Fake drugs, real worries
High prices and the Internet are making U.S. patients easy prey
Other pharmacies are doing similar deals. A Hollywood, Fla., man was informed by the Medicine Shoppe in Vancouver that the Lipitor he had ordered for his wife would take a little longer to ship: It was coming from Fiji. Small wonder the enterprising Qualtrade Pharmacies of Karachi, Pakistan, faxed this message to Internet pharmacies in Canada known to fill lots of U.S. scripts: "We have the pleasure to advice [ sic ] you that we are in a position to supply the drugs and medicine attached herewith of well known branded companies like Abbot [ sic ], Ely [ sic ] Lilly. . . . "
No one knows how many other Internet sites sell prescription drugs. One New York City investigative firm estimated that there are more than 1,400 Internet pharmacy sites. A consultant for Federal Express found 650,310 sites in a Web search where the FedEx brand was used on the same page as a list of the top 22 drug names. The Drug Enforcement Administration says there are 537 sites selling controlled substances. Many offer narcotics without a prescription by charging from $49 to nearly $200 for a "medical consultation fee," to have a doctor write a script for hydrocodone, Valium, or some other controlled substance.
False advertising. What is clear is that no matter how often Internet sites claim they will supply FDA-approved, Canadian, or any other type of drugs, there are no guarantees that the sites will deliver on their advertising claims. In July, for example, FDA investigators purchased drugs from a website advertising "Canadian Generics" that displayed a Canadian flag and offered "generic" Lipitor, Viagra, and Ambien, three brand-name products that have no generic equivalents. After ordering and analyzing them, the FDA found the drugs to be counterfeits. The registered owners of the websites were not in Canada but in China and Belize.
The sheer volume of drug packages entering the United States as a result of Internet ordering is crippling the FDA's ability to prevent unsafe or unapproved drugs from reaching consumers. "Before the price issue became so important," says William Hubbard, associate commissioner of policy and planning for the FDA, "people were buying mostly lifestyle drugs over the Internet, like Viagra. There was a much smaller number of packages. But in recent years the number of shipments has skyrocketed."
Drug parcels arriving at international mail facilities in the United States have been estimated at 10 million annually. But the number may be even higher, according to a study on prescription drug imports done for the Pharmaceutical Research and Manufacturers of America by Giuliani Partners, a consulting firm led by former New York City Mayor Rudolph Giuliani. At the mail center at JFK International Airport in New York, U.S. Customs officials told Giuliani that in March 2004, they received about 40,000 packages of suspected drug shipments for inspection each day. That adds up to 10.4 million per year at this facility alone--and the country has 13 others. Customs officials at the mail center in Miami told congressional investigators when they visited in March 2003 that the center routinely receives about 30,000 pharmaceutical shipments each day, or more than 7 million annually.