page.
  • Your state board of pharmacy, your health care provider and your (legitimate, flesh and blood) pharmacist are excellent resources for learning how to buy and use medications safely.
  • Look for sites with the VIPPSseal (Verified Internet Pharmacy Practice Sites) which are accredited. Or use Verify Before You Buy, a service from the Center for Safe Internet Pharmacies, or LegitScript.  
  • Look for “.pharmacy” at the end of a web address. When a website ends in .pharmacy, it has been verified by NABP. Unlike logos, the pharmacy domain cannot be faked or forged.
  • Some of the most well-known and safe online pharmacies include Caremark Rx LLCCostco Wholesale Corporationpharmacy and Wal-Mart Stores Inc.
  • Check pharmacy: Not Recommended Sites for an extensive list of sites that NABP eschews.

Don’t Put Your Trust in Social Media Sites

Sadly, the same platforms that allow us to connect with others can contain their own dangerous minefields of scam artists and fakes. Facebook, Snapchat, Twitter, and others can all be breeding grounds for the purchase of harmful narcotics and counterfeit pharmaceuticals.

Cosentino writes, “According to the Alliance to Counter Crime Online, drugs sales on these platforms fall into two categories: Illegal narcotics like heroin, cocaine and fentanyl, sold by individuals and criminal syndicates, and controlled substances such as opioid painkillers sold without prescriptions by rogue online pharmacies. Social media algorithms enable the targeting of specific populations who are likely to want the products they are hawking.”

Rogue Pharmacy Warning Signs

Cosentino includes the following red flags of an online pharmacy:   

  • Prescription medicines are dispensed after the patient has completed an online questionnaire but there is no prescription submitted or contact with doctor
  • There is no toll-free phone number or street address for the internet drug outlet on their website, and the only way to communicate with them is by e-mail
  • No pharmacist consultation is available either by phone or secure web-based communication
  • They ship prescription drugs worldwide or are located outside of the U.S.
  • Their prices seem outlandishly inexpensive

Baney explains, “Consumers are way too trusting when it comes to purchasing services or products online, including medication. Taking an anonymous vendor’s word about safety and efficacy is putting your health in their hands, even if you have no idea who they are.”

She adds this very straightforward and very wise advice: “Verify before you buy, and don’t buy medications from social media companies and online marketplaces.”

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(originally reported at

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