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Americans have been ordering medication over the Internet from foreign pharmacies for about 15 years. How many reported deaths or serious adverse reactions would you guess have been associated with purchases from international online pharmacies that require a prescription? Zero. Sadly, rogue online pharmacies, domestic and foreign, have contributed to injury and even death.

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

Patient Harm From Online Pharmacies


Section 1127 requests that GAO report on “the harmful health effects that patients experience when they consume prescription drugs purchased through such pharmacy Internet Web sites.” GAO did not do so. By “such pharmacy Internet Web sites,” Section 1127 means online pharmacies that “act in violation of federal or state laws,” which under most circumstances would encompass all international online pharmacies, due to drug importation and state pharmacy laws. There are zero incidents of reported deaths or even serious adverse reactions to date from prescription orders obtained from safe international online pharmacies. In contrast, rogue online pharmacies, especially domestic ones, have killed and sickened several people, though even with rogue online pharmacies there have been surprisingly few reported incidents of patient harm.

In a review of patient harm data spanning the years 2001-2012 published by ASOP there were no reports of an American being killed or sickened by medication ordered from an international online pharmacy that required a valid prescription. According to ASOP’s research, nine Americans who had purchased either counterfeit drugs or real drugs from websites that did not require a valid prescription were sickened or killed. Out of three imported orders, two people were sickened and one died. Six of the nine prescription orders were domestic; four led to death; one to permanent injury and one to temporary illness. Out of the five deaths attributed to online pharmacies between the years 2001 and 2012, four were linked to domestic purchases, three were due to ingesting controlled drugs, and in all instances prescriptions were either not required or issued to consumers who filled out online questionnaires, allegedly reviewed by a licensed prescriber.

Even more striking are the lack of adverse reports of improperly dispensed prescription drugs from international online pharmacies. Between 44,000-98,000 Americans die each year from domestic medication errors, including thousands made in U.S. retail pharmacies. Domestic medication errors are a problem that injure and kill Americans on a large scale, in contrast to online pharmacies, rouge or otherwise, but have received seemingly less critical attention than online pharmacies and personal drug importation from the NABP and NACDS.1

The greatest recent tragedies relating to Americans ingesting bad pharmaceuticals are related to the lawful supply chain, and not related to the Internet or personal drug importation. Eighty-one Americans died from tainted Heparin in 2007-2008, made by an American company with bad Chinese pharmaceutical ingredients. Sixty-four Americans died and 751 were sickened from fungal meningitis contracted by U.S.-made tainted steroid injections sold by poorly regulated compounding pharmacies.

1 Even worse, the NACDS defends chain pharmacy practices when confronted with the deadly problem of dispensing errors, asserting that pharmacies should not have to report errors to the government. See “Walgreens Told to Pay $25.8 Million Over Teen Pharmacy Tech’s Error,” ABC News, March 1, 2010, at [Last accessed 10/7/2014].
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