About Online Pharmacies and Canadian Pharmacy Websites

General Facts about Online Pharmacies

  • There are between 30,000 to 35,000 online pharmacies operating at any one time [1]; and 20 new illegal online pharmacy sites are launched every day.[2]
  • More than 96% of online pharmacies websites are operating illegally, failing to comply with applicable laws and safety standards and nearly 10% of these sites sell controlled substances.[3]
  • 89% of illegal online pharmacies do not require a valid prescription.[4]
  • 50% of medicines sold online from sites that hide their physical address are counterfeit.[5]
  • Products sold by illegal online pharmacies often contain too much, too little or no active ingredient; are manufactured in unsafe conditions; and/or contain materials such as floor wax, mercury, concrete, chalk, boric acid, road tar, antifreeze, and other potentially deadly poisons.: [6]
  • Buying medicines from illegal online pharmacies increases your risk of credit card fraud and identity theft.[7]
  • Nearly one in four adult Internet consumers has purchased prescription medicine online. Of those, nearly one in five did not use a website associated with a local pharmacy or health insurance plan.[8]
  • 85% (77/87) of pharmacists claim they are not provided training to properly educate patients about illegal internet pharmacies, regardless of their current practice site.[9]
  • When shown an illegal website, 17.5% (14/80) of pharmacists believe the website is legal based on the look of the webpage.[10]

Canadian Online Pharmacies and U.S. Consumers

  • 100% of search results for “buy medicine online lead consumers to illegal and unsafe websites.[11]
  • 65% of search results for “prescription drugs” lead U.S. consumers to illegal and unsafe websites.[12]
  • 40% of online searches that lead US consumers to illegal and unsafe websites direct users to “Canadian” online pharmacy sites that do not solely provide Canadian products to US patients.[13]
  • Countries such as India, Costa Rica, and Vanuatu are all known sources of counterfeit drugs with supposed Canadian origins. A 2005 investigation by the US FDA found that 85% of all seized drugs labeled as originating in Canada were found to be shipped from other countries.[14],[15]
  • An FDA evaluation of non-FDA-approved imported drugs revealed that while half of imported drugs claimed to be Canadian or Canadian pharmacies, 85% were from different countries.”[16]
  • In NABP’s nearly 20 years of experience evaluating online pharmacies, U.S. consumers buying medications from Canadian online pharmacies rarely, if ever, receive the Health Canada-approved products afforded to Canadian customers.[17]

About Specific “Canadian” Pharmacy Websites

  • RxNorth.com, Owner and President Andrew Strempler indicted and convicted for selling counterfeit drugs.[18]
  • CanadaDrugs.com: CanadaDrugs, approved by both CIPA and PharmacyChecker, and its partners and affiliates were involved in selling counterfeit cancer medicine to US patients via the company’s wholesaler business, as detailed in the indictment.[19]
  • Apex Care Pharmacy, run by Titilayo Akintomide Akinyoyenu (aka Tommy Akin), is now under federal indictment. ApexCarePharmacy was approved by PharmacyChecker.[20]
  • ShopEastWest.com, promoted on PharmacyChecker’s website, was found to be selling prescription drugs without a prescription from India; the principal was recently convicted of illegal online medicine sales and was sentenced in 2016.[21] Indictment indicated that “a patient who had allegedly ordered Ultram, a prescription-only opioid pain reliever, who had previously from the same website, committed suicide. (Doctors are specifically warned not to prescribe Ultram to patients who are suicidal or addiction-prone.)”[22]
  • TotalCareMart.com, a supposedly Canadian online pharmacy certified by PharmacyChecker that the Canadian government ordered to be shut down.[23]
  • LiveWellrx.com, which sold to an undercover “13-year-old” muscle relaxants without a valid prescription.[24]
  • CanadaDrugCenter.com, selling dangerous and substandard products found to contain toxins and too-little active pharmaceutical ingredient (see above).[25]
  • Three Canadian citizens were indicted in March 2017 by the U.S. Attorney for Western PA for operating seven websites offering prescription medications online that were fraudulently labeled as Canadian. Drugs were sourced from suppliers in Turkey, Great Britain and elsewhere and sent to a reshipper in the UK before being shipped to Washington state and New York for repackaging and sale to U.S. consumers. None of the prescription drugs were labelled for use inside the United States.

Case Study: CanadaDrugCenter.Com

  • In 2013, the Maine legislature passed LD171, a law permitting the importation of prescription medicines from licensed retail pharmacies in Canada and other countries deemed safe.
  • Concerned about the safety and efficacy of medicines sold from Canadian online pharmacies, the Maine Pharmacy Association President, Kenneth McCall, ordered four prescriptions from canadadrugcenter.com: Cobix, the generic equal of Celebrex; Izra, the generic version of Nexium; and Clopivas, the generic equivalent of the popular blood thinner Plavix. See below.
  • Though ordered from the same website, each product was manufactured, shipped and mailed from a different address; and none of the medications provided were legitimate.[26]

[1] Internet Drug Outlet Identification Program, National Association of Boards of Pharmacy, 2016

[2] The Internet Pharmacy Market in 2016, LegitScript and the Center for Safe Internet Pharmacies, January 2016

[3] Internet Drug Outlet Identification Program, National Association of Boards of Pharmacy, 2016

[4] Buying Medicine Online – What Are the Risks, National Association of Boards of Pharmacy

[5] Substandard, Spurious, Falsely Labelled, Falsified and Counterfeit Medical Products, World Health Organization

[6] Poisons Found in Counterfeit Medicines, Partnership for Safe Medicines, 2012

[7] What You Need to Know Before You Buy Prescription Medications Online, Disease Management, 2015

[8] Buying Prescription Medicines Online, U.S. Food and Drug Administration, 2013

[9] Pre-Publication Study (2017). Purdue University College of Pharmacy, Center for Mediation Safety Advancement

[10] Pre-Publication Study (2017). Purdue University College of Pharmacy, Center for Mediation Safety Advancement

[11] LegitScript, 2017

[12] Online Pharmacy Market Spotlight Report: The United States, ASOP Global and LegitScript, July 2016

[13] Id.

[14] Headache Pills Made of Rat Poison and Viagra Made of Chalk: We Reveal the Chilling Truth About Internet Drugs, Daily Mail, April 2009

[15] Policy Implications of Importing Drugs into the United States,

[16] Califf Vows Not to Lower or Remove FDA Regulations, Regulatory Affairs Professionals Society, January 2016

[17] NABP Letter to Congress, February 2017

[18] Press Release, U.S. Food and Drug Administration Office of Criminal Investigations, June 2012

[19] U.S. vs. CanadaDrugs.com LTD Partnership, et al.  Indictment, June 2015.

[20] Washington, D.C., Area Pharmacist Indicted and Arrested on Charges Involving Illegal Pharmaceutical Shipments

United States Department of Justice, March 2015

[21] Four Indicted on Charges of Violating Federal Drug, Fraud, and Money Laundering Lawsd, U.S. Attorney’s Office Western District of Pennsylvania, January 2015

[22] LegitScript blog: https://www.legitscript.com/blog/2015/02/asian-capital-equities-indictment-pulls-back-curtain-fraud-intimidation-patient-deaths/

[23] TotalCareMart.com, Yet Another CIPA- and Pharmacy-Checker Approved Online Pharmacy, Ordered to Shut Down, LegitScript, August 2015

[24] Setting the Record Straight, LegitScript

[25] Setting the Record Straight, LegitScript

[26] Drug Importation: Maine’s Experience with Unreliable Foreign ‘Pharmacies’, Partnership for Safe Medicines, March 2016.