Rutgers Model Congress
Senate Caucus on Narcotics
Online Sale of Prescription Drugs
East Brunswick High School
With the creation of the internet, the world community became more connected and many
things became easier to do. However, the internet has also made it easier to conduct illegal
activity such as identity theft, music piracy, and illegal drug sales. Rogue internet pharmacies,
websites that sell prescription drugs without a prescription, pose a threat to the people of the
United States because they are easily accessible and can sell fraudulent drugs. Policy makers
have tried to silence these rogue pharmacies, but despite their efforts they still pose a threat.
With a new approach to drug enforcement and health care, rogue pharmacies will be less harmful
Online pharmacies have revolutionized the pharmaceutical business ever since it was
started, but have caused concern among government workers over the years. Many online
pharmacies are convenient. They let consumers know about the drugs they take, allow the
disabled or those unable to maneuver to have drugs they need, give the convenience of being
open 24 hours everyday, and maintain privacy for those who do not want to share medical
conditions in public (Hubbard 2). Services like these are the reason why many elderly customers
use online sales to get the drugs they need (Bettelheim 11). Authorities have recognized
different types of online pharmacies. The first includes pharmacies like Drugstore.com
PlanetRx.com that require patients to submit a prescription from a licensed physician when
ordering prescription medication. These online pharmacies pose virtually no threat to American
health. However, the other pharmacies are rogue meaning they do not have ties to a licensed
physician or affiliation with the Food and Drug Administration (FDA). These cause trouble
because consumers cannot be certain about the quality, purity, or legality of the drugs they buy
online and they fail to advise patients about the potential health risks the drug has (12). Patients
who buy prescription drugs from a rogue pharmacy are at risk of suffering major side effects,
some which can be life threatening through dangerous drug interaction or contamination
(Hubbard 4). The FDA cannot verify that drugs sold by unlicensed internet pharmacies are
manufactured under current good manufacturing practices (cGMP) even if the website’s base of
operation is within the borders of the United States. These drugs can be easily altered or
counterfeit. Some websites will not even have a licensed physician filling prescriptions for their
customers (3). Moreover, rogue pharmacies diagnose and sell patients drugs simply through a
questionnaire; no doctor visit necessary. This fails to meet the standards of the Federation of
State Medical Boards, Special Committee on Professional Care and Ethics, who denounce the
practice the substitution of face-to-face care with an online questionnaire calling it “outside the
bounds of professional conduct” (qtd. in Hubbard 4). This practice moreover, violates the Food
Drug and Cosmetic Act (FD&C) (3). Some online pharmacies will even sell to a person without
a prescription or a questionnaire. Consequently, people are allowed to buy prescription drugs
without a prescription. There has been a report of a cat named Tom receiving 10 100mg pills of
Viagra via internet by his owner filling out a questionnaire. It also enables a person to acquire
human growth hormones and other illegal drugs easily which is growing concern in today’s
society. Teens are more likely to take advantage of this activity as Gary Wadler, a member of
the World Anti-Doping Agency, says “Who is the most comfortable with the internet? Kids, the
same people who have the air of indestructibility.” (qtd in Ruibal, Sal 2). It is not only the
convenience and easy access to drugs that attract customers to using rogue pharmacies. Due
high drug prices in the United States, rogue pharmacies will import similar drugs from foreign
nations since they are cheaper. For example, a bottle of tamoxifen, a drug used to fight breast
cancer, is $360 in the States and $60 in Germany (Snow 3). The elderly, who make up 12% of
the national population, use more than one-third of all prescription drugs and thus impacted the
most by high healthcare costs, and often resort to buying the cheaper foreign drugs (Bettelheim
15). The problem with this is again, the FDA cannot make sure that these drugs are
manufactured under cGMP since they are in foreign countries beyond inspection of the FDA
(Hubbard 3). To add to the problem, rogue pharmacies are difficult to detect. They can easily
assemble their website to look like a legit pharmaceutical company, change the location, and
alter the appearance of the website if needed. Even if the operators of a rogue pharmacy are
reprimanded, states can do very little to convict them if the perpetrator conducted his actions
outside state borders (4). Some states like Kansas have had to settle with restraining orders
against certain rogue pharmacies (Bettelheim 13). It is nearly impossible to convict a foreign
seller because the FDA may have jurisdiction over a country that violates the FD&C Act to a US
resident, but confront the same obstacles other law enforcement agencies encounter while going
after a foreign man who broke US law. The only things the FDA can do are ask a foreign
government to take action against the rogue website or ask Customs to stop the importation of
drugs (Hubbard 5).
Rogue pharmacies have become a growing concern in the State of Florida. Nineteen
percent of the eighteen million residents in the State of Florida are elderly (Hobbs 1). The
elderly resort to buying drugs online not only because they are easier to access, but primarily
because they are cheaper than drugs found at a conventional pharmacy. The reason being is that
some of the internet pharmacies illegally import drugs from foreign nations where the drugs are
cheaper due to price restrictions placed on the pharmaceutical companies by foreign
governments. The elderly are in the most need for medications, and due to high healthcare
costs and a fixed income they collect from social security, they often resort to using rogue online
pharmacies (Snow 1). This a risk to the health of the senior citizens because the FDA does not
know how the drugs sold this way are manufactured, and can cause severe health risks (Hubbard
The Republican Party, along with the Democratic Party, believes that this problem is a
large concern mostly because of the high costs of prescription drugs. There is no doubt that the
current healthcare system has problems. The United States spends 16% of its gross domestic
profit (GDP) on pharmaceuticals compared to 10% in other western nations. It is also predicted,
under the current system that the average Fortune 500 Company will spend more on healthcare
than it actually earns in revenue (Ballaro 1). Both parties believe that lowering the cost of
healthcare will make people less inclined to buy from international rogue pharmacies. However,
the Democratic Party believes the best way to lower healthcare costs is to implement a national
health care system. Democrats say that with an universal healthcare plan, many more people
will go to the doctor’s office because they can afford it, and it will save money because less
severe illnesses, which are more expensive to treat than regular visits, will develop due to these
visits (3). What democrats fail to realize though is that universal healthcare has been
implemented in other countries and has failed. It takes a person eighteen weeks to receive
treatment from a single doctor after a referral has been filled, more than 8 weeks to get an MRI,
and about four weeks to get an ultrasound (Driscoll 2). Furthermore, the government would also
have to make a list of which drugs to buy in bulk, and if an individual needs a drug that is not
listed, he or she would have to pay for them individually which would not “fly after [patients
have] gotten used to the broad coverage that currently exists in the benefit” (qtd. in Frates 3)
Whit Ayers, a Republican pollster, said. The Republicans suggest that the current system should
be tweaked by funding more insurance companies to increase competition, ultimately lowering
both the cost of healthcare premiums and pharmaceuticals for consumers. Not only doe it lower
the cost, but it also allows people to see the specialist they want to see, and they can see him or
her rather quickly after the referral has been filled. The private companies have the right to buy
whatever drugs they want in bulk, and become more personal with their customers by buying the
drugs they need. Knowing this, people, based on their medical condition, can select which
health care company is right for them based on the cost and what services they provide (Driscoll
3). The United States has always been known for its advancements in society thanks to
capitalism, by implementing universal healthcare, the nation becomes more socialistic and takes
a step backward.
Along with reforms in the healthcare system, new legislation will also help quell the
problem of rogue online pharmacies. In 2005, The Internet Pharmacy Consumer Act was
introduced to Congress. This new law was rejected by Congress because it banned the use of all
internet drug transactions and the shipment of drugs through mail (109th Congress 1). Not all
online pharmacies are bad, in fact some provide the same drugs and deliver them to the disabled
which is why this bill was rejected. However, a similar law should be passed by Congress that
requires websites to post the identities, and licensing information about the sellers of the drugs.
Also, the bill should provide more money to the FDA, the DEA, and Customs for further training
and to purchase instruments that will help catch the rogue pharmacy leaders. Currently the DEA
has received $34.7 million and Customs has received $28 million from the government, but still
needs more (The White House 30). There should also be a joint federal-state task force created
in order to evaluate current laws and see if they are adequate as Thomas Biley Jr., the House
Commerce Committee Chairman, has proposed (Bettelheim 13).
Rogue pharmacies thrive off of the errors in the American healthcare system by selling
cheaper drugs and making them available without a prescription. By making some changes in
the current system, rather than totally disbanding it, this problem can be solved without
jeopardizing the heath of the people. With the implication of these new reforms, we can make
prescription drugs cheaper for those who need and protect the health of the American people by
getting rid of rogue pharmacies, making everybody happy.
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29 Mar 2008.
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<http://www.whitehousedrugpolicy.gov/publications/policy/2004ndcs.pdf> 29 Mar 2008.