MDA / Quest Vol 10 No 5 /Buying Online from U.S. Pharmacies

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QUEST Volume 10, Number 5, SEPT./OCT. 2003

BUYING ONLINE FROM U.S. PHARMACIES

General Information

U.S. Internet pharmacy sites are a mixed bag. On the plus side, prices overall are lower than at standard pharmacies from 10 percent to 50 percent depending on the drug. In addition, the sites offer privacy and convenience versus driving, parking and waiting in line.

Many chain drugstores, like Costco, Kmart or CVS, have online pharmacies that sometimes offer even lower prices than their brick-and-mortar outlets. (Some stores will match this discount if asked.)

Even William Hubbard, associate commissioner for the FDA, has stated, "Prescription drugs sales over the Internet can provide tremendous benefits to consumers."

But theres a downside. Many online pharmacies have sprung up like mushrooms in the night and should be scrutinized before you bite. Particularly prevalent are pharmacies that specialize in "lifestyle" medications such as sexual enhancement, hair growth, herpes, smoking cessation and weight loss. Most of these pharmacies will write you a prescription sight unseen, as a way to "save you embarrassment."

"Steer clear" of online prescriptions and sites that dont require prescriptions, advise both the FDA and American Medical Association. The AMA says online prescribing doesnt provide "minimum standards of care," which include examining a patient, discussing the prescription and following up to see how things went. In addition, these sites often dont list a physical address, just an e-mail address, making it difficult to track them down if you have problems. Sites that dont require prescriptions usually are foreign-based, and the drug quality may be compromised.

PharmacyChecker.com, an Internet site that evaluates online pharmacies, estimates that of the 300 to 400 sites now in business, about half are located in the United States, and about half arent properly licensed (see "Warnings and Guidelines," below).

But if you take time to check out a site carefully, following the guidelines below, reputable online pharmacies can provide real savings in money, time and effort.

Warnings and Guidelines

PharmacyChecker.com surveyed 12 sites in April and evaluated how well they fulfilled these five key criteria for a good site:

Verified pharmacy license (50 percent werent licensed)
Privacy policy protecting personal information (33 percent didnt have)
Verified, posted physical address and telephone number (42 percent lacking)
Security of online financial transactions (17 percent not secure)
Requirement of an original prescription (33 percent didnt require)

Beware of additional fees, such as high shipping charges, and medical, order and account set-up fees.

The National Association of Boards of Pharmacy (NABP) offers companies that meet its strict standards (and pay a fee) a Verified Internet Pharmacy Practice Sites (VIPPS) seal of approval to display on the site. So far, only 12 sites have applied for the seal and are listed at www.nabp.org. NABP isnt a government agency.

Online Resources

Online price comparison sites:

www.PharmacyChecker.com

www.DestinationRx.com

www.Pillbot.com
To report suspect online pharmacies, go to the FDA site, www.fda.gov, and look for "Report a Problem with a Product."

For more online pharmacy guidelines, check with the FDA or NABP.

SPOTLIGHT

Dorothy Lois Harris, 66, of Dunlap, Tenn., and her husband, Mack, scrimp by on Social Security, Medicare and their small ministerial annuities. Found in 1999 to have hyperkalemic periodic paralysis, Dorothy is battling the Teachers Insurance and Annuity Association for disability pay but hasnt seen a penny yet.

Dorothy spends $505 every three months at Drugstore.com (www.drugstore.com) for prescriptions and over-the-counter supplements to help her heart, pain, hormones and the intermittent paralysis that leaves her incapacitated for days, weeks and sometimes months at a time. Mack also takes $450 in medication every three months following heart bypass surgery.

After comparing online prices at Rite Aid, CVS and Wal-Mart, Harris chose Drugstore.com, where she estimates she saves from 25 percent to 33 percent over her local drugstore. Although she knows she could save even more in Canada, she worries about getting exactly the same drugs. Her online savings outstrip either of the two discount drug cards she carries — Save Rx and Together Rx — but shes still nervous about the future.

"I fear that our ability to buy needed medications is coming to an end. Our income shrinks each year and all our costs are quickly going up."

ONLINE PRICES VERSUS RETAIL OUTLETS
PRESCRIPTION¹	TARGET Pharmacy² Retail Outlet	WAL-MART Pharmacy² Retail Outlet	AMERICA Rx Amercarx.com Free shipping over $60	FAMILY MEDS Familymeds.com Free shipping
Glucophage (diabetes) 500 mg, 100 pills	$79.39	$77.72	$75	$62.87
Diltiazem (generic) (high blood pressure) 240 mg, 30 pills	$52.99	$47.36	$37.80	$32.87
Neurontin (seizures, pain) 100 mg, 30 pills	$19.99	$24.54	$13.20	$14.87
Lipitor (high cholesterol) 10 mg, 45 pills	$94.50	$94.50	$92.25	$88.20
TOTAL	$246.87	$244.12	$218.25	$198.81

¹Prices based on same barnd, dosage and number of pills. Per-pill prices have been rounded off.
²Prices based on Arizona retail outlets.

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