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					    Rutgers Model Congress
       Florida/Republican
  Senate Caucus on Narcotics
Online Sale of Prescription Drugs
       Scott Kominkiewicz
  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

to Americans.

       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

4).

       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.
                                        Works Cited



109th Congress. S. 339 [109th]: “Internet Pharmacy Consumer Protection Act”. 16 February
       2005. <http://www.govtrack.us/congress/bill.xpd?bill=s109-399> 29 Mar 2008.

Ballaro, Beverly. “The United States Needs a Single-Payer Health Insurance System”. Points of
       View: Health Insurance. 2007. MasterFile Premier. Online. EBSCOhost.
       <http://search.epnet.com> 29 Mar 2008.

Bettelheim, Adriel. “Drug Makers Under Siege”. CQ Researcher. Vol. 9 no. 33. 1999 Sept. 3.
       <http://www.library.cqpress.com/cqresearcher/cqresrre1999090306> 29 Mar. 2008.

Driscoll, Sally. “Fiscal Responsibility Leads to Quality Health Care”. Points of View: Health
       Insurance. 2007. MasterFile Premier. Online. EBSCOhost. <http://search.epnet.com>
       29 Mar 2008.

Frates, Chris. “Drug Program Success Could Slow Reforms”. Politico. 2008 Mar. 10. Online.
        Internet. <http://dyn.politico.com/printstory.cfm?uuid=9A88F6F9-3048-5C12-
        0002479F83507583> 29 Mar. 2008.

Hobbs, Frank. “The Elderly Population”. United States Census Bureau. 2000. Online.
       Internet. <http://www.census.gov/population/www/pop-profile/elderlypop.html> 29
       Mar. 2008.

Hubbard, William K. “Statement before the Committee on Government Reform”. 27 March
      2003. <http://www.fda.gov/ola/2003/pharmsales0327.html> 29 Mar 2008.

Ruibal, Sal. “Steroids Are Just a Click Away”. USA Today. 2007 Mar. 1. General Reference
       Center. Online. Gale Group. <http://find.galegroup.com/itx/start.do?prodId=GRCM>
       29 Mar 2008.

Snow, Wyn. “FDA Stangling Consumer Health”. 6 November 2003.
      <http://www.supplementquality.com/news/skyrocketing_drug_costs.html> 29 Mar 2008.

The White House. “National Drug Control Strategy.” 2004.
      <http://www.whitehousedrugpolicy.gov/publications/policy/2004ndcs.pdf> 29 Mar 2008.

				
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