Availability of Antibiotics for Purchase Without a Prescription on the Internet

We congratulate Dr. Mainous and his colleagues for addressing the issue of the purchase of antibiotics on the internet without a valid prescription. In addition to concerns about increasing antibiotic resistance, this practice places the consumer in danger of adverse drug events due to potentially inappropriate use of antibiotics (incorrect dose, duration, etc.). Furthermore, there are additional risks that arise with the consumption of counterfeit medications that may be sold by illegitimate pharmacies on the internet. Unfortunately, counterfeit medications may be contaminated with potentially dangerous substances, contain the wrong active ingredients, or contain no active ingredients at all.[1]

In 1999, the National Association of Boards of Pharmacy® (NABP®), along with support from consumer advocacy groups, and state, national, and professional associations, started the Verified Internet Pharmacy Practice Sites™ (VIPPS®) accreditation program for internet pharmacies.[2] In order to receive VIPPS® accreditation, an internet pharmacy must comply with licensing requirements of each state to which pharmaceuticals are dispensed. The accreditation process involves a thorough review of all policies and procedures and an on-site inspection of the facilities where medication is received, reviewed, and dispensed. Once accredited, these sites are allowed to display the VIPPS® Seal, which indicates that the pharmacy has met requirements to ensure authenticity and security of prescription orders and products, patient confidentiality, quality assurance, and consultation between pharmacists and patients. In 2009, the Vet-VIPPS™ program was launched as an expansion of the Verified Internet Pharmacy Practice Sites™ program in order to accredit facilities that dispense veterinary pharmaceuticals.[3]

A useful service for consumers provided on the NABP® website allows for a database search of internet pharmacies that are VIPPS® accredited. According to NABP®, a review of approximately 5,000 websites which sell medications on the internet has revealed that 95% are not in compliance with pharmacy laws and standards of practice.[4]

Although the purchase of medications on the internet can be risky, there is a mechanism by which consumers can identify reputable pharmacies to purchase medications from. Healthcare providers and patients alike should be made aware of the VIPPS® program offered by NABP® since it serves as a valuable resource to help improve medication safety with pharmaceuticals purchased on the internet. Additionally, the FDA allows consumers to report suspicious websites or unlawful sale of medicines on the internet via their website at [5]: http://www.accessdata.fda.gov/scripts/email/oc/buyonline/buyonlineform.cfm

References:

1. Counterfeit Medicines - Filled With Empty Promises [Internet]. Silver Spring (MD): U.S. Food and Drug Administration; 2009 [cited 2009 Dec 04]. Available from http://www.fda.gov/Drugs/ResourcesForYou/ucm079278.htm

2. VIPPS® Accreditation Program [Internet]. Mount Prospect (IL): National Association of Boards of Pharmacy®; 2009 [cited 2009 Dec 04]. Available from: http://www.nabp.net/index.html

3. Veterinary-Verified Internet Pharmacy Practice Sites™ [Internet]. Mount Prospect (IL): National Association of Boards of Pharmacy®; 2009 [cited 2009 Dec 04]. Available from: http://www.nabp.net/index.html

4. NABP Report Highlights Rise in Pharm Spam That Feeds Rogue Internet Industry [Internet]. Mount Prospect (IL): National Association of Boards of Pharmacy®; 2009 [cited 2009 Dec 04]. Available from: http://www.nabp.net/index.html?target=/vipps/consumer/listall.asp& 5. Reporting Unlawful Sales of Medical Products on the Internet. Silver Spring (MD): U.S. Food and Drug Administration; 2009 [cited 2009 Dec 04]. Available from http://www.fda.gov/Safety/ReportaProblem/ucm059315.htm

Competing interests:   None declared