Federal Investigators Testify on Canadian, Online Prescription Drug Safety
While purchasing prescription drugs from Internet pharmacies can "pu[t] consumers at risk of taking counterfeits or using medications improperly," drugs purchased from sites based in the United States or Canada are generally more reliable and safe, according to testimony from federal investigators at a Senate Permanent Subcommittee on Investigations hearing on Thursday, USA Today reports. Officials from the General Accounting Office presented results from a six-month report that is "likely to provide fuel for supporters and opponents" of two bills currently being debated that would legalize importing drugs from other nations, USA Today reports (Appleby, USA Today, 6/18). From January to June, GAO made 68 purchases of prescription drugs from online pharmacies based in the United States, Canada, Mexico, Spain, Thailand and seven other countries. The report found that 24 of 29 U.S. online pharmacies and 21 online pharmacies based outside of Canada or the United States sold medications without doctors' prescriptions; all 18 Canadian sites included in the report required prescriptions. Prescription drugs from U.S. and Canadian pharmacies typically came with proper labeling information and included patient instructions and warnings, according to the report. The report noted that the samples from U.S. and Canadian pharmacies had comparable chemical compositions to FDA-approved medicines. However, FDA Acting Commissioner Lester Crawford wrote in the report, "Whether a foreign product contains the same active ingredient is no guarantee that it is identical to the FDA-approved product" (California Healthline, 6/17).
Four samples from U.S.-based pharmacies were found to be either counterfeit or not chemically comparable to the drug ordered (Heldt Powell, Boston Herald, 6/18). Investigators said the Internet pharmacies seemed to "cate[r] to people who cannot get medications conventionally," with some sites charging three to 16 times the prices provided at local pharmacies, the AP/St. Louis Post-Dispatch reports. GAO senior investigator Robert Cramer said at the hearing, "It seems that the key thing here is having your credit card" (Sherman, AP/St. Louis Post-Dispatch, 6/18).
Sen. Norm Coleman (R-Minn.), who is chairing the two-day hearing, said there is a large volume of drugs arriving at central hubs in the United States every day, with 40,000 incoming parcels arriving daily at New York's John F. Kennedy International Airport, and 30,000 arriving in Miami. Coleman is co-sponsoring a bill that would include a licensing requirement for online pharmacies and a user fee for businesses importing prescription drugs (Boston Herald, 6/18). Former New York Mayor Rudolph Giuliani, whose firm Giuliani Partners is conducting research funded by the Pharmaceutical Research and Manufacturers of America, testified that U.S. inspectors look at only about 10% of packages containing drugs sent from other countries. "The present system is overwhelmed at this point," Giuliani said (Rovner, CongressDaily, 6/17). He added, "It is pretty much right now a wide open system" (AP/St. Louis Post-Dispatch, 6/18).
Family members of people who have died from drugs acquired online testified that it is easy to obtain drugs from pharmacies in other countries. Francine Haight, a California nurse whose son died after an overdose of drugs he purchased online, said, "Our seniors think they can buy from Canadian pharmacies and save money. What they do not know is that when they click on something that says Canada, it actually takes them to Africa or India. Drugs are being distributed daily like candy, and it's very dangerous" (Boston Herald, 6/18).
"[R]ogue Internet pharmacies" working with "a few unethical physicians and pharmacists" have become the "drug suppliers to a nation," Sen. Dianne Feinstein (D-Calif.), who co-sponsored the reimportation bill with Coleman, writes in a San Diego Union-Tribune opinion piece. Feinstein cites the case of a California physician whose license was recently revoked after he allegedly wrote -- through multiple Web sites -- 11,000 prescriptions for 1,500 patients in 2001 and 2002. She writes that this physician and others like him were able to operate because of the "anonymity of the Internet," which does not hold the operators of online Web sites "accountable for their actions." Feinstein proposes that "modest, but important steps" are needed to ensure the quality of prescriptions obtained online, including requiring all Internet pharmacies to provide basic disclosure information; prohibiting "virtual examinations" such as online medical questionnaires; and allowing state attorneys general to file cases against online pharmacies in federal district court, instead of in every state in which the pharmacy operates (Feinstein, San Diego Union-Tribune, 6/18).
ABCNews' "World News Tonight" on Thursday reported on testimony at the subcommittee hearing. The segment includes comments from Dr. Marcia Crosse, acting director for health care, public and science issues at GAO (Douglass, "World News Tonight," ABCNews, 6/17). A video excerpt of the segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.