- The Washington Times - Tuesday, April 4, 2000

Having recently discovered the convenience of drive-through pharmacies, I am chagrined to learn that the truly high-tech shopper gets prescriptions filled on line.
Not that being high-tech is important, but anything to make life simpler is something I want to know about. However, a visit to a dozen or so virtual pharmacies shows that many sites are peddling "trendy" drugs that some shoppers might not want to admit to wanting when they are in a bona fide doctor's office.
Say you want to buy a weight-loss drug but don't want to hear a lecture about dieting from your general practitioner. Not a problem dozens of Web sites will sell fat-reduction drugs and other so-called "recreational" medications to anyone with a credit card.
Some on-line sites make it so easy they even provide virtual doctors who "diagnose" conditions such as impotence or hair loss. The consumer provides the health information or not and a prescription is ordered, filled and delivered in a day or so.
The whole transaction can take place without your ever needing to talk to a human being. No questions asked. No admonishments. No warnings about potential dangers of drug interactions or side effects. Also no guarantee of the quality of the merchandise.
At EPrescribe.com, for example, "board-certified" physicians save consumers the nuisance of making an appointment with a doctor and sitting in the waiting room, according to a blurb on the site's home page. The real laugh is that the site promises confidentiality, as if anything involving a credit card and electronic commerce could be kept secret. Tell that to the hackers who break into supposedly secure computer systems.
On-line pharmacies are available in abundance on the Internet and are beginning to attract significant sales, according to government and industry sources. Brick-and-mortar stores such as CVS are opening their own sites to keep pace with the competition. (CVS' site is one of a handful that meet the pharmaceutical industry's standards of scrutiny for on-line drug sales).
While on-line pharmacies offer some price savings and convenience, this is a marketplace where buyers have little recourse if mistakes are made. And the mistakes could be lethal.
As with most electronic commerce, legal supervision is scant. Some controlled substances, such as narcotics, may not be sold on line or shipped by mail order, but federal and state laws have little to say so far about regulating other aspects of on-line pharmacies.
Food and Drug Administration officials are concerned about the agency's inability to police this relatively new arena, where it is easy to hide illegal activity and disappear when authorities start an investigation.
The FDA, which wants more money to police on-line drug sales, recently told a congressional panel on "e-drugs" that many Internet pharmacies sell illegal versions of prescription drugs. Some sites sell non-FDA-approved concoctions for bodybuilding and experimental cancer therapies that pose a serious health threat to consumers.
"Individuals not licensed to sell prescription drugs can easily create Web sites that appear to represent legitimate pharmacies," Dr. Jane E. Henney said in testimony last month before the Senate Committee on Health, Education, Labor and Pensions. "Unlike other forms of electronic commerce, the unauthorized sale of prescription and unapproved drugs poses a potential threat to the health and safety of consumers," she said.
The FDA is asking Congress for a new outlay of $10 million to enhance its enforcement of illegal Internet drug sales. It also wants Congress to enact laws that would make it tougher for Internet pharmacies to operate. A starting point would be to require such sites to comply with the state and federal licensing laws that apply to brick-and-mortar stores.
Not all is gloom and doom with on-line pharmacies, FDA notes. Electronic commerce offers the chance for greater convenience, potentially lower costs and improved accuracy as doctors gain the ability to transmit prescriptions directly to pharmacies on line.
But the health risks are significant if consumers are not cautious. Just like the get-rich-quick schemes that proliferate on the Internet, many heavily promoted health remedies are useless.
As for the quality of on-line physician services, a recent New England Journal of Medicine report says many Web sites send patient information to doctors who are unlicensed to work in the United States and who get paid for the number of prescriptions they approve. The report also notes that some consumers have been duped into paying for drugs that are merely placebos.
"Health fraud on the Internet is a huge problem," says Holly Anderson, spokeswoman for the National Consumers League, a District-based nonprofit group that researches consumer issues. The league recommends that shoppers who want to use on-line pharmacies check with the National Association of Boards of Pharmacy to see if the Web site is among those that meet the group's seal of approval.
The American Medical Association suggests that consumers avoid any Web sites that offer to dispense drugs without a physician's prescription.
Have a question on work or family finances? Get in touch with Anne Veigle at 202/636-3014 or e-mail evie1@infi.net.

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