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The Global Counterfeit Drug Problem and Safe International Online Pharmacies Are Not Related

On May 14th, an article appeared in ForeignAffairs.com called “Dangerous Doses: Fighting Fraud In The Global Medicine Supply Chain.” Authors Tim Mackey, Bryan Liang, and Tom Cubic simultaneously report on the counterfeit drug threats and tragedies experienced globally while deceptively attempting to link safe international online pharmacies to this problem. Our vice president, Gabriel Levitt responded in Telling the whole truth about online pharmacies. His response is published below.


Telling the whole truth about international online pharmacies

Over a decade of experience and empirical studies [See “Unveiling the Mystery of Online Pharmacies: an Audit Study” in National Bureau of Economic Research] have shown that credentialed international online pharmacies sell safe and affordable medication, not counterfeit drugs, to Americans who otherwise might cut back or not take their medications at all. These credentialed websites work with licensed pharmacies that require a prescription and meet high safety standards for mail-order pharmacy. They just happen not to be located in the United States, which explains their low prices. They are not a part of the counterfeit drug threat but the authors of this article would like you to think that they are

So why do these authors take this position? Although not well disclosed, the two senior authors are directly affiliated with pharmaceutical corporate interests. Pharmaceutical companies in the U.S. do not want their sales undercut by lower cost imports of the same exact medicines they sell here because it negatively affects their profits. No one disputes this. Bryan Liang maintains a leadership position with the Partnership for Safe Medicines (PSM), which is largely funded by pharmaceutical companies and is currently led by the Deputy VP of Public Relations for the Pharmaceutical Researchers and Manufacturers of America (PhRMA). Thomas Cubic is head of the Pharmaceutical Security Institute (PSI), an organization of pharmaceutical company members. I believe the two entities share an office in Virginia.

The pharmaceutical industry has focused a lot of its lobbying muscle against drug importation laws that could help millions of Americans obtain needed medication. The pharmaceutical industry position is advocated on many levels through Liang’s Partnership for Safe Medicines and Cubic’s PSI, as well as through PhRMA and the National Association of Boards of Pharmacy with the goal of preventing non-US online pharmacies from selling to Americans even if they are safe. A careful reader would certainly find their position in this article.

The authors here accurately acknowledge that a majority of the world’s counterfeit drugs and the subsequent sickness and death they cause are found in countries with weak drug regulations and/or enforcement of laws. But they try and equate huge tragedies in developing countries where counterfeit drugs kill hundreds of thousands with the real but different dangers posed by the Internet.

Let’s just make one thing clear: The counterfeit drug problems found through online pharmacies in the rich countries are real but miniscule compared to the tragedies reported about in poorer countries. In fact, examples provided in this article perfectly reflect the sharp dichotomy in the numbers of counterfeit drug victims in the United States and in poorer countries. Eleven years ago one young American named Ryan Haight, 18, tragically died from an overdose of pills purchased online, which he should have never received. But it’s worth noting that the drug, Vicodin, was real – not counterfeit. In this case, the problem was dispensing medications without proper medical supervision – not counterfeit drugs. The people who sold him the Vicodin went to jail. In Niger, a much larger tragedy occurred – 2,500 people died out of 50,000 who were inoculated with bogus medication. Of course this had nothing to do with U.S. drug importation or online pharmacies. One might have expected the authors to mention the 238 Americans who died after ingesting fake Heparin, which was circulating thorough the legal U.S. drug supply in 2007 and 2008. This, too, had nothing to do with online pharmacies but exceeds in victims any reported incidents having to do with the Internet.

The authors would like you to believe that CanadaDrugs.com, a credentialed international online pharmacy, is a part of the counterfeit drug problem so as to foster actions that could block access to such sites. They state that one of its suppliers is responsible for the counterfeit Avastin in the United States. They fail to mention, however that the counterfeit Avastin had nothing to do with online pharmacies, safe or otherwise. As it happens, many pharmacies in the United States have at one time or another unintentionally sold counterfeit medication – including CVS and Walgreens, which is not a reason to shut them down.

The source of the most recent large scale problem with intentionally sold substandard medications distributed in the United States is in fact GlaxoSmithKline. They were fined $750 million for intentionally distributing millions of substandard pills all across the country. These products were manufactured at their facility in Puerto Rico. U.S. Marshalls confiscated $2 billion of products from the plant in 2005, the largest such seizure in history and worth at least four times the value of all drugs imported by Americans from Canada each year.

There is no doubt that companies and people operating websites that purposefully sell fake drugs or even real drugs without a prescription need to be shut down, and in many cases criminally prosecuted. Victims of bogus online pharmacies certainly go underreported and the problem is very serious. But it’s a different problem from the large scale counterfeit operations that are killing hundreds of thousands of people in poorer countries – a crisis that demands immediate action to prevent the next massacre. The UNDOC may in fact be a better venue for international enforcement efforts, as the authors point out, because police actions may exceed the WHO’s mandate. Interpol’s enforcement work in Operation Pangea definitely took out a lot of bad guys – more such efforts are needed. Certainly working in concert, tapping their respective strengths, UNDOC, Interpol, WHO-IMPACT can bring us to a better place where the counterfeit drug threat goes on the decline.

But when it comes to the American pharmaceutical market, we find 48 million Americans not filling a prescription each year due to cost – an underreported crisis from which many die. Some of these Americans seek affordable and genuine medication online from Canada and other countries to acquire needed medication.

To directly address the core of Foreign Affairs readers, we must not allow our foreign policy and multilateral actions to disadvantage American consumers who are struggling or can’t afford prescription medication. So as we ramp up our efforts to stop criminals from infesting the world with fake drugs let’s not enact policies that will block the access of Americans to life saving medications simply because it improves our corporate balance sheets.

Gabriel Levitt

Vice President
PharmacyChecker.com

President
United Nations Association Brooklyn Chapter

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RxrRights.org Applauds Drug Reimportation Amendment Sponsored by McCain and Franken

In their blog yesterday, our friends at RxRights.org, an advocacy group dedicated to helping Americans afford needed prescription medication, applauded Senator McCain’s (R-AZ) amendment to the Food and Drug Administration Safety and Innovation Act to greater facilitate safe and legal personal drug importation of prescription medications from verified Canadian pharmacies. Despite Senator McCain’s emphasis on verification and product authenticity, and co-sponsor Al Franken’s (D-MN) statement on this bill’s role in reducing overall healthcare spending, the amendment failed in a 12-9 vote in the Senate Committee on Health, Education, and Labor and Pensions.

Those against the bill cited drug product safety issues and concerns over the anonymity of the internet. Most vociferously, Senator Barbara Mikulski (D-MD) claimed that even with the bill consumers would still not know where there drugs were coming from, failing to recognize or understand that the solution to this problem is written in the amendment, which calls for a verification process that would identify safe online pharmacies. Just such a program was adopted by Kathleen Sebelius, now Secretary of the Department of Health and Human Services, when she was Governor of Kansas.

For more on this vote, please visit RxRights.org.

Click here for a video of the committee hearing. Coverage of the amendment begins at 28:40.

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New York Times Op-Ed Calls For Legalization of Personal Drug Importation From Credentialed International Online Pharmacies

The main Op-Ed article in today’s New York Times, “The Wrong Way to Stop Fake Drugs,” calls for the legalization of personal drug importation from credentialed international online pharmacies, such as those approved in the PharmacyChecker.com Verification Program. Authored by Roger Bate, a resident scholar at American Enterprise Institute, the central message of the piece is that the technical ban on personal drug importation does not help the fight against counterfeit drugs but does discourage Americans from getting needed medication. We couldn’t agree more.

Dr. Bate offers evidence-based and compassionate approaches to help uninsured/underinsured Americans obtain medication at affordable prices and reduce the threat of counterfeit medication domestically and abroad. For more on this story see today’s press release

For the past year, Americans who buy medication from international online pharmacies have engaged through RxRights.org to help stop government actions that could block their online access to safe and affordable medication. Taking the cue from this latest op-ed, Americans should start asking their leaders to pass legislation directing the FDA to provide accurate information about online pharmacies. At the very least, the FDA should cease its categorical warning against all international online pharmacies for the simple reason that some are very safe and can help more Americans afford needed medications.

We looked at the top five brand name drugs by sales today to highlight the incredible price discrepancies between US pharmacy and international online pharmacy prices.

Price Comparisons for Lipitor, Advair Diskus, Nexium, Abilify, and Plavix

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Congressman Ron Paul’s Statement About Pharmaceutical Industry-FDA Collusion And What FDA Should Do About Online Pharmacies

As reported in DigitalJournal this past Wednesday, at a press conference in Keene, NH, Congressman Ron Paul (TX-14), Republican candidate for president, accused the pharmaceutical industry and the FDA of being in “bed together.” He derided their arrangement, characterized by a revolving door of people repeatedly switching jobs back and forth between the FDA and pharmaceutical industry, as collusion to reduce competition in the pharmaceutical marketplace, resulting in higher drug prices. When it comes to online pharmacies, personal drug importation and drug prices, Congressman Paul’s critique resonates all too loudly.

The pharmaceutical industry, through their main trade association Pharmaceutical Researchers and Manufacturers of America (PhRMA) has lobbied vigorously to keep safe personal drug importation illegal, and to scare Americans away through its media relations juggernaut and funding of the Partnership for Safe Medicine from buying safe and affordable medication online from Canada and other countries. PhRMA even commissioned the publication of a novel about a terrorist conspiracy – The Karasik Conspiracy in which terrorists attack Americans with bad drugs sold from Canada! This effort backfired and they pulled the plug on the publishing company, which then went ahead and published a different version of The Karasik Conspiracy novel in which a pharmaceutical giant poisons medications to protect its profits. (more…)

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Study Published by National Bureau of Economic Research Shows Online Pharmacies Approved by PharmacyChecker.com Offer Savings and Safety

A new study published by the National Bureau of Economic Research finds that pharmacies approved in the PharmacyChecker.com Verification Program sell safe medication and can help Americans achieve substantial savings. By filling 370 prescriptions through 41 online pharmacies and testing the authenticity of the medications received, independent researchers from the American Enterprise Institute in Washington, D.C. found no test failures among online pharmacies verified by third-party verifiers, such as PharmacyChecker.com.

Since all online pharmacies approved by PharmacyChecker.com – whether American or foreign – are licensed, require a prescription, and meet high standards of online pharmacy safety, the results of this study are not the least bit surprising. Past studies have shown the exact same results. Still, the FDA ignores the facts and continues a consumer education policy recommending that Americans completely avoid non-US online pharmacies. We believe the FDA’s policy is unethical and unfair.  More importantly, its policy is bad for the public health because less access to  affordable prescription drugs means fewer Americans will procure needed medications.

For more on this study see our news release.

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NABP July 2011 Progress Report – Is Turning a Blind Eye Toward Needy Americans Really Progress?

In its July 2011 Progress Report, the National Association of Boards of Pharmacy (NABP) continues to do a disservice to Americans by classifying safe pharmacies in other countries as “rogue.” Out of the 8,000 sites “Not Recommended” by NABP, PharmacyChecker.com research shows 53 are safe international online pharmacies.

It is laudable and helpful to Americans when the NABP exposes truly rogue pharmacies, i.e., those that sell Americans fake drugs or even real drugs but without a prescription. However, the NABP has chosen, year after year, to lump in with these rogues, any pharmacy that is not based in the United States.

How can the NABP do this? Unfortunately, U.S. law says it is, under most circumstances, illegal for Americans to get their medicine from Canada or other countries. So NABP freely uses terms like “rogue,” “illicit,” and “illegal” when describing any foreign pharmacy. We see no reason to mislead the public into thinking that safe foreign pharmacies pose a danger and belong in the same group as rogue pharmacies. (more…)

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