Current Online-Pharmacies News Results

Medications from the Web: Use of Online Pharmacies by Emergency Department Patients.

J Emerg Med. 2010 Jul 23;
Mazer M, Deroos F, Shofer F, Hollander J, McCusker C, Peacock N, Perrone J

BACKGROUND: Internet access and online pharmacies are a resource for purchasing medications. It is unclear if this venue is being used by emergency department (ED) patients to obtain medications. OBJECTIVE: We sought to determine the frequency of and to characterize online pharmacy use by ED patients. We hypothesized that students and younger patients would be more likely than others to obtain medications via online pharmacies due to their familiarity with the Internet. METHODS: This prospective, cross-sectional survey occurred in an urban university ED. We enrolled a convenience sample of adult patients. The study was Institutional Review Board approved, and informed consent was obtained. To determine differences between online pharmacy users and non-users, chi-squared or Fisher's exact tests were used for categorical data, and t-test or Wilcoxon rank sum tests were used for continuous variables. RESULTS: There were 1657 patients who completed the survey. The mean age was 39 years, standard deviation 16 years; 947/1657 (57%) reported awareness of online pharmacies; 89/1657 (5.4%) patients used the Internet to order medications. More patients with prescription plans ordered medications from online pharmacies (94.3% vs. 70%; p<0.0001), and Internet users were more commonly on multiple medications (median 3 vs. 1; p<0.0001). There was no difference in age (39.4 vs. 41 years; p=0.2) or student status (13.8% vs. 14.9%; p=0.8) between the two groups. CONCLUSIONS: Approximately 5% of ED patients used the Internet to obtain medications. Contrary to our hypothesis, younger patients were not more likely to use the Internet for medications. Patients on multiple medications and those with prescription plans used online pharmacies more frequently.

"Save 30% if you buy today". Online pharmacies and the enhancement of peripheral thinking in consumers.

Pharmacoepidemiol Drug Saf. 2010 Sep; 19(9): 970-6
Orizio G, Rubinelli S, Schulz PJ, Domenighini S, Bressanelli M, Caimi L, Gelatti U

PURPOSE: Online pharmacies (OPs) are recognized as a potential threat to public health. The growth of an unregulated global drugs market risks increasing the spread of counterfeit medicines which are often delivered to consumers without a medical prescription. The aim of the study was to assess the strategies of argumentation that OPs adopt in their marketing. METHODS: A sample of 175 OPs was analyzed using the content-analysis method, and evaluated by relying on the Elaboration Likelihood Model (ELM) of persuasion. RESULTS: Almost 80% of the sample of OPs did not ask for a medical prescription by the consumer's physician. The selling arguments used included privacy policy, economic, quality, and service issues. About one-third of the OPs did not declare any side-effects regarding the drugs offered. CONCLUSION: Our results show that OPs advertise their products in an argumentative fashion that enhances consumers' peripheral reflection: by analogically playing with the selling of other commodities, they magnify aspects of the online trade that consumers might find convenient, but overshadow the nature and risks of the actual products they sell. Copyright (c) 2010 John Wiley & Sons, Ltd.

'Fatal 2,4-dinitrophenol poisoning... coming to a hospital near you'.

Emerg Med J. 2010 Aug; 27(8): 639-40
Siegmueller C, Narasimhaiah R

An adult man was brought into the emergency department after deliberate ingestion of dinitrophenol: an agent that uncouples mitochondrial oxidative phosphorylation. The patient rapidly developed a hyper-metabolic state with fever, respiratory failure and died within a few hours after admission. Dinitrophenol is used in the manufacture of dyes, pesticides and explosives. Sub-acute poisoning is associated with weight-loss and the substance had been prescribed for this purpose during the 1930s in the United States before being banned due to serious side effects. Although remaining unlicensed as a drug, dinitrophenol is widely available through mail-order websites and online pharmacies, which promote it as an anti-obesity treatment. This case highlights the need for awareness of possibly increasing rates of accidental poisoning with a growing obesity prevalence and availability of this unlicensed drug through the internet. Additionally, we discuss the use of dantrolene in dinitrophenol poisoning and question whether current Toxbase/UK National Poison Information Service treatment guidelines regarding the indication and dosing of this drug, the only relatively specific treatment in dinitrophenol poisoning presently recommended, could be revised.

Hormone replacement therapy advertising: sense and nonsense on the web pages of the best-selling pharmaceuticals in Spain.

BMC Public Health. 2010; 10: 134
Chilet-Rosell E, Llaguno MM, Cantero MT, Alonso-Coello P

BACKGROUND: The balance of the benefits and risks of long term use of hormone replacement therapy (HRT) have been a matter of debate for decades. In Europe, HRT requires medical prescription and its advertising is only permitted when aimed at health professionals (direct to consumer advertising is allowed in some non European countries). The objective of this study is to analyse the appropriateness and quality of Internet advertising about HRT in Spain. METHODS: A search was carried out on the Internet (January 2009) using the eight best-selling HRT drugs in Spain. The brand name of each drug was entered into Google's search engine. The web sites appearing on the first page of results and the corresponding companies were analysed using the European Code of Good Practice as the reference point. RESULTS: Five corporate web pages: none of them included bibliographic references or measures to ensure that the advertising was only accessible by health professionals. Regarding non-corporate web pages (n = 27): 41% did not include the company name or address, 44% made no distinction between patient and health professional information, 7% contained bibliographic references, 26% provided unspecific information for the use of HRT for osteoporosis and 19% included menstrual cycle regulation or boosting feminity as an indication. Two online pharmacies sold HRT drugs which could be bought online in Spain, did not include the name or contact details of the registered company, nor did they stipulate the need for a medical prescription or differentiate between patient and health professional information. CONCLUSIONS: Even though pharmaceutical companies have committed themselves to compliance with codes of good practice, deficiencies were observed regarding the identification, information and promotion of HRT medications on their web pages. Unaffected by legislation, non-corporate web pages are an ideal place for indirect HRT advertising, but they often contain misleading information. HRT can be bought online from Spain, without a medical consultation or prescription constituting a serious issue for public health. In our information society, it is the right and obligation of public health bodies to ensure that such information is not misleading.

Online consultations in cyberpharmacies: completeness and patient safety.

Telemed J E Health. 2009 Dec; 15(10): 1022-5
Orizio G, Schulz P, Domenighini S, Bressanelli M, Rubinelli S, Caimi L, Gelatti U

Many online pharmacies that serve as a substitute for original or personal medical prescriptions use a health questionnaire for consumers to complete on their Web site for buying prescription-only medicines. A content analysis of online medical questionnaires from a sample of online pharmacies (OPs) examined their completeness. Fifty-seven questionnaires were identified in which online pharmacies sought health status assessment from online purchasers. To evaluate the questionnaires, a checklist tallied their characteristics, including general features, medical history requested, and involvement of the consumer's doctor. Drug allergies were queried in 55 OPs (96.5%) and other allergies in 40 (70.2%). All of the questionnaires asked whether the consumer had suffered or was currently suffering from a particular illness, but a question about past surgery was present in 23 sites (40.3%) only; 40 sites (70.2%) asked women if they were pregnant or breastfeeding. Only 30 pharmacies out of 57 (52.6%) asked if the consumer's family doctor was aware of his/her intention of buying online and an even lower percentage (19.3%) asked if the purchase was based on a medical diagnosis rendered by a physician. Less than 20% of the pharmacies asked for the name, address, or telephone number of the consumer's family doctor. The results confirm the inadequacy of online pharmacy medical questionnaires in the assessment of health status for prescribing drugs. The results suggest that these questionnaires aim more at giving the consumer a false sense of health assurance than performing an effective assessment of his or her health status relative to the drug purchase.

Search engines continue to advertise rogue online pharmacies.

BMJ. 2009; 339: b3457
Siva N

Marketing and pricing strategies of online pharmacies.

Health Policy. 2009 Oct; 92(2-3): 187-96
Levaggi R, Orizio G, Domenighini S, Bressanelli M, Schulz PJ, Zani C, Caimi L, Gelatti U

Internet and e-commerce have profoundly changed society, the economy, and the world of health care. The web offers opportunities to improve health, but it may also represent a big health hazard since it is a basically unregulated market with very low consumer protection. In this paper we analyze marketing and pricing strategies of online pharmacies (OPs). Our analysis shows that OPs use strategies that would be more suitable for a commodity market than for drugs. These strategies differentiate according to variety (brand or generic), quality, quantity, and target group. OPs are well aware that the vacuum in the legislation allows them to reach a target of consumers that pharmacies cannot normally reach, such as those who would like to use the drug without consulting a physician (or, even worse, against the physician's advice). In this case, they usually charge a higher price, reassure the users by minimizing on the side effects, and induce them to bulk purchase through sensible price discounts. This analysis suggests that the selling of drugs via the Internet can turn into a "public health risk", as has been pointed out by the US Food and Drug Administration.

Prescription drug misuse: is technology friend or foe?

Drug Alcohol Rev. 2009 Jan; 28(1): 81-6
Nielsen S, Barratt MJ

INTRODUCTION AND AIMS: Prescription drug misuse and related harms have been increasing considerably over the past decade. At the same time, there has also been rapid growth in the use of online and Internet technologies. Thus, it is important that we understand the role online and Internet technologies play in prescription drug misuse. DESIGN AND METHODS: Published work addressing the role of technology in prescription drug misuse is explored. Topics include: Internet supply, online monitoring of prescription drug use trends and electronic prescription monitoring. RESULTS: Little is known about the prevalence of acquiring prescription drugs from online pharmacies. Prescription drugs are easily accessible through vendor websites, and 'rogue' no-prescription websites have proven difficult to control. There has so far been limited application of real-time monitoring to prevent overuse of prescription medications. Online monitoring of drug use trends may also prove to be a useful and timely source of information about new methods of 'off-label' prescription drug use. DISCUSSION AND CONCLUSIONS: Technology has the potential to play a more prominent role in facilitating drug acquisition, while also enhancing the monitoring and prevention of prescription drug misuse. As technology becomes more ubiquitous in everyday life, the continued investigation of its relationship with prescription drug misuse becomes even more important.

The potential dual use of online pharmacies.

Sci Eng Ethics. 2010 Mar; 16(1): 59-75
Letkiewicz S, Górski A

The technological advances of the 20th century resulted in the creation of the Internet and its introduction into everyday life on a global scale. The Internet provides access to information and the sale and purchase of goods. Medications are also subject to trade. Their sale is conducted by online pharmacies and their global turnover amounts to hundreds of billions of dollars. Medications ordered over the Internet are sent by mail all over the world. Considering the events of recent years, we cannot exclude the risk of a terrorist attack through online pharmacies. Terrorists can establish such companies, legally or illegally, or acquire ones already existing. Parcels, which are highly trusted by the customers of online pharmacies, can, for example, be contaminated with dangerous materials. The sale of online medications in the international system is potentially dangerous and requires international regulation.

Cyberdrugs: a cross-sectional study of online pharmacies characteristics.

Eur J Public Health. 2009 Aug; 19(4): 375-7
Orizio G, Schulz P, Domenighini S, Caimi L, Rosati C, Rubinelli S, Gelatti U

As e-commerce and online pharmacies (OPs) arose, the potential impact of the Internet on the world of health shifted from merely the spread of information to a real opportunity to acquire health services directly. Aim of the study was to investigate the offer of prescription drugs in OPs, analysing their characteristics, using the content analysis method. The research performed using the Google search engine led to an analysis of 118 online pharmacies. Only 51 (43.2%) of them stated their precise location. Ninety-six (81.4%) online pharmacies did not require a medical prescription from the customer's physician. Online pharmacies rise complex issues in terms of patient-doctor relationship, consumer empowerment, drug quality, regulation and public health implications.

Patient-oriented methotrexate information sites on the Internet: a review of completeness, accuracy, format, reliability, credibility, and readability.

J Rheumatol. 2009 Jan; 36(1): 41-9
Thompson AE, Graydon SL

OBJECTIVE: With continuing use of the Internet, rheumatologists are referring patients to various websites to gain information about medications and diseases. Our goal was to develop and evaluate a Medication Website Assessment Tool (MWAT) for use by health professionals, and to explore the overall quality of methotrexate information presented on common English-language websites. METHODS: Identification of websites was performed using a search strategy on the search engine Google. The first 250 hits were screened. Inclusion criteria included those English-language websites from authoritative sources, trusted medical, physicians', and common health-related websites. Websites from pharmaceutical companies, online pharmacies, and where the purpose seemed to be primarily advertisements were also included. Product monographs or technical-based web pages and web pages where the information was clearly directed at patients with cancer were excluded. Two reviewers independently scored each included web page for completeness and accuracy, format, readability, reliability, and credibility. An overall ranking was provided for each methotrexate information page. RESULTS: Twenty-eight web pages were included in the analysis. The average score for completeness and accuracy was 15.48+/-3.70 (maximum 24) with 10 out of 28 pages scoring 18 (75%) or higher. The average format score was 6.00+/-1.46 (maximum 8). The Flesch-Kincaid Grade Level revealed an average grade level of 10.07+/-1.84, with 5 out of 28 websites written at a reading level less than grade 8; however, no web page scored at a grade 5 to 6 level. An overall ranking was calculated identifying 8 web pages as appropriate sources of accurate and reliable methotrexate information. CONCLUSION: With the enormous amount of information available on the Internet, it is important to direct patients to web pages that are complete, accurate, readable, and credible sources of information. We identified web pages that may serve the interests of both rheumatologists and patients.

Impact of Internet pharmacy regulation on opioid analgesic availability.

J Stud Alcohol Drugs. 2008 Sep; 69(5): 703-8
Boyer EW, Wines JD

OBJECTIVE: Access to prescription opioid analgesics has made Internet pharmacies the object of increased regulatory scrutiny, but the effectiveness of regulatory changes in curtailing availability of opioid analgesics from online sources has been not assessed. As part of an ongoing investigation into the relationship between the Internet and substance abuse, we examined the availability of prescription opioid analgesics from online pharmacies. METHOD: From a pharmacy watch Web site, we constructed a data set of postings entered every 3 months beginning November 1, 2005, that were related to the purchase of prescription opioid analgesics. Trained examiners assessed whether the final post described accessibility of pain medications that was increasing or decreasing. RESULTS: We identified 45 threads related to the availability of opioid analgesics from Internet pharmacies. Of the 41 (91%) threads describing the declining availability of opioid analgesic agents from Internet pharmacies, 34 (82%) received posts on November 1, 2007. Despite the subjective nature of the research question, there was high interobserver agreement between coders (kappa= .845) that availability of opioid analgesics from online pharmacies had decreased. This finding was supported by a dramatic rise in the number of pageviews (an accepted measure of Web site visitor interest in a page's content) of Web pages describing decreased availability of opioid analgesics. CONCLUSIONS:These data suggest striking decreases in the availability of prescription opioid analgesic pharmaceuticals. This self-reported change in drug availability may be related to increased regulation of and law enforcement operations directed against Internet pharmacies.

State prescription drug price Web sites: how useful to consumers?

Res Briefs. 2008 Feb; 1-16
Tu HT, Corey CG

To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches.

Critical factors for assessing service quality of online pharmacies: a research framework.

Int J Electron Healthc. 2006; 2(4): 398-414
Lin B, Hsieh CT

There is a rapid growth of research on the online pharmacy and applications of the internet to pharmaceutical services. Increased data access to the general public has given rise to a class of sophisticated pharmaceutical consumers. With experienced and sophisticated consumers, rendering quality service is a key for online pharmacies. This paper identifies several key dimensions of service quality with a research framework for guiding online pharmacy systems' development and evaluation.

An examination of selected drug availability at online pharmacies.

Int J Electron Healthc. 2005; 1(3): 291-302
Koong KS, Koong LY, Liu LC, Yu M

According to the literature, prescription cost and convenience are generally regarded as the most important reasons for buying online. This study examines the availability of selected prescription drugs at some of the online pharmacies in the USA. Specifically, the drugs examined are among the ten most often prescribed by physicians.

Mapping e-health strategies: thinking outside the traditional healthcare box.

Int J Electron Healthc. 2005; 1(3): 261-76
Wen HJ, Tan J

E-health has evolved and emerged in many forms; for instance, prescription refills, appointment scheduling, online billing, online medical records, and patient provider communications. Among other marketable e-health strategic applications, the use of e-health information has proliferated and has been presented in the form of content-only health gateways, physician directories, physician-only sites, and online pharmacies. The adoption of the web as an e-health medium has caused both traditional and e-healthcare providers to rethink and experiment with innovative ways of providing healthcare services. The e-providers who can effectively market themselves on the web will have a distinct advantage. At this time, a lot of education appears to be needed in this field in order to ensure that key players in this arena are contributing to the growth and success of e-health. In this paper, we present a general framework for mapping e-health strategies based on e-health business structures and their value proposition. Such e-health systems may be designed to meet the needs of e-stakeholders and for gaining competitive advantages. We believe that by opening up this line of discussion, it will provide future-orientated healthcare executives and entrepreneurs with useful insights into feasible e-health strategic solutions and their commercial potentials.

'Uppers' keep going up.

Br J Psychiatry. 2007 Oct; 191: 279-81
Ghodse H

Amphetamine-type stimulants are the second most widely used drugs in the world. Overprescription results in diversion for recreational use and the development of dependence. The internet plays a significant role in global misuse of amphetamine-type stimulants, permitting uncontrolled dispensing by online pharmacies and providing information on techniques for illicit manufacture.

Online pharmacies: safety and regulatory considerations.

Int J Health Serv. 2007; 37(2): 279-89
Montoya ID, Jano E

Sales of consumer products over the Internet have grown rapidly, including sales of pharmaceutical products. Online pharmacies mimic mail order pharmacies. To operate legally online, pharmacies must be licensed in every state in which sales occur. Although online pharmacies provide benefits to consumers, when compared with traditional pharmacies patients' safety may be compromised. Purchasing prescription drugs online may pose a risk to consumers because they cannot tell whether the site is offering drugs of the same quality offered by a retail pharmacy. There is also a possibility that prescription drugs purchased online may be counterfeit, illegal, or unapproved. A U.S. General Accounting Office study conducted in June 2004 showed that most counterfeit and unapproved drugs sold online are from non-U.S. pharmacies. The Food and Drug Administration and other government agencies have worked to enforce laws on drug sales over the Internet. The biggest challenge in regulating non-U.S. pharmacies is due to their off-shore location. Unfortunately, given the widespread anonymous and ever-changing nature of the Internet, it is very difficult to close down illegal websites.

Drugs: just a click away. Online pharmacies can make dangerous drugs easy to get, but also can promote better health care. Should we regulate them?

State Legis. 2007 Jun; 33(6): 45, 47, 49
Brand R

[Evaluation of Brazilian online pharmacies]

Rev Saude Publica. 2007 Apr; 41(2): 297-300
Gondim AP, Falcão CB

The growing number of Internet users brought forth an increase in the search for Brazilian online pharmacy services. Aiming at evaluating the validity of information disseminated in these websites, a descriptive study was carried out in 18 virtual pharmacies concerning legal aspects, accessibility, sources of information and drug advertising. It was found 15 pharmacies did not have authorization of the Brazilian National Health Surveillance Agency; the manager pharmaceutical officer's name could not be found in 17 of them; 17 pharmacies marketed drugs with no registration, especially herbal medicines, and did not show either information on adverse drug reactions or this agency's alerts and health recommendations. Since health control and drug commerce in Brazilian online pharmacies have not been yet regulated by proper government agencies, these gaps found in the sites can pose risk to the users' health.