Economically Speaking: State monitoring increasing number of Internet pharmacies

Joseph L. Driskill is the director of the Missouri Department of Economic Development.

Using the Internet to purchase prescription drugs has become increasingly popular since the late 1990s when pharmaceutical products first became available online. But aside from the benefits these Web sites offer, such as convenience and more affordable pricing, there are also problems with this venue that could pose threats to the health of unwary consumers.

While many of these Internet-based businesses are legitimate, there are a number of illicit sites that concern federal and state regulatory agencies such as staff at the Missouri Board of Pharmacy, a professional licensing agency under the Department of Economic Development's Division of Professional Registration.

The board enforces minimum standards of pharmacy practice and licensure in Missouri and protects Missourians against incompetent or illegal practices.

Regulating online pharmacy practices is a growing concern for the Pharmacy Board and other state and federal regulators. Since the first major cyberspace pharmacy opened for business in February 1999, the number of online pharmacies has dramatically increased over a relatively short period of time.

It is now estimated that there are more than 1,000 Web sites that sell prescription drugs.

According to Forrester Research, a technology consulting firm based in Cambridge, Mass., consumers bought approximately $2.8 billion worth of prescription drugs online in 2002. The research firm predicts that online prescription drug sales will more than double to $6.7 billion this year and double again in 2004, reaching nearly $15 billion.

In response to increased use of the Internet for prescription drug purchases, the Pharmacy Board has been working to ensure that online sites that provide pharmaceutical products and services are in compliance with Missouri practice acts and with state and federal drug laws.

Over the past year, the Board of Pharmacy has maintained an active presence on the Internet in order to review questionable sites.

A board inspector attempts to purchase prescription medications from entities that appear to offer products and services that are noncompliant with Missouri laws.

To date, the board has visited 45 sites offering human and/or veterinary prescription drugs.

The board inspector has been able to complete 21 purchases, while another 14 sites have refused to provide products since the inspector became active on the Internet.

Over the course of its analysis, the board has observed a substantial increase in Internet sites offering prescription drugs directly to consumers without an established doctor-patient relationship. For example, many sites simply require an individual to complete an online questionnaire, without any method of verification or proof of a valid patient examination or an individual's age.

The ongoing review has also revealed that drugs are being dispensed to Missouri citizens from unlicensed and unregulated locations, even though Missouri requires licensure of all drug outlets doing business in the state whether or not the physical location exists in the state.

In addition, most sites offer consumers little or no guarantee that the drugs supplied to them are safe and effective, while other sites are giving access to prescription drugs and controlled substances to consumers that should not have them due to untoward effects or contraindications of the drugs.

The board has also found some businesses committing fraud.

To safely take advantage of the benefits of online pharmacies, the Missouri Board of Pharmacy encourages consumers to search the National Association of Boards of Pharmacy Web site www.nabp.net to locate a pharmacy certified by the Verified Internet Pharmacy Practice Sites program. The VIPPS seal of approval is located on pharmaceutical Web sites that have met a rigorous review and passed an onsite inspection.

As a consumer, you can rest assured that the Missouri Board of Pharmacy is working hard to protect Missourians from illicit online pharmacies.

For more information about online pharmacy practices, contact the Missouri Board of Pharmacy by e-mail at www.pharmacy@mail.state.mo.us, by telephone at 573-751-0091 or by mail at PO Box 625, Jefferson City, Mo. 65102.