- The Washington Times - Sunday, January 20, 2002

The growth of e-commerce has meant consumers can point and click to get anything from home furnishings to groceries to prescription drugs. Online drug shopping offers convenience, privacy and, in some cases, lower prices.

But some of those consumers may be paying a greater price with their health and their wallet if they are not careful.

A great deal of the sites are legitimate drugstores, and consumers can use those sites with the same confidence they would their neighborhood pharmacies. But a number of what the Food and Drug Administration calls "rogue sites" sell unproven products or sidestep established procedures meant to protect consumers.

Some of the rogue sites, for example, may require a customer to only fill out an online questionnaire rather than have a face-to-face consultation with a medical professional before filling the prescription.

"Some drugs are available by prescription only for a reason," says Dr. Eric Brass, professor of medicine at the University of California at Los Angeles and a former chairman of the FDA's nonprescription drug committee. "Bypassing an assessment by an appropriate health care professional means the consumer may be given a drug that will not treat their condition, or may expose them to avoidable potential adverse effects."

At a legitimate online pharmacy, users open an account and submit credit and insurance information. Consumers must then submit a valid prescription. This can be delivered by fax or mail or a doctor can call it in. Sites typically have a toll-free number or e-mail address where users can contact a pharmacist.

Many of the unethical sites specialize in drugs such as Viagra (impotence). Propecia (baldness) or Xenical (weight loss), says Jeffrey Shuren, a medical officer of the FDA's Office of Policy, Planning and Legislation. Others are based in foreign countries and may feature prescriptions at a much cheaper cost than in the United States. The FDA warns, however, those drugs may be a different formula or may be expired.

A 1999 study by researchers at the University of Pennsylvania tracked Internet sales of Viagra and Propecia on 46 Web sites. The study found that 37 of the sites required a prescription or an online questionnaire. Nine sites, all based outside the United States, required no prescription or medical recommendation.

Researchers Bernard Bloom and Ronald Iannocone were also concerned that with sites requiring a questionnaire, there was no way to prove a doctor actually reviewed the information and no way to check whether a consumer was providing false information.

The FDA offers these tips to avoid dealing with unethical pharmacies:

• Check with the National Association of Boards of Pharmacy (www.nabp.net or 847/698-6227) to see if a Web site is a licensed pharmacy in good standing.

• Do not do business with a site that offers to sell you drugs for the first time without a physical exam or a prescription from a doctor. Also, be wary of a site that does not offer access to a pharmacist for questions.

• Beware of sites that offer "amazing results" or a new cure for an ailment.

• Do not buy from foreign sites because it is generally illegal to import drugs bought from these sites. It also is more difficult for the U.S. government to help if you get ripped off.

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