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Educating American Consumers About Buying Medications From Foreign Pharmacies: What’s Right and Wrong?

Tens of millions of Americans cannot afford medication, which can lead to more sickness, hospitalizations, and even death. Despite this public health crisis, our trusted regulatory authorities, the pharmaceutical industry, and U.S. pharmacy trade groups work together to scare Americans away from ordering much more affordable medications from foreign pharmacies. Is that right or wrong?

This week, in our continuing quest to get the truth out and for our elected leaders in Congress to take bold action to protect online access to safe and affordable medication, we’re publishing the next section of our report called Online Pharmacies, Personal Drug Importation, and Public Health

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Internet Society and Online Access to Affordable Medication: The Problem with dot Pharmacy

We’ve talked a lot about the efforts of the National Association of Boards of Pharmacy (NABP), funded by big pharmaceutical companies, to curtail online access to safe and affordable medication by conflating rogue online pharmacies with safe international online pharmacies: most distressingly through its application to the Internet Corporation for Assigned Names and Numbers. I had the opportunity to present our position about the importance of maximizing online access to safe and affordable prescription drugs by participating on a panel organized by the Internet Society New York Chapter. The focus of the panel overall was on public interest commitments as they pertain to new generic top level domains (gTLD) (i.e., new domain endings such as .book, .amazon, .religion, .nyc, and .pharmacy). Such gTLD’s area acquired through the opening up of this space by ICANN.

The mission of the Internet Society is directly applicable to the issue of online access to affordable medicine:  “By connecting the world, working with others, and advocating for equal access to the Internet, the Internet Society strives to make the world a better place.”

The NY Chapter recently held a meeting in my home borough of Brooklyn! Members of the New York Chapter are currently concerned with potential abuses of the .nyc domain space. For example, the organizer of the panel and board member, Thomas Lowenhaput, is concerned that a corporation like Domino’s or Pizza Hut will own the domain pizza.nyc, not only obtaining a commercial advantage but denigrating New York pizza’s culinary cultural soul. The heart and soul of New York pizza has nothing to do with national retail pizza chains so there should be safeguards preventing commercial abuses of those premium domain names. You get the idea!

On the panel, I talked about NABP’s plan to operate the domain space called .PHARMACY because we believe it furthers pharmaceutical corporate interests at the expense of consumers, although in this case the issue is health not pizza! I informed the meeting’s participants that the NABP’s application to ICANN to operate .PHARMACY was funded by pharmaceutical companies and that its domain registration policies will help serve their commercial interests. Not surprisingly, pharmaceutical companies prefer it when consumers pay much more at U.S. pharmacies for the same medications sold in Canadian and other foreign pharmacies at a much lower cost.

NABP’s policies will prohibit a .PHARMACY registration to any non-U.S. pharmacy that sells medication to consumers in the U.S. The basis for its policy mirrors and relies on the discriminatory U.S. and state regulations prohibiting safe personal drug importation. In so doing, NABP is using the levers of Internet governance to support domestic policies that impede consumers from obtaining medications they need. Essentially, in the parlance of the Internet Society, I told the group that NABP’s vision of .PHARMACY undermines the Internet’s promise as a tool to “make the world a better place.”

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VISA Policies Curtail Consumer Access to Safe Medicines Online: “Reminiscent of China or North Korea!!”

Some consumers who order medication from safe international pharmacies are finding themselves unable to use their VISA credit cards. We hope that doesn’t interfere with their ability to access safe and affordable medication. What’s going on?

Essentially, in taking actions to stop rogue online pharmacies from selling medication, VISA’s online pharmacy policy ends up discriminating against consumers seeking affordable medication from safe international online pharmacies. It appears that VISA has adopted the online pharmacy worldview of LegitScript, a verification service that categorizes safe international online pharmacies as “unapproved” (but not “rogue”) and teams up with big pharmaceutical companies and U.S. chain pharmacies!  VISA’s policy may set a precedent for more credit card payment processors; discontinued service to rogue pharmacy websites is good, but if service is discontinued to safe international online pharmacies, including ones approved by PharmacyChecker.com, that’s bad. (more…)

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ICANN and Online Pharmacies: NABP’s Scheme for .Pharmacy is not What’s Best for Global Consumers

A Letter to the ICANN Community

Today, the Wall Street Journal reported on the subject of rogue online pharmacies and the Internet Corporation for Assigned Names and Numbers (ICANN). The gist of the article is that ICANN is not doing enough to stop dangerous pharmacy websites. There is reason to believe that ICANN could do more but it could also do too much to the detriment of consumers who cannot afford medication locally. There’s an appropriate middle ground for getting rid of rogue pharmacy sites, but not overreaching and ending online access to safe and affordable medication. Willfully ending such access threatens the public health and treads on global norms relating to human rights and access to medications.

Earlier this month I attended an ICANN conference for the first time, which was in Los Angeles. We’ve written on several occasions about the application by the National Association of Boards of Pharmacy (NABP) to ICANN to operate a new generic top level domain (gTLD) called “.pharmacy”. To remind many of our readers, gTLDs are the endings of websites, such as .com, .org, .gov, .edu, .int, etc. The bottom line here is that we and many others believe that NABP, if its application is successful, will use its new ICANN-conferred legitimacy to stifle competition, mislead the public about online pharmacies, and in doing so curtail access by Americans and consumers worldwide to safe and affordable medication online.

I met many dedicated, interesting and well-informed people at the ICANN conference, including those serving within the ICANN community and others following it closely. To follow up with them I wrote the following letter.

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Three cheers for EasyDNS: the future of online pharmacies and domain registrars

EasyDI’m writing this blog post to say thank you to a domain registrar called EasyDNS and its CEO, Mark Jeftovic, and to talk about what’s up with registrars and online pharmacies, as it could affect your online access to safe and affordable medication. EasyDNS’s new online pharmacy policy denies service to rogue online pharmacies but not safe online pharmacies.  It will accomplish this policy by providing service to online pharmacies only if they are approved by LegitScript or PharmacyChecker.

In short, domain registrars are companies that help people obtain website names; names such as www.rxrights.org, www.doctorswithoutborders.org, www.WebMD.com, www.nytimes.com, etc.  The most popular of these registrars in America is Go Daddy. If all registrars deny service to a person or a company, such as a rogue online pharmacy, then it cannot reach the public. If all registrars deny service to safe online pharmacies with very low drug prices then the public will not have access to them.

Our friends at RxRights gave a strong shout out to EasyDNS this week as well.

You might be thinking that this is no big deal. Who wouldn’t want to stop rogue pharmacy sites but allow safe, low-cost online pharmacies to operate? Well, earlier this year the National Association of Boards of Pharmacy (NABP) sent letters out to 200 registrars telling them to take down websites that NABP doesn’t recommend. No matter how safe it might be, the NABP does not recommend any international online pharmacy that sells to Americans, instead unfairly calling them rogue sites.

Popular Internet freedom blog Techdirt published an article about NABP called, “Pharmacy Group Lies To Registrars: If We Complain About A Site, It Must Be Taken Down No Questions Asked.”  It wrote: “The NABP is basically an organization designed to artificially inflate the price of drugs in the US, cynically using highly questionable claims to pretend that they’re focused on ‘public safety.’”

For the record, there is not a single reported death by a person who ordered from an international online pharmacy, ones that NABP calls “rogue,” that requires a valid prescription and fills orders through licensed pharmacies. The industry has been around for about fifteen years now. (more…)

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The Google Online Pharmacy Settlement: Why It’s Both Wrong and Right

UPDATED: August 24, 2011, 6:30pm

The United States Department of Justice just announced that Google will be paying a $500 million penalty to the U.S. government for allowing Canadian pharmacies to advertise to Americans. We are familiar with this case, having been asked to testify in it – and we are mentioned several times in the settlement.

Although we tried to help Google vet pharmacy advertisers from 2006 to 2009, it is clear that Google was not limiting pharmacy advertisers to just those verified in our Pharmacy Verification Program – as noted on pages 4 and 5 of the settlement. That was bad because it allowed advertising by pharmacies that did not require valid U.S. prescriptions and/or sold controlled substances into the U.S.  – activities which we do not permit in our program. As noted on page 6 of the settlement, the $500 million amount is based on revenues generated from the advertising and sales of “controlled” substances, not all medicines.

On the other hand, we believe that efforts to help Americans find more affordable and safe sources of medication are necessary and should be praised. And Google also did that: Although it can’t anymore – at least not through advertisements  – and we think that’s wrong.

Unfortunately, the Department of Justice is publicizing the settlement in a misleading manner that paints all non-U.S. online pharmacies as “patently unsafe,” and “contributing to America’s pill problem”.  Peer-reviewed research shows that buying prescription medications from licensed pharmacies in other countries, and specifically those verified in the PharmacyChecker.com Verification Program, is safe. Genuine medicines (and no controlled substances) are obtained, typically at savings of 80% or more on brand name medications – and prescriptions are required.  Also, while the DOJ’s announcement emphasizes the illegality of personal drug importation, it fails to mention that individuals, as a matter of FDA’s policies, are not prosecuted for buying non-controlled drugs from outside the U.S. for their own use.

An FDA representative says in today’s announcement that the settlement “demonstrates the commitment of the Food and Drug Administration to protect the US consumer and hold all contributing parties accountable for conduct that results in vast profits at the expense of public health.” While this is in part true, it ignores the fact that much greater profits are being made by pharmaceutical companies at the expense of public health by keeping Americans captive to inflated drug prices. As the Centers for Disease Control and Prevention recently reported, 25 million Americans did not take their prescribed medication due to cost in 2009, almost double the number in 1997. Personal drug importation from properly verified and reputable Canadian online pharmacies clearly benefits public health by making drugs more affordable for Americans.

For a take on this situation from the perspective of a knowledgeable physician who purchases his own medicine from abroad, see the recent article by Stephen Barrett, M.D., founder of Pharmwatch.org and Quackwatch.org.

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