"Convenience" isn't a word most people would apply to purchasing prescription medications.
With doctors writing more prescriptions than ever--a record 2.2 billion last year in the United States--long waits at drugstore pharmacy counters are commonplace. And managed-care restrictions on the amount of medicine you can buy--often just a 30-day supply--can mean frequent trips to the store.
But the emergence of online pharmacies may offer salvation to consumers sick of the drugstore rat race.
Following on the heels of other e-commerce success stories, both entrepreneurs and drugstore chains are racing to establish online pharmacies. By one unofficial count, the number of such pharmacies has soared this year from a couple dozen to more than 400.
"Within the last six months, it has really exploded," said Carmen Catizone, executive director of the National Assn. of Boards of Pharmacy, a professional association representing all state pharmacy boards. "A few people were beginning to look at online pharmacies last year. But over the last holiday season, retailers saw how sales at such places as Amazon.com really took off. That's what got online pharmacies going."
While a clear boon to consumers--offering convenience, privacy and the opportunity to compare prices--the trend is not without serious problems. In particular, a growing number of online pharmacy sites will sell medications without a prescription, a development that could be unlawful and is widely viewed as unethical and dangerous.
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Lawmakers and health professionals have expressed concern that consumers will confuse legitimate, state-licensed "pharmacy-based" sites that require a doctor's prescription, with "prescribing-based" sites that dish out drugs for a price after a cursory cyberspace consultation.
"The Internet can be an extremely valuable medical resource under certain circumstances," said Dr. Herman Abromowitz of the American Medical Assn. in congressional testimony in July. "The AMA, however, is gravely concerned about the current misuse of the Internet for prescribing purposes. . . . Every day patients are endangered when they are permitted to receive prescription medications via the Internet without adherence to proper safeguards that ensure good medical practice."
Others are worried, too. The Federal Trade Commission, the National Assn. of Boards of Pharmacy, several states' attorneys general and executives for the nation's largest chain drugstores (such as CVS and Rite Aid) have called for heightened oversight of online pharmacies.
Even Pfizer, maker of the impotence remedy Viagra, has filed a complaint with the Federal Trade Commission (one of several state or federal agencies with some authority over Internet prescribing) to stop the prescribing of Viagra without adequate safeguards.
"The appropriate parties should just crack down on these people, and crack down hard because lives are at stake," said Mitchell Reed, vice president of brand strategy and communications for the new online pharmacy-based CVS.com. However, consumers can safely navigate online pharmacies with a little knowledge and common sense.
To begin, consumers--especially those without a lot of Internet experience--need to distinguish between the pharmacy-based and prescribing-based sites. Many online shoppers may be surprised to find that typing the words "online pharmacy" into a search engine will probably land them in the world of prescribing-based pharmacies.
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One such pharmacy offers eight popular medications to consumers willing to fill out a short personal health questionnaire and pay with a credit card. The available medications include Viagra, Propecia (for hair loss), Xenical (weight loss), Zyban (smoking cessation), Celebrex (arthritis treatment) and Preven (emergency contraceptive).
The transaction costs $75 for the consultation, which, the site attests, is reviewed by a doctor, plus fees for the medication (ranging from $105 for 10 50-milligram Viagra pills to $48 for one Preven kit) and overnight shipping charges of about $18. Shoppers are referred to other sites for information on what the medication does and who it is best suited for.
The risks in using these prescribing sites are overwhelming, said the AMA's Abromowitz. He said that the AMA objects to prescribing-based sites because of their failure to provide: 1) a patient exam; 2) dialogue with the patient; 3) completion of a reliable medical history; 4) patient information about the medication; and 5) follow-up with the patient on the outcome of the therapy.
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