(Updated 2022) More and more people are buying medications online.
Residents of Maine are able to buy medications online from Canadian pharmacies legally again, after a period in which such sales were illegal. Maine residents are celebrating; Canadian drug prices are much lower than American ones. Other Americans might well be envious of Maine residents.
It’s hard to miss the terrifying stories about the high prices of Epipen injectors, or the skyrocketing prices exemplified by the Martin Shkreli scandal over the medication Daraprim. A terrific piece by Libby Rosenthal in The New York Times about the high prices of asthma medications might only reinforce the idea that buying overseas makes sense: An inhaler that costs $175 here is dispensed free in Britain; a nasal spray that costs $250 by prescription in Oakland costs $7 in Europe and is available over the counter.
For most U.S. citizens, buying prescriptions online from an overseas pharmacy is a questionable proposition: either the pharmacy seems untrustworthy, or the sites aren’t selling what you think they are. Also, it’s technically illegal unless you meet certain criteria — verifying in writing that it’s for your own use, no more than 3 months, no commercialization of the drug to U.S. residents– though enforcement seems to be spotty.
So you don’t live in Maine, and you are tempted to buy medications online to save money, from a Canadian or other online seller? Be careful. Who knows if they’re really selling what they say they’re selling?
Finding out if a site is legit
The FDA has a campaign called BeSafeRX giving advice about this topic. They say it’s legit if it:
- Always requires a doctor’s prescription
- Provides a physical address and telephone number in the United States
- Has a licensed pharmacist on staff to answer your questions
- Is licensed with a state board of pharmacy
It’s not legit, they say, if it:
- Does not require a doctor’s prescription
- Is not licensed in the United States and by your state board of pharmacy
- Does not have a licensed pharmacist on staff to answer your questions
- Sends medicine that looks different than what you receive at your local pharmacy, or arrives in packaging that is broken, damaged, in a foreign language, has no expiration date, or is expired
- Offers deep discounts or prices that seem too good to be true
- Charges you for products you never ordered or received
- Does not provide clear written protections of your personal and financial information, or sells it to other websites
The National Association of Boards of Pharmacy has a certification program called Verified Internet Pharmacy Practice Sites (VIPPS).
The VIPPS site says: “The safest way to purchase drugs online is through pharmacies accredited by the VIPPS or Vet-VIPPS programs. Choosing to buy your prescriptions from a trustworthy provider can help eliminate the risks associated with sites that fail to comply with federal and state laws and regulations. Protect yourself from these rogue sites and select a VIPPS pharmacy for you and your family.”
The site also says: “NABP recognizes that some non-accredited Internet pharmacies may be operating legitimately. Of those entities that approve non-accredited Internet pharmacies, LegitScript.com is the only one that adheres to NABP-recognized standards.
“NABP does not collect data on the prices of prescription medications. Information and price comparisons on medications available at legitimately operating Internet pharmacies are available at Pharmahelper.com, which lists only those Internet pharmacies that adhere to NABP-recognized standards.”
Some other verification options
Recognizing that something like a NABP certification program might exist to protect the business of member pharmacies, I looked at the other entities that say they are certifiers of online pharmacy sites.
We looked a little deeper at Pharmacychecker and LegitScript. They seem to have been in a long fight over legitimacy and business practices, with accusations and counter-accusations flying back and forth. Some of the background can be found on in this post about a court case.
PharmacyChecker, based in White Plains, has been in business since 2004, and its site says it “collects, evaluates, and reports credentials, prices, and customer feedback regarding pharmacies that operate online and through mail-order and fax (generally referred to as ‘online pharmacies.’ … PC helps consumers continually find the lowest priced products from the most qualified and reputable online pharmacies. PC also provides customized reports and services as market intelligence about the online pharmacy industry.”
LegitScript’s site says it “makes the internet and online payments safer for legitimate businesses and their customers by uniting comprehensive big data and unparalleled human expertise to weed out criminal activity and unethical practices.We work where the need is greatest: in highly regulated and complex sectors, including transaction laundering detection, pharmaceuticals, online gambling, and more.”
The two competitors are apparently fighting over business. LegitScript’s site says “PharmacyChecker, a company that performs online pharmacy veriﬁcations and approves pharmacies engaged in illegal drug importation, has repeatedly published false and personal attacks against LegitScript and its President, John Horton.
“PharmacyChecker has been informed that its allegations are false, yet declines to remove the misleading information. So, let’s set the record straight … PharmacyChecker is a competitor. Google used to require Internet pharmacy advertisers to be PharmacyChecker-approved, but terminated its contract with PharmacyChecker in 2010 (followed by Yahoo and Microsoft), and then hired LegitScript to monitor Google’s Internet pharmacy ads in the US and EU. After that, the personal attacks against LegitScript started.”
There’s nothing directly relating to this on the PharmacyChecker site. The Electronic Frontier Foundation says PharmacyChecker is one of the few, if not the only, verification organization that encourages people to import medications from overseas, and that LegitScript (and other verifiers) want to keep online pharmacies from conducting business in the United States, calling this “unaccountable online censorship.”
Be careful. Do your homework.
This is all murky, but you should know: if you’re buying medications online, be careful. As referenced above, here is an FDA site with some cautionary notes.
Consumer Reports did a post in May 2022 about online pharmacies, mentioning online sales from Amazon, Costco, GeniusRX, Honeybee Health and others separate from online sales from the traditional drugstores like CVS and Walgreens.
“CR also found substantial savings if you order your medication for multiple months,” Jennifer Kraus wrote. “For example, at Ro Pharmacy, you can get a 30-day supply of generic Lipitor — a cholesterol-lowering medicine — for $9.90. A year’s supply? Just $19.80.
“But there may be some drawbacks if you’re paying out of pocket for your medication. For one, that money won’t typically go towards your insurance deductible.
“Another drawback — you might not be able to find your exact prescription.”
How do you pick a legitimate online pharmacy? People’s Pharmacy has a handbook.
Online pharmacies will trumpet their certifications. NorthwestPharmacy.com, for example, says it is a member of the Canadian International Pharmacy Association, and has Norton Shopping Guarantee certification as well as TrustPilot. Is it legit? Do your homework.
As we’ve said before, often people find they’re able to buy medications at home for less if they shop around. Our acquaintance Dr. David Belk, a California internist who’s written extensively about the costs of care, often recommends that people go to Costco. Here’s thorough explanation of his understanding of medications, which is definitely worth a read, which includes several lists he’s posted of common medication and prices derived from several sources.
One solid source for information about medications is The Peoples Pharmacy, an informative and no-nonsense look at the world of medications.
We have also heard anecdotally from people who go overseas and buy a lot of a given drug or supply — birth-control pills purchased in volume in South Africa, diabetic test strips bought in Europe and so on. We are not certain that importing in volume is legal, so we don’t give advice about this. Sometimes if you shop around, you can find good deals at home.
Here’s our roundup on how to save money on prescriptions.