For those of us looking online for safe and affordable medication, it’s very disconcerting to hear about the problem of fake Canadian online pharmacies, or any fake online pharmacy, and the myriad ways they can endanger your health, such as by sending counterfeit or substandard medication or engaging in identity theft. We can help you avoid the bad guys.
Just last week the FDA reported that – through Operation Pangea VI – thousands of illegal online pharmacies, including fake Canadian ones, were shutdown to protect Americans from dangerous medication. The FDA should be applauded for shutting down dangerous sites. However, even though there are real Canadian and other international online pharmacies that are safe and have very low drug prices, the FDA continues to warn Americans not to use them through its BeSafeRx program. We believe this confuses Americans about what they need to do to obtain prescribed and affordable medication safely online.
A fake Canadian online pharmacy is essentially a website dressed up with the Canadian flag, maple leafs, with red and white colors, or other graphics of Canada, but without actual ties to Canada. In fact, a majority of so called “Canadian” online pharmacies are based overseas, many in Russia and Eastern Europe. Some of them are even known to have ties to organized crime. Simply put, they are not Canadian pharmacies. Like all rogue online pharmacies, fake Canadian online pharmacies often:
Don’t require prescriptions;
Don’t publish verifiable and useful contact information;
Don’t fill orders through licensed pharmacies;
Don’t sell real or safe medications;
Don’t have licensed pharmacist dispensing your prescription order; and
Don’t protect your personal and financial information.
A real Canadian online pharmacy offers the following:
Regulated medications that are approved by a respected national drug regulatory authority;
Prescription fulfillment through licensed pharmacies, dispensed by licensed pharmacists;
Requirement of your valid prescription, issued by your doctor – NOT through an online questionnaire;
Verifiable contact information, including telephone number and mailing address;
Online pharmacy operation by or affiliated with a licensed Canadian pharmacy; and
The ability for consumers to speak with a licensed pharmacist for counseling;.
There are a small number of real Canadian online pharmacies that no longer work with a Canadian bricks and mortar pharmacy because they have transferred prescription fulfillment to licensed pharmacies in other countries. They retain the Canadian moniker or have the word “Canada” in their web addresses to keep their original branding and website. That doesn’t mean they are not safe. However, they ought to be transparent and disclose that medications ordered come from pharmacies outside of Canada.
This brings up an important side note: where are your medications really coming from and who is making them? When you buy a prescription medication at your local U.S. pharmacy that does not mean it was made in the United States. Almost half of all prescription drugs sold in U.S. pharmacies are imported. Furthermore, U.S. pharmacies do not inform you who made the active ingredients (the main ingredient that treats you) – in the medication you are taking. Most active pharmaceutical ingredients – 80% according to the FDA – found in U.S. pharmacy prescription drugs are made outside the U.S., mostly in India and China. If you buy a prescription drug from Canada and most other countries the same holds true. Don’t despair, the U.S. and many other countries have strong safety protocols to protect their prescription drug supplies: those same supplies usually just cost much more in the United States.
Here’s a chart to show you the difference between real and fake Canadian online pharmacies. As you’ll see it’s like day and night:
Real Canadian Online Pharmacies
Fake Canadian Online Pharmacies
Sells only regulated medication?
YES
NO
Prescription fulfilled through licensed pharmacies and by licensed pharmacists?
Last year, PharmacyChecker.com criticized BeSafeRx, the U.S. Food and Drug Administration’s online pharmacy public education campaign, for implying that all online pharmacies located outside the U.S. are fake pharmacies. BeSafeRx discourages Americans who cannot afford medicine at their local pharmacies from accessing medicine online internationally, which has been shown to be safe if done properly. Real pharmacies in Canada and other countries sell the same medication sold here for much lower prices. Misinformation becomes a public health threat when it discourages people from finding viable ways of accessing needed medication. BeSafeRx has a new database program that enables consumers to check the license of a U.S. pharmacy found online. That’s nice, but the program reinforces the message that Americans should only buy from U.S. pharmacies, never over the Internet from foreign pharmacies. What is the FDA’s logic?
Here is an excerpt from the FDA’s website on importing prescription drugs:
FDA cannot ensure the safety and effectiveness of products that are not FDA-approved and come from unknown sources and foreign locations, or that may not have been manufactured under proper conditions. These unknowns put patient’s health at risk if they cannot be sure of the products identity, purity, and source. For these reasons, FDA recommends only obtaining medicines from legal sources in the U.S.
Just because the FDA does not vouch for prescription medication sold in other countries does not mean that prescription medications sold abroad are less safe than those sold domestically. There are other national drug regulatory authorities to help safeguard medication. For example, Health Canada’s Therapeutic Products Directorate approves and regulates drugs in Canada in almost exactly the same way the FDA does here. Americans who order medication from safe international online pharmacies, such as those verified by PharmacyChecker.com, receive medication regulated under the authority of a foreign country.
The new FDA database is only helpful if you need to check the license of a U.S. pharmacy found online with prices you can afford. If you can’t afford to pay a pharmacy’s prices, the safety of its medications are irrelevant.
A new U.S. FDA public education campaign called BeSafeRx (www.fda.gov/BeSafeRx) would be much more helpful if it were more truthful. In launching the campaign, designed to alert consumers to the potential dangers of online pharmacies, the FDA Commissioner said, “If the low prices seem too good to be true, they probably are.” In actuality, low prices from online pharmacies outside the U.S. are often quite real and are offered from licensed pharmacies selling genuine products. The problem is that U.S. prices are just unbelievably high. The U.S. pharmaceutical and pharmacy industries (which don’t want to lose profits and consumers to lower priced pharmacies) in other countries, have come out as big supporters of BeSafeRx.
Correctly, the FDA alerts consumers that there are thousands of dangerous pharmacy sites that should be avoided, but safe international pharmacies do exist. Independent studies and over a decade of experience show the high degree of safety Americans can find in personally imported medication from online pharmacies which have been properly credentialed by PharmacyChecker.com. For many Americans they provide the only way to afford their medicine. International online pharmacies verified by PharmacyChecker.com require prescriptions and sell genuine medication at prices much lower than available domestically: often 90% lower.
The big losers of FDA’s online pharmacy campaign are American consumers and taxpayers. American consumers lose by having to pay much higher prices in U.S. pharmacies, or, tragically, by not taking their medication at all. In 2010, 48 million Americans did not fill a prescription due to high drug prices, according the Commonwealth Fund. This is a national health crisis, which is only getting worse. As taxpayers, we lose because when people end up getting sick by not taking needed medication they are more likely to end up in emergency rooms across the county incurring medical costs paid for by our dwindling national coffers (you and me).
Remember, our Secretary of the Health and Human Services Department (which oversees the FDA) – Kathleen Sebelius – operated her own drug importation program as Governor of Kansas. During her tenure, consumers could order prescription medication from pharmacies in the Canada, Ireland, New Zealand, and the UK found through the State of Kansas website. If it was safe then it is safe now. It appears that only the political calculation has changed in perverse deference to the big pharmaceutical companies.
Tod Cooperman, MD, President, and Gabriel Levitt, Vice President
PharmacyChecker.com
Americans are speaking out against the provisions of a new law signed by President Obama on July 9th that will hinder their access to safe and affordable medication. In a news story last week on a Minneapolis-St. Paul NBC affiliate, Kare 11, we learn about Minnesotans who could be negatively affected by Section 708 of Food and Drug Administration Innovation and Safety Act, which allows for the seizure and destruction of personally imported medication.
Rico Anderson imports his prescription medicine for Crohn’s disease from Canada, paying $135 for a one month supply. In the U.S., this medicine would cost over $700 a month. That’s almost $7,000 dollars in annual savings. In contemplating having to face higher U.S. prices, Mr. Rico lamented that: “if it gets to a point where you’re deciding if you have to buy your medicine or pay your mortgage or put food on your table what are you going to do?”
The NBC report features Lee Graczyk, lead organizer of RxRights, a prescription affordability advocacy group. Days before the law passed Mr. Graczyk emphasized both the economic and health costs that result from unaffordable medication: “People are using this option because they cannot afford to buy the medications here. If this law passes, they can’t afford to buy the medications and stop taking the medications, they not only put their health at risk, but as a nation, it’s going to cost us more money.”
Visit RxRights.org to learn how Americans can fight back and protect their access to safe personal prescription drug importation from verified online pharmacies.
To compare prices on prescription medication from Canada and other foreign countries visit PharmacyChecker.com.
The problem of Americans not taking medications is caused by high costs of prescription drugs, undesirable side-effects, health literacy, forgetfulness among other reasons. Medication non-adherence is a $317 billion problem. The U.S. Surgeon General and the Department of Health and Human Services issued a request to individuals and organizations to submit information about the national problem of medication adherence. Specifically, the government’s request presents “the opportunity to identify issues relevant to all levels of government, as well as individuals, health care providers, and industry and private organizations in efforts to improve medication adherence in adults with chronic conditions.”
Since cost is one of the critical factors inhibiting Americans from getting needed medication, we believe the government should take more proactive steps to provide useful information about how to obtain affordable medication online. Our analysis and recommendations are published below. For a PDF copy click here.
The Honorable Howard K. Koh, MD., M.P.H.
Assistant Secretary for Health
The Honorable Vice Admiral Regina M. Benjamin, M.D., M.B.A.
Surgeon General of the United States
Room 710-H
200 Independence Ave., SW
Washington DC 20201
Re: Request for Information on Prescription Medication Adherence
Submitter: Gabriel Levitt, Vice President, PharmacyChecker.com, 333 Mamaroneck Avenue, White Plains, NY 10605. (718) 387-4526, Gabriel.levitt@pharmacychecker.com.
Prescription medication non-adherence should be treated as a national crisis since so many Americans suffer as a result. Some of the reasons for non-adherence are health literacy, psychological issues, side effects of medications, and lack of support systems. There are also tens of millions of Americans who simply can’t afford medication. A survey by the Commonwealth Fund found that 48 million Americans did not fill a prescription in 2010 due to high medication costs.[i] The data show the negative health and economic effects of non-adherence to prescription medication. First, it’s been reported that 121,000 people die each year due to prescription non-adherence.[ii] Second, according to the FDA, non-adherence to prescription medication costs the country $290 billion annually in additional health care costs.[iii] Third, numerous studies have shown that cost is either the number one reason, or a major factor for non-adherence. [iv]
Access to safe and affordable medication should be encouraged through all available sources, including personal drug importation. Over the past 15 years millions of Americans have obtained needed prescription drugs through non-U.S. online pharmacies, despite its technical illegality. Currently, the U.S. Food and Drug Administration does not prosecute people for small quantities of personal drug imports.
The FDA discourages Americans from ordering from any non-U.S. online pharmacy, not because it’s illegal but for safety reasons. Its position is that the drugs ordered from Canadian and other foreign pharmacies are not regulated by the FDA, and are therefore unsafe. That position is simply unsubstantiated. Fortunately for people living in other countries there are other national regulatory authorities that regulate drugs to make sure they are safe and effective.
We’ve established that the problem of prescription medication adherence is so severe in large part due to high drug prices. If it is safe to order less expensive medication online that allows Americans to adhere to their doctor’s prescription then we should encourage their use. Are non-US online pharmacies safe?
The evidence shows that properly credentialed non-US online pharmacies which fill orders from licensed pharmacies, require a valid prescription, and provide verifiable contact information on their websites safely dispense genuine medication. The medication purchased for personal drug importation is often the same brand name product – from the same manufacturer – sold here but at a much lower price, often 80% less than U.S. pharmacies. A consumer is almost certain to receive proper care and safe medications from one that meets the aforementioned criteria and is certified in the PharmacyChecker.com Verification Program.[v] In fact, U.S. Government Accountability Office studies have shown the relative safety of Canadian online pharmacies compared to U.S. online pharmacies.[vi]
We recommend that the Secretary of Health and Human Services instruct the U.S. Food and Drug Administration to:
Correct its website and consumer communications about online pharmacies to reflect the facts demonstrated by over a decade of studies and consumer experience. The FDA website should communicate that “if you decide to purchase medication online from Canada or another country then only use properly credentialed websites.”
Explicitly allow, at least on a temporary basis, personal drug importation through properly credentialed non-US online pharmacies.
By taking these steps fewer Americans will go without needed prescription medication because it will be affordable. Moreover, more people taking prescribed medication will lead to fewer hospitalizations and emergency room visits, resulting in lower healthcare costs for the nation.
Sincerely,
Gabriel Levitt
Vice President
PharmacyChecker.com, LLC
[v] Bate, Roger, Ginger Zhe Jin and Aparna Mathur. “Unveiling the Mystery of Online Pharmacies: An Audit Studay”. National Bureau of Economic Research. Working Paper #17655 (http://www.nber.org/papers/w17955.pdf). April 2012.
[vi] U.S. Government Accountability Office. Some Internet Pharmacies Pose Safety Risks For Consumers, GAO-04-820. Washington, DC. Government Accountability Office June 2004. See http://www.gao.gov/new.items/d04820.pdf (last accessed June 26th, 2011).
Consumers searching for Adderall online should use extreme caution. The FDA announced that it found fake Adderall, a drug for Attention Deficit Hyperactivity Disorder and Narcolepsy, is being sold online. Adderall is a controlled substance, a prescription drug with greater addictive potential and subject to strict regulatory controls. Reputable international online pharmacies, such as those approved in the PharmacyChecker.com Verification Program, do not sell this product or other controlled substances to Americans.
Sales of controlled substances online are governed by the Ryan Haight Online Pharmacy Consumer Protection Act, which expressly bans the sale to Americans of controlled substances online from pharmacies that are not registered with the U.S. Drug Enforcement Agency. The Act also prohibits pharmacies from dispensing controlled medication based only on a remote medical consultation, meaning the patient’s prescription must be the result of an initial physical exam. For more see PharmacyChecker.com: Controlled Substances and Online Pharmacies – Use Extreme Caution.
The FDA did not identify the websites that are selling the fake Adderall. According to the FDA, the fake Adderall contained Tramadol and acetaminophen, which is medication to treat pain. The FDA’s announcement also included pictures of authentic and fake Adderall.
Legitimate Adderall
Counterfeit Adderall
Whether the problem is lack of supplies, which is a current problem for Adderall, or high costs, it is understandable that Americans are trying to find access online to needed medication that they cannot get at their local drugstores. But it’s critical to use common sense and only buy from credentialed online pharmacies. This will enable you to get most medications you need and protect yourself from falling victim to fake and dangerous drugs.
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A source for news and analysis about drug prices and safety, online pharmacies and personal drug importation, published on behalf of American consumers.
For those of us looking online for safe and affordable medication, it’s very disconcerting to hear about the problem of fake Canadian online pharmacies, or any fake online pharmacy, and the myriad ways they can endanger your health, such as by sending counterfeit or substandard medication or engaging in identity theft. We can help you avoid the bad guys.
