Pandora's Online Pillbox - prescription drugs available online without a prescription - Brief Article

Kiplinger's Personal Finance Magazine, Oct, 1999 by Kristin Davis

Yes, you can buy drugs online without a prescription. But you won't save money.

The delivery man left my prescription of Viagra on the front porch in a discreet Fed-Ex envelope. Heaven knows what I'll do with the pills (I'm female and seven months pregnant); I ordered them simply to prove that buying pharmaceuticals without a prescription is as easy as clicking a mouse.

Dozens of Web sites sell drugs such as Viagra, Propecia (for hair loss), Claritin (for allergies), Valtrex (for herpes) and Celebrex (for arthritis) to virtually anyone with a valid credit card. If you don't have a prescription, you must complete a brief medical questionnaire online, which is purportedly reviewed by a physician before your order is approved. (No sweat in my case; the "correct" answers were already checked.) The online consultation typically costs $65 to $85.

There's just one problem. The American Medical Association and regulators say that dispensing drugs based on a superficial questionnaire is unsafe and unethical, if not illegal. "Prescribing drugs without physically examining a patient or reviewing medical records is, in most cases, far below the acceptable standard of medical care," said Dr. Herman Abromowitz, trustee of the AMA, in testimony before Congress recently.

No kidding: WWMT-News 3, in Grand Rapids, Mich., recently submitted online orders for Viagra with truthful medical questionnaires for a cat named Tom (height, 6; weight, 15; past surgery, neutered), a dog named Phrederick L. Schnauzer, a reporter's deceased grandfather (born in 1900), and an employee taking heart medication that is dangerous to combine with Viagra. Only the schnauzer was turned away.

Prescribing drugs without a valid doctor-patient relationship is illegal, the states say, though there aren't yet any state laws that address Internet prescriptions. It is also illegal to prescribe or dispense drugs to residents of a state when the doctor or pharmacist isn't licensed in that state, and several states are trying to shut down online pharmacies on those grounds. The Food and Drug Administration says it is giving states first crack at legal action, though it will step in when states do not act. "We have about 60 cases right now in this area," says FDA associate commissioner William Hubbard. "There may be as many as 200 to 400 sites, however."

WHAT'S THE INCENTIVE? You may save yourself a little time or embarrassment by avoiding a doctor's visit, but you won't save money (and you may be risking your health). For ten 100 milligram Viagra tablets, we paid $100, plus $15 shipping and $75 for the 14-question online consultation--a total of $190. Online drugstores that require a prescription from your doctor, such as PlanetRx and Drugstore.com, charge around $90 for twelve 100 mg tablets, with free shipping. Other drugs, such as Propecia and Claritin, were also cheaper at pharmacies requiring an existing prescription. Plus, health insurance probably won't cover an online medical consultation, and may not cover medication prescribed online.

There are savings to be found at foreign pharmacies, such as those in Mexico. Again, however, you are on questionable legal ground, and the safety risk may be even greater. Generally, you're allowed to drive or walk across the border to a Mexican pharmacy and bring back a 90-day supply of a prescribed drug. But if you mailorder drugs from a foreign pharmacy without a prescription, you run the risk (albeit small) of having your package seized by Customs. "If the Drug Enforcement Administration and the Coast Guard can't interdict all the people bringing cocaine into this country, how the heck are we going to find all these little pills?" admits Hubbard. But it does happen. Many women have taken the risk with fertility drugs--because they're expensive in this country and often aren't covered by insurance--and some have had their orders confiscated, says Theresa Grant, president of the International Council on Infertility Information Dissemination.