Illegal online pharmacies ‘threat to public health’

A paper published by think-tank the Centre for Reform has warned of the dangers of unregulated online pharmacies and is urging the government to take seriously the problem of prescription drugs being ordered with no medical checks on the patient.

The paper, entitled ‘Online Pharmacy: Patient Choice or Patient Peril?’, a collation of speeches made in a seminar about the benefits and problems that come from online pharmacies, calls for numerous laws to be tightened and for public campaigns to be carried out about the danger of ordering prescription-only drugs from non-accredited sources.

Jim Thomson, chief executive of the Centre for Mental Health, strongly argued the case for tighter regulation after the death of one schizophrenia patient who had taken 23 prescription-only drugs, all ordered online: "I believe that it is perhaps the biggest current threat to public health. Yet in the UK, for example, this is not a top priority for law enforcement agencies, and the regulator is woefully underresourced."

According to Thomson, the main reason why people are drawn to online pharmacies and part of the danger is that it offers a convenient bypass for many people’s stigma attached with talking to one’s GP about mental health problems.

Thomson said: "I am angry with the bureaucrats, who sit on their hands and let it happen — or worse, who advise on legislation and policies that effectively encourage it."

David Pruce, director of Practice and Quality Improvement at the Royal Pharmaceutical Society of Great Britain, told E-Health Insider that there were already some measures in place to verify the legitimacy of the pharmacies. "All pharmacies out there online or bricks-and-mortar have to register as a pharmacy. We have a team of inspectors that inspect the premises."

"Where I think there is a problem is that the public find it difficult to know what is a legitimate pharmacy and what is a dodgy website."

According to Pruce, one of the simplest ways that the public can check a website’s credentials is by looking on the RPSGB’s website: "All online pharmacies must display the name of the place where they are working from. If you want to check out whether that site is legitimate, check the registration address with our website; people can easily do that online."

However, he recognised that not all patients would be aware of this, and that many might take a ‘.co.uk’ after the address as a guarantee that the site is based in the UK; which, of course, is no such thing.

"Pharmacy is quite well regulated," said Pruce, who agreed that an information campaign would be a good idea to raise awareness of the problem. "What we need is a way of helping the public to know what is a real, registered and regulated online pharmacy and what is a website based abroad."

Dr Julian Harrison, commercial director of Pharmacy2U Ltd, writing in the paper, concurred: "Patients may not realise this, or may be unwilling to ask if they are obtaining something that they want, legally or not. Thus they run the risk of purchasing medicine that might, frankly, be counterfeit or adulterated."

Nicholas Bromley, editor of the report, said in the report: "The natural first line of attack would be the illegal websites themselves… The Royal Pharmaceutical Society of Great Britain is working on a logo that would indicate that their website is registered." The logo and the need for pharmacies to register should be publicised widely; however, as Bromley pointed out, a simple image on a webpage could easily be copied by criminals.

"I don’t think anyone would say it would be an easy task," Bromley told E-Health Insider about how to minimise the risks posed by criminal outfits. "But there are some simple and direct things that can be done."

Bromley called for "a much more enthusiastic" approach by government to combat the problem. International actions were needed; for instance, holding countries with lax standards on dispensing prescription-only drugs to account through trade agreements.

Nevertheless, there is a growing need for online pharmacies as they serve needs traditional bricks-and-mortar establishments may not. "It can be said that one aspect of what the legitimate online pharmacy does is to help with stigma," said Bromley. "People are nervous and unconfident about going to their GP."

Face-to-face contact was still important, however. "Neither service is ever going to disappear."

Links

Centre for Reform