Beware of online drug dealers

A SECOND wave of fly-by-night medical sites claiming to sell popular drug treatments at low prices to anyone with a computer and credit card is afflicting the online medical trade. The internet annually accounts for about $1.1bn(£700m) in medicine sales through legitimate websites, but no-one knows how many sales are made via rogue websites that offer brand-name medications with no advance prescription.

Three years ago, when questionable online pharmacies first came to attention, most were based in the US or aimed at an American audience. One Mexican routinely prescribed anti-impotence drug Viagra to Americans he met only in cyberspace, while an Alabama couple built a $55m annual business selling the likes of Viagra, Celebrex and Propecia to international consumers who did not have valid prescriptions.

But now websites have gone global, moving offshore where they can more easily target consumers with less fear of detection by regulators whose jurisdications stop at their own borders.

Regulators believe rogue operators are lured by the ease of establishing drug-dispensing websites from foreign locations and a burgeoning market. Forrester Research estimates the online drug market will grow to $15bn by 2004 as consumers, doctors and businesses become more familiar with online ordering. 'These sites try to stay one step ahead of law enforcement,' said the US Food and Drug Administration's Tom McGinnis, director of pharmacy affairs. 'They change their name, then change the server, making them very hard to track.'

Consumers in the US and Britain may be lured by the prospect of avoiding a time consuming visit to the doctor but should be wary of any site that offers a drug and writes the prescription without seeing a physician, say health experts.

One website DirectMed recently sent random offers to customers in the US and European Union promising fast delivery of global top-sellers Viagra, Paxil, Claritan and Prozac among a dozen other often-prescribed drugs. DirectMed's home page claims to have qualified medical staff standing by to write the prescription based on customer answers to an online medical questionnaire. However, there is no way to contact the operators of the site - which ships drugs overnight by Federal Express - to find out if the 'doctors' reading the questionnaires are licensed or to discover where they live.

McGinnis, who has received complaints relating to 4,000 websites in two years, works closely with Britain's Ministry of Health to track down rogue sites targeted at US and UK consumers.

One problem for regulators is differing licensing rules. In America, for example, it is not illegal in some states for doctors to prescribe medicine over the internet without seeing the patient first, even though medical authorities and the FDA strongly advise against it.

One way to tell whether the site is legitimate is if there are contact numbers and addresses and names that can be verified. 'If there is no phone number or listing of the place of business, you put yourself at risk if you order a medication from them,' said McGinnis. 'The drugs are of unknown quality.'

Price watch

CONSUMERS tend to think online pharmacies provide a cheap alternative to bricks-and-mortar stores but that is not always the case. DirectMed offers a month's supply of GlaxoSmithKline's anti-anxiety treatment Paxil for $119, slightly higher than the rate at drugs stores. Add in a $75 'consultation fee' and postage and the price soars to more than $6 per dose, double the usual cost. An investigation of the 20 best-selling drugs by Canadian newspaper The Globe found all were cheaper to buy from conventional outlets.