Prescription for trouble.(online pharmacies)(Industry Overview)

One morning not long ago, CONSUMER REPORTS senior editor Tod Marks logged onto the Internet and did a simple search using the phrase "prescription drugs for sale." In seconds, the names of 150 sources appeared onscreen, nearly one-third of them accompanied by troubling boasts, such as," No prescription? No doctor? No problem."

No kidding. In a follow-up investigation to "Relief for the Rx Blues" (October 1999), we found that despite claims of increased scrutiny by government regulators and medical and pharmacy-industry trade groups, suspect web sites that sell prescription drugs are flourishing. Ordering medications online without benefit of a proper diagnosis remains about as easy as clicking your way through cyberspace for books or clothes. Unfortunately, an ill-prescribed drug can carry far more serious consequences than a bad ending or a bad fit.

Without visiting or speaking to a doctor, Marks was able to buy seven different prescription drugs--to help him lose weight, quit smoking, combat osteoporosis, and fight aging, depression, seasonal allergies, and bacterial infection. Except for the antihistamine, which might have helped his hay fever, Marks, a healthy 44-year-old nonsmoker, had no business taking those medications.

Sites like those Marks visited are estimated to number in the hundreds, and they're only likely to multiply. Jupiter Communications, which tracks Internet businesses, projects that the annual sale of prescription drugs online will rise from about $23 million to nearly $1 billion over the next few years. Many of those sites will be legitimate, of course, but others will be established by companies looking to make a fast buck off consumers intent on treating themselves. Clearly, there's a demand for these pharmacies, termed "rogue" by government regulators and lawmakers. Just as clearly, there shouldn't be. According to the American Medical Association, the Federation of State Medical Boards, the Food and Drug Administration (FDA), and the Department of Justice, among many other sources, they're unethical at best and illegal at worst.

HOW TO TELL ROGUE FROM RIGHT

Long before the Internet existed, Congress and state legislators enacted safeguards to protect patients from unsafe and counterfeit drugs, and from unethical doctors and pharmacists. Before receiving medicine for the first time, a patient is generally interviewed and examined by a licensed doctor, who issues a prescription for an FDA-approved drug. The prescription is then filled by a registered pharmacist working in a licensed pharmacy that meets state standards.

Legitimate online pharmacies such as CVS.com, an adjunct to the drugstore chain, as well as properly licensed Internet--only drugstores such as PlanetRx.com and drugstore.com, follow those procedures. They require confirmation from your doctor for any drug you request and let you e-mail or phone questions to a pharmacist. To open an account, you submit credit-card and insurance information. The pharmacy openly lists facts about its licensing.