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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.

The policy, as articulated by VISA in cooperation with LegitScript, holds that an international online pharmacy can be operating safely, ethically, and legally where they operate but still be denied a merchant account for processing VISA card transactions. The main reason boils down to the technical federal restrictions on personal drug importation in the U.S. While millions do import medicine for their own use, under most circumstances, the FDA communicates that it’s not technically legal for them to do so. I write “technically” illegal because the federal government has never taken criminal enforcement actions against individuals for importing small quantities of prescription medication for their own use. About five million Americans buy medication for their own use from a foreign source each year due to high domestic drug prices. VISA is trying to make it harder by telling its merchant bank clients to cut service to pharmacies outside the U.S. that sell to Americans.

The Canadian International Pharmacy Association (CIPA), a trade association of Canadian pharmacies in the business of selling prescription medication internationally, recommends that Americans use personal checks instead of credit cards. That sounds like a reasonable idea to me.  Good old-fashioned checks of course don’t carry the heavy transaction fees of credit cards. Most people end up spending too much on credit card late fees anyway.

How do consumers view VISA’s policy? I’d like to share with you an email from a retired but still licensed physician in Florida, Michael M. Michaels, M.D.:

I ordered medication from [NAME OF ONLINE PHARMACY REDACTED] and offered to pay using a visa card. I was told “your government has prohibited visa credit cards from payments to Canadian pharmacies”…

Does your organization know anything about this? I also read on RxRights.com that our government is planning to “block” websites of Canadian pharmacies. This is stuff that is reminiscent of China or North Korea!! Is any of this legal and if so, is anything being done to prevent the obscene “lobbying” power of big pharma? Any comment from you would be appreciated.

 

Admittedly, I was pleased to read this intelligent outrage, but there are important caveats about the message that require discussion and clarification. I don’t believe the U.S. government has actually told VISA that its cards cannot be used to process prescription drug purchases from non-U.S. online pharmacies that sell to Americans, whether they are rogue or safe (but I’m not sure of this). More likely, we’re bearing witness to the neo-censorship efforts of what are referred to as “voluntary agreements” among private companies to self-censor. If you’re having trouble sleeping, you can read about all of this in my past congressional testimony. Basically, the Obama administration, through the White House Office of the Intellectual Property Enforcement Coordinator, leaned on Internet companies and other online “gatekeepers,” such as credit card companies and domain registrars, to voluntarily take on the problem of rogue online pharmacies, which they have lumped together with safe international online pharmacies.

Is the government actually planning to block foreign websites that sell medication to the U.S.? The drug companies would like that, and they do spend a couple hundred million bucks a year on lobbying — so you never know. And remember, the FDA has to do things to protect you (yes, even you diehard libertarians out there), such as warning about and shutting down clearly dangerous pharmacy websites. Had the Stop Online Piracy Act (SOPA)  passed, Pharma’s nefarious goals might have been achieved. The answer to the question, then, is “kind of” but it’s impossible to say how far they would go to shutdown safe access to affordable medication, knowing that there are bad public health ramifications for doing so.

Are VISA’s actions legal? I’m sorry to say it, but they probably are. I believe VISA can do business with, or not do business with, whomever they want. Due to the technical federal restrictions on personal drug importation VISA can rationalize it.

Why would VISA do this if they don’t “have to”? When it comes to “rogue” sites –  they might feel basic human responsibility to do the right thing. How about safe international online pharmacies? Because there are so few safe international online pharmacies, relative to the number of rogues, and the government and drug companies are not too happy about personal drug importation, VISA probably thinks – “what the hell, let’s just keep this simple to avoid potential problems.” The victim is the American consumer.

Finally, Dr. Michaels asks if there’s anything we can do about it? I’m happy to say YES! Keep working with RxRights to let our elected officials know that your votes will be swayed by this issue and they must help maximize access, online and off, to safe and affordable medication!

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