In George Orwell’s famous novel 1984, published in 1949, we find a future in which totalitarian, one-party rule has run amuck on a global scale. It is a world in which whatever “The Party” (think Communist or Nazis) states is a fact must be believed, regardless of the obtuse logic and propagandistic origins of that so called “fact.” The quintessential and frightening example provided by Orwell is the notion that 2+2=5 if The Party Say’s so. When I attended the Partnership for Safe Medicines (PSM) conference last week, it felt as if many people were willing to believe absurd notions about online pharmacies. Most positions espoused at PSM’s conference support the following fallacious statement: IF an online pharmacy is not based in the U.S. and sells prescription drugs to the U.S. THEN it is dangerous. They essentially put on a show in which different people in a myriad of ways communicate that 2+2=5.

The event, called the PSM Interchange, is a Lion’s Den with many people who are directly paid by drug companies, indirectly paid by drug companies, U.S. pharmacies or their trade groups, or those who would like to be paid by the aforementioned entities someday, either directly or indirectly. PSM’s stated mission, “working together to protect the safety of your prescription drugs,” is, it seems, a smoke screen for big drug companies working together to keep drug prices as high as possible in their most cherished market – America.

As I see it, PSM was conceived and launched to oppose reforming drug importation laws that would bring down U.S. pharmacy prices and to scare Americans away from buying medications internationally. According to its press release in 2004: “The Partnership for Safe Medicines will be working with consumers, concerned officials, and the media on an education campaign about the dangers of importing foreign drugs into the US. Peter Pitts will be the official spokesman for the Partnership.” You will not find Peter Pitts on the Board of Directors. But that Mr. Pitts was originally viewed as a good candidate for PSM spokesperson figures. Mr. Pitts is president and co-founder of the Center for Medicine in the Public Interest (CMPI). According to a very revealing article in the Bio Ethics Forum, “CMPI exemplifies the use of PR by industry to distort public discourse for industry advantage. In the permanent war for the public’s mind, transparency and truth are the first casualties.” I’m going to guess that Mr. Pitts went on to found CMPI back in 2004 or 2005 instead of settling in with PSM.

As a conference attendee at the PSM Interchange this year, and for the last five years, I’m dumbstruck by the performances of some – but not all – speakers for their abuse of honesty, full disclosure and logic in service of pharmaceutical commercial interests. They want you to believe that 2+2 equals 5. There were so many speakers communicating in, to borrow Orwell’s vernacular, doublethink that I don’t have time to document all in this one blog post. For today I’ll reserve my criticism for the PSM panel called “The Impacts of Fake Online Pharmacies on Patient Safety.”

First let’s address the title of the panel. Some fake online pharmacies have made people sick and even killed a few people. That’s one too many. How many Americans have died or even reported a serious adverse health reaction associated with buying non-controlled medication from a safe international online pharmacy? Zero.

Libby Baney, the Executive Director of the Alliance for Safe Online Pharmacies (ASOP) was one of the panelists. ASOP is funded, according to its website, by Eli Lilly, the National Association of Chain Drug Stores (NACDS), and LegitScript. Ms. Baney’s presentation regurgitated two popular media points about online pharmacy usage and data that without elaboration can be misleading. First, her slideshow stated that “23% of adult Internet consumers surveyed have bought prescription medicine online (US FDA).” Without elaborating on that data, one might go away thinking that a quarter of American adults are dangerously buying medication online. I was able to raise my hand during another presentation to remind the lions that the FDA survey cited by Ms. Baney actually found that 83% of the 23% who bought medications online did so in association with their health insurance, which means from domestic, licensed pharmacies. The real numbers can be found using really simple math. According to the FDA’s survey, about 3.91% — not a quarter – of adult Internet users have purchased medication online in a manner the FDA considers risky.

Ms. Baney’s slides also stated that “50% of the prescription medicines sold online by websites that hide their physical address are counterfeit (WHO).” The source is the World Health Organization. I recall that Ms. Baney added in her verbal remarks that that this is “according to WHO’s own research.” I can almost guarantee you that Ms. Baney or anyone else has never seen this research done by WHO, and that it does not exist. I’ve asked members of congress to ask WHO for the data and WHO either could not or would not produce it. I write this with full agreement with Ms. Baney that online pharmacies should include a verifiable mailing address and that most rogue online pharmacies do not provide an address. At the same time, I’ve seen intelligent journalists rely on this statistic as if it came from a peer-reviewed study of WHO academics with no connection to the pharmaceutical industry. I believe that the statistic found on the WHO’s websites came from a study associated with the University of London, in cooperation with Pfizer, and that the data only relates to Viagra.

The president of the Maine Pharmacy Association, Kenneth “Mac” McCall, III, participated on the panel with Ms. Baney. Mr. McCall’s group is suing the State of Maine over its law that removed obstacles to groups in Maine that wish to help their employees obtain lower cost medication from Australia, Canada, New Zealand, and the United Kingdom. In her brilliant motion to dismiss that lawsuit, filed with PhRMA as a plaintiff, the Maine Attorney General writes “Plaintiffs filed this lawsuit to preserve their financial interests, as they are concerned that [the new law] may reduce their sales…” It’s not inconceivable that Mac has his own financial interests to protect.

Mr. McCall re-tells the story of how he purchased three generic medications from a Canadian online pharmacy that did not come from Canada. What he doesn’t say is that that’s because he ordered the drugs from countries other than Canada, knowingly, despite the name of the website, which had the word Canada in it. As I wrote in the Bangor Daily News, the online pharmacy, which is one approved by PharmacyChecker.com, required prescriptions and dutifully sent the safe prescription products ordered, ones dispensed by licensed pharmacists. If Mac had ordered brand versions from Canada, Australia, New Zealand, or the UK then that’s what he would have received. It’s not a secret that real Canadian online pharmacies partner with licensed pharmacies in other countries.

Mr. McCall questioned the integrity of PharmacyChecker.com by noting that we have a Verification Program fee for our online pharmacy program. That’s true. Learn about it here. His misleading implication is that PharmacyChekker.com is pay-to-play and should not be trusted. Does that apply to the online pharmacy verification program supported by drug companies and U.S. chain pharmacies? You can also learn about the higher VIPPS Program fees of the National Association of Boards of Pharmacy, the group that PSM encourages consumers to look to for online pharmacy safety. NABP’s fees are not only higher but the drug prices of its online pharmacy members are often out of reach for Americans. What Mac either doesn’t know (and this is likely) or doesn’t’ want you to know is that PharmacyCheker.com approves only those online pharmacies that meet our standards. According to the presentations at PSM, there are about 40,000 online pharmacies – most of them rogue! There are only 52 international online pharmacies in our program.  Apparently over 99% of online pharmacies don’t meet our standards. That seems pretty selective: the opposite of pay-to-play scheme.

Finally, Mr. McCall’s presentation wrongly conflates CanaRx, the company that manages prescription benefit importation programs in Maine, with online pharmacies. CanaRx is not an online pharmacy. It’s worth noting that CanaRx is also not a member of PharmacyChecker. That Canadian-based group has served Maine residents for over a decade with what any objective observer would find to be safe mail-order pharmacy services that have helped municipalities, companies and consumers save millions of dollars. This attack by Mr. McCall makes clear that the target is not just “online pharmacies” but any personal drug importation that might negatively affect the U.S. pharmacy members of the Maine Pharmacy Association.

That gets us to a third panelist; Tod Brown, Executive Director, Massachusetts Independent Pharmacists Association. I was utterly astonished by Mr. Brown’s presentation. In apparently trying to disparage the pharmacy services of CanaRx, Mr. Brown set about explaining how self-insured groups and municipalities save a lot of money in a very organized fashion by working with CanaRx, which helps broker prescription sales from licensed pharmacies in Australia, Canada, New Zealand, and the United kingdom. If that business model of safe personal drug importation spreads, international online pharmacies could become less relevant.

I’m out of time for the day but I’ll resume detailing who’s who in this Lion’s Den in a Part II. The bottom line about PSM is that a big part of its focus is opposing drug importation legal reform that would help lower prices for Americans; promoting and funding groups, policies and actions that curtail access to safe international online pharmacies; and encouraging the demonization of companies and individuals who sell real (not counterfeit) medications from foreign pharmacies to Americans at lower prices than available locally. Ignoring, or denying, the safety of PharmacyChecker-approved international online pharmacies does not make them not safe.  No matter what The Party (or PhRMA) might say, 2+2=4.