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.pharmacy domain to help consumers buy medicines online with confidence

Lin-Nam Wang reports on an initiative to provide a safe online space for buying medicines

By Lin-Nam Wang

Lin-Nam Wang reports on an initiative to provide a safe online space for buying medicines

Despite the authorities’ recent successes in closing down rogue websites selling medicines and in seizing counterfeit drugs (2013;291:3), the battle against the criminals goes on. “We’ve tried a number of ways to shut down the system but, as you can imagine, it can be very difficult,” said Carmen Catizone, executive director of the US National Association of Boards of Pharmacy (NABP).

Speaking at the World Pharmacy Congress in Dublin last week, Mr Catizone explained that the minute there is any sign of trouble, nefarious website operators will close the page or create a new page or change the look of the page. “The individuals behind these networks are very smart and will do whatever they can to mislead patients,” he said. A trick used to lull consumers into a false sense of security, for instance, is to put a UK or Canadian flag on the site when in fact customers are buying from China, India or eastern Europe.

The rogue website problem is serious. For example, a recent NABP review of over 10,000 websites showed that only 3 per cent were operating in compliance with US pharmacy laws, a statistic Mr Catizone called “sobering”. And the potential for patient harm is great, with reports of cases of spiralling blood pressure or uncontrolled diabetes because a medicine bought on the internet was fake or sub-dose. He pointed out, also, that many patients worry about reporting problems and getting into trouble because they have gone outside the system to buy their medicines. Many are also unaware they are giving their credit card details and medical history to unsecure sites and that information is being sold around the world.

Nevertheless, the supply of medicines via the internet seems here to stay. Generations are coming through that are more comfortable ordering things on their phone or iPad than doing things face to face. They are doing things on a global scale and regulators need to meet that big challenge, Mr Catizone warned. One strategy that has been adopted to do this is to persuade credit card companies to stop processing payments to dodgy sites, but this has had varied success.

Get your full copy of our special edition of FIP coverage, available as a downloadable pdf or as a mobile app (search for "Pharmaceutical Journal" at Google Play, Amazon or App Store) Erwin Kho www.zerbamine.nl

Global pharmacy community

An imminent strategy, however, looks promising: the NABP has successfully applied to the Internet Corporation for Assigned Names and Numbers (ICANN) to own and operate the generic top-level domain “.pharmacy”. This means that in a similar way to .gov or .edu, a coalition of pharmacy groups can issue the domain to any legitimate pharmacy or entity within the pharmacy distribution chain. “We hope that will separate for consumers the illegal sites from the legal sites. Illegal sites [will not be able to] obtain a .pharmacy registration. . . . ICANN will not allow anyone else to have a .pharmacy. It’s not something they can copy. They cannot mimic or create it. Everything in place on the internet prevents them from doing that,” Mr Catizone said. In addition, it is hoped that .pharmacy will create a global community because it will be available to any legitimate entity in any country where the regulator has worked with the NABP and the International Pharmaceutical Federation to establish parameters, which, in turn, will lead to uniform standards across the world, he said.

The plan is for the .pharmacy domain to be operational by the end of the year. Mr Catizone acknowledged that, having invested in .com or .org, some companies might be reluctant to use .pharmacy. However, he said the intention is that they would keep these domains and use .pharmacy as an identifier to direct to their original site. He said that the NABP is prepared to work with all countries willing to establish the global community. A document explaining how .pharmacy will be run and how sites will be screened is available at www.nabp.net.

Closer to home

In Great Britain the General Pharmaceutical Council runs an internet pharmacy logo scheme so consumers can identify legitimate sources of medicines but participation is voluntary and includes a fee.

Managing director of registered internet pharmacy Pharmacy2U Daniel Lee believes that pharmacies on the web need more regulation and better promotion of how to recognise safe sites. “It’s so easy now to create or copy a website, which ultimately puts patients at risk,” he told The Journal.

But things are changing. In Europe, under the Falsified Medicines Directive that came into effect this year, each member state is being asked to establish an online database of approved internet pharmacies. Each website will have to display a “common EU-approved logo” to show that it is entitled to supply medicines. A Medicines and Healthcare products Regulatory Agency spokesman told The Journal that “the logo and the means by which its authenticity is protected will be determined by the European Commission and specified in an implementing act. This will come into force one year after the date of publication. The logo is being negotiated at the European Commission.” He added that, in terms of the NABP plans, the MHRA is represented on the Alliance for Safe Online Pharmacies and will monitor developments.”

The GPhC, too, is awaiting further information from the NABP and said it is currently considering a number of issues in relation to the sale and supply of medicines via the internet as it develops new guidance for pharmacy about distance-selling.

Education, education, education

Although there will always be people willing to buy and sell medicines on eBay (2013;291:3), good consumer education should minimise this practice. Moreover, it could be argued that none of the above strategies will have a significant impact without education. There have been public campaigns such as Pfizer’s “Real danger” but pharmacists can also play a part.

RPS head of corporate communications Neal Patel said: “Internet pharmacies are obviously a useful route for people who perhaps would not ordinarily drop into a high street pharmacy. The important thing about buying online is that it is done as safely as possible. Pharmacists have an important role to play in guiding patients through the maze of options available to them on the web.”

RPS tips on buying medicines safely over the internet are given in the Panel. Looking for the .pharmacy domain will probably be added to such lists in future.

Advice for consumers

•    Look for the address of the pharmacy operating the website — it should be connected to a “bricks and mortar” pharmacy — and check it is registered at www.pharmacyregulation.org.
•    Reputable sites won’t supply a prescription medicine without a prescription.
•    Fake medicines can harm you. You can’t be sure what they contain.
•    Don’t buy medicines online without talking to a real health professional.

 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11125478

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