I was reminded of the state of the pharmaceutical industry the other day when a
new ex-pat from the USA asked me about the safety in buying drugs/medications in
this country over the counter or from the net.
Now, every day I receive at least four email offers of
cut-price drugs that will keep me in a state of perpetual priapism. For those
unsure of this condition, it is a state of continuing (and painful) male
erection and the term was coined after the Greek god Priapus who is shown in
paintings to have a central member that puts the (in)famous John Holmes of porn
movies to shame.
However, this is actually a serious situation. If most drugs
are only available through pharmacies world-wide, on the prescription of a
doctor, is it safe to just buy over the internet, without any doctor’s advice?
I believe it is not safe. As the American Food and Drug
Administration (FDA) reports in its website, “Patients who buy prescription
drugs from websites operating outside the law are at increased risk of suffering
life-threatening adverse events, such as side effects from inappropriately
prescribed medications, dangerous drug interactions, contaminated drugs, and
impure or unknown ingredients found in unapproved drugs.”
The FDA goes on to warn “… certain drugs be dispensed only
with a valid prescription because they are not safe for use without the
supervision of a licensed health care practitioner. Generally, before the
practitioner issues a prescription for a drug the patient has never taken
before, he or she must first examine the patient to determine the appropriate
treatment. Subsequently, the patient receives the drug from a registered
pharmacist working in a licensed pharmacy that meets state practice standards.”
That situation is certainly not the case when you look at buying blue diamonds
over the ‘net, is it?
The incidence of internet pseudo-pharmacies is also very
high. In the US, according to the American Medical Association, there are at
least 400 web sites that both dispense and offer a prescribing service - half of
these sites are located in foreign countries. Some have estimated that the
number of websites selling prescription drugs may now be closer to 1,000.
As far as I can see it, one of the big problems is the lack
of regulation that these “net pharmacies” work under. Are the blue diamonds
‘real’ blue diamonds?
According to the World Health Organization (WHO), it has been
fighting drug counterfeiting since it became a major threat in the 1980s. The
problem was first noticed by the pharmaceutical industry. They saw that their
own products were being copied, and it went on from there.
In fact, the WHO estimates that 25 percent of medications
bought in street markets in developing countries are fake. My own experience in
some of the poorer SE Asian countries has been that another 50 percent are real
but out of date, leaving around 25 percent genuine manufacturer’s stock.
Some authors say that the figures are even worse than that.
An international study published in Tropical Medicine and International Health
in 2004 found that 53 percent of Artesunate tablet packs sold in the region did
not contain Artesunate, a vital antimalarial drug. You can see the danger.
The reports come in from all over the world. The WHO cited
the case of a counterfeit iron preparation that has killed pregnant women in
Argentina. Hundreds of children in Bangladesh suffered kidney failure and many
died due to a fake paracetamol syrup diluted with diethylene glycol, according
to a study published in the BMJ.
The FDA in the US estimates that worldwide sales of fake
drugs exceed USD 3.5 billion per year, according to a paper published in April
2005. The Center for Medicines in the Public Interest in the US predicts that
counterfeit drug sales could reach USD 75 billion globally if action is not
taken to curb the trade.
According to WHO, drugs commonly counterfeited include
antibiotics, antimalarials, hormones and steroids. Increasingly, anticancer and
antiviral drugs are also faked. And you can add to that, the ‘blue diamonds’.
Never forget the phrase “Caveat emptor” (Let the buyer beware).
You have been warned. Get your medications on prescription
from a registered pharmacy you can trust.