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No Prescription? No Problem

Rip-offs, fake drugs, mislabeled prescriptions--and worse--on the Internet

Wincing in agony, Barbara Stouffer* tried to tune out the echoing voices of her four kids. Her head throbbed with such piercing pain that the 38-year-old New Jersey mother could barely get out of bed--much less pay attention to her children. Earlier that day, the headache pressure was so excruciating that she had crawled on hands and knees to the bathroom to throw up.

Wearily, she reached for the crumpled white envelope near her bedside. Painkillers, white pills flecked with blue, from an overseas Web site rolled loose inside. She knew she was taking her chances with a drug she had bought without a prescription, but her migraine was unbearable. She popped two of the pills in her mouth, swallowed hard, and felt a slight burning sensation in her stomach. Twenty minutes later, relief finally came.

For Stouffer and millions of other online pharmacy users, the Internet offers swift salvation. A computer and a credit card provide unlimited access to cheap drugs, potent painkillers, and hope-in-a-bottle experimental medications. Internet shoppers have privacy and, in many cases, can skip expensive and sometimes embarrassing visits to a doctor.

This year, consumers will spend an estimated $15 billion on Web-bought drugs, predicts the Internet data firm Forrester Research. Many will order from legitimate online businesses--including major US drugstore chains such as CVS and Eckerd, as well as some Canadian suppliers--that require a faxed or mailed prescription from a licensed doctor who's done a face-to-face physical exam. Other customers, lured by relentless spam, low prices, and easy access, will visit sites where the only requirement for delivery is a credit card. No prescription? No problem.

In a 4-month investigation, Prevention probed the shadowy world of rogue Internet pharmacies to examine the way this new phenomenon is unfolding and to better understand how consumers are using the Web to get prescription drugs. To determine whether buying drugs online is a safe and reliable option, we reviewed government and court records, visited scores of e-pharmacy Web sites, and analyzed drug prices for comparisons. We interviewed dozens of authorities, including FDA officials, counterfeiting experts, pharmacists, doctors, law enforcement officials, e-pharmacy employees, and online consumers. Without prescriptions--and sometimes by listing false symptoms on the sites' medical questionnaires--Prevention sources ordered a wide variety of drugs. Each medication was advertised as the genuine product, but because the investigation included apparent foreign and unregulated sites, there was no way our sources could know what they were getting, where it was sent from--or whether it would come at all. Some drugs arrived in vials and boxes bearing the logos of manufacturers; others arrived in unlabeled plastic bags and envelopes.

*Names changed to protect the privacy of the individuals who agreed to be interviewed

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