If the current discussion about fake news has taught us anything, it’s that things on the internet are often not what they seem. All too easy to create and disseminate globally, fake news has invaded our homes and eroded our trust in the internet as a source of legitimate information and products — and yet, every day, fake news stories succeed in duping countless readers.
The same dynamic is also at work when it comes to medicines sold online, and policymakers in Congress should consider the fake news phenomenon when advocating that U.S. citizens access prescription drugs from Canada. Such prescription drug importation policy could further expose patients — consumers who lack the resources and expertise to distinguish real pharmacies from their fake, but often quite convincing, counterparts — to the very real dangers of illegal online pharmacies.
At any one time, there are more than 35,000 online pharmacy websites offering prescription medicines to U.S. consumers and 96 percent of these sites are illegal — they sell prescription drugs without requiring a prescription, operate without a pharmacy license, and/or dispense counterfeit, adulterated or unapproved medicine from foreign sources to U.S. patients.
Further, approximately 3,400 of these sites will sell controlled substances such as Percocet or Vicodin directly to consumers, bypassing state prescription drug monitoring programs and exacerbating the already devastating prescription drug abuse epidemic. Illicit fentanyl sold online is the most recent example of this deadly threat.
Thousands of online pharmacies claim to be Canadian or to be selling Health Canada-approved medicines. To a U.S. consumer, it sounds good — cheap, safe Canadian medicine delivered discreetly to your door. But, as with fake news, many of these outlets are imposters.
The U.S. Food and Drug Administration found 85 percent of drugs ordered from so-called Canadian internet pharmacies actually came from 27 other countries, and a number of the drugs were counterfeit. In fact, drug safety experts report that there are no Canadian online pharmacies consistently selling Health Canada-approved medicines to U.S. consumers. But the global scope and anonymity of the internet make it all too easy (and too profitable) for foreign online pharmacies to make false claims.
To compound matters, no U.S. law, penalty or government resource can fully protect U.S. consumers from foreign actors who blatantly disregard U.S. laws and hide in jurisdictions that will not extradite criminals. The FDA, Federal Trade Commission and U.S. law enforcement cannot and should not be asked to do the impossible job of ensuring the safety of foreign-sourced medicines and offshore online pharmacies – and the Canadian government says it cannot ensure claims about online “Canadian” medicines are accurate.
Even if proposed laws required consumers to buy only from U.S. government-certified safe foreign online pharmacy sites, consumers could still do a web search for “safe Canadian medicines online” and be lured in by tens of thousands of legitimate-looking but non-certified sites. Lists tracking certified safe online pharmacy sites have been around since 1999, yet have proven ineffective. The FDA has said it cannot certify the safety of medicines from foreign countries, and the U.S. government is simply incapable of inspecting the nearly one million packages shipped to the U.S. from foreign countries. (For more, read the Government Accountability Office discussion of fake Canadian pharmacy sites).
When I was in Congress representing the border state of California, I felt comfortable supporting prescription drug importation legislation, as I believed my constituents would get real medicine from brick and mortar pharmacies in Canada or Mexico. But the importation legislation of today is not what it was years ago; the internet is a game-changer. We know from fake news that consumers implicitly trust what they find online, often to their detriment and — in the case of medicines — potentially to their death.
Given all of this, it would be reckless for Congress to send the message to U.S. consumers that they can get Health Canada-approved medicines safely online. The current state of online pharmacies makes this impossible and dangerous for patients. The U.S. government must learn the lessons of fake news and protect patients online – and avoid espousing policies that could put them further at risk.