Online Pharmacies and Telemedicine

There are a number of online pharmacies, with a medical affiliation is that take great pain to differentiate themselves form unlicensed overseas pharmacies. These pharmacies, stress that they are “American based companies that provides consumer’s easy access to FDA approved online prescriptions over the Internet and are quick to point out that “An online consultation can be just as relevant as an in-person consultation.” It is interesting to note that many of these online pharmacies also point out that “While they are committed to making access to online prescriptions easier, they believe that the Internet can not replace the importance of regular doctor visits to fully evaluate your health and any medical conditions.” Many of these online pharmacy sites also makes a wealth of drug information available on its web site that enables the consumer to educate themselves on drugs that may have been prescribed. The Internet has for all intensive purposes is quickly replacing the brick and mortar base physician as a patient’s primary health care provider.

A sales pitch, of course, or is it? Most of the legitimate online pharmacies ensure that they comply with state and federal regulation. The doctors are licensed in all 50 states and their pharmacies are too. These legitimate Internet pharmacies cater to those that are looking for a better price; for some it comes down to making the choice of eating cat food on crackers in order to afford their medications because of the high US drug prices. In other cases patients resort to cyber-medicine to avoid the embarrassment of having to deal with a physician or pharmacy that may be judgmental. Many of these online pharmacies will arrange a consult with a licensed, medical doctor over the phone and will then fill the prescription accordingly.

According to Henkel (2000) “More and more consumers are using the Internet for health reasons” and references a study carried out by a market research firm Cyber Dialogue Inc., “that found that “health concerns are the sixth most common reason people go online” (Henkel 2000).

For many people a trip to the pharmacy is an ordeal. In some cases the local pharmacy may also be located in the closest town which may mean a long drive if one lives in a rural community. Online pharmacies provide a means through which their prescriptions can be delivered conveniently and quickly. Being online also allows the consumer to shop for the best prices, an important factor if one is living on a pension.

The Internet has also created a more aware user. It is not unusual for a consumer to research drugs on the Internet. A consumer may have seen a TV or magazine advertisement advertising a new drug. Ultimately, the Internet also provides the consumer the opportunity to enter into a doctor patient relationship that may in fact be more legitimate than the doctor who makes a physical appearance. Further information on doctors that practice telemedicine can be found at:

It is interesting to note, as discussed previously, that consumers are becoming dissatisfied with the care and treatment they receive from both brick and mortar physicians and pharmacies. Zanf (2001), references a study by Lang and Fullerton that “Identified four factors related to outpatient pharmacy services: professional communication, physical and emotional comfort, demographics, and location and convenience.” All of which are contributing factors as to why more and more consumers are resorting to cyber-medicine.

The Dark Side

There is also a dark side to the Internet pharmacy, as previously discussed, spam email touting the availability of any prescription drug one could want, without a prescription, is something everyone is familiar with has reached epidemic proportions.

From Ambien, and of course Viagra to more powerful drugs such as Oxycontin, you can have it all. Over night shipping is available in most case, or so these emails proclaim.
In some instances this pharmacy spam originates from unscrupulous individuals who have no intention of delivering the drugs, realizing that very few people, if any, will complain about the non delivery of an illegal drug through the mail.

In other cases the drugs are sent without a prescription from countries where that particular drug may legally be sold without a prescription, or at least the laws are more relaxed. Valium, for example, is sold over-the-counter in Taiwan.

According to Crawford (2004) “Consumers who purchase drugs online thinking that they are they are getting the same drugs as they would from their local brick-and-mortar pharmacy are being misled, and as a result are putting their health, and eventually their lives at risk” Crawford cites examples of Internet pharmacies supplying drugs that were under strength, contaminated and mislabeled (Crawford 2004).

According to Won (2005) Drug-industry executives think the Internet and mail-order operations will be the biggest source of counterfeit drugs over the next five years, according to a report released today by Ernst & Young. According to James G Dickinson (2005):

The federal government in July shut down an alleged illegal Internet pharmacy for selling counterfeit drugs and issued a warning on other counterfeits found to have been sold in Mexican border pharmacies to individual patients from the U.S. The Internet pharmacy had sold more than $7 million in counterfeit Viagra and other prescription drugs over the past five years, according to the San Diego Union-Tribune. The San Diego-based operation required individuals to complete a $35 “doctor consultation” survey before receiving the prescriptions, but the survey was never shown to a health professional to evaluate whether a safety risk existed, the paper says (Dickson, 2005).

In a separate action, the FDA warned Americans about counterfeit versions of Merck’s cholesterol drug Zocor and generic Carisoprodol – used for treating musculoskeletal conditions – that had been imported from Mexico by individual Americans (FDA, 2005).

Over the last year patients suffering from pain, and other conditions that they are reluctant to see a doctor face-to-face, have had the option of consulting a doctor online. The ability to consult with a doctor online, and then to receive drugs as a result has come under much controversy. This has for the most part been as a result of not adequately screening patient’s records, or ordering from unregulated overseas pharmacies.

The Internet – a new way of marketing

Not all Internet pharmacies are illegitimate, however, and there are many pharmacies that provide the consumer with a legitimate prescription by overnight service. My last prescription came by mail. The whole transaction was completed over the Internet. It was a prescription that my doctor had given to me personally, however. As discussed, what constitutes a doctor patient relationship is at the crux of the online pharmacy debate. This of course has implications as to what constitutes a legitimate prescription. What constitutes a legitimate prescription is a hotly debated topic.

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