Ray D’Alonzo, Ph.D., is an Associate Director of Research and Development at Procter & Gamble Pharmaceuticals where he has worked for 29 years and led research programs in bone metabolism, infectious disease, respiratory disease, arthritis, and nutrition. He has published scientific papers on a wide variety of topics from the chemical composition of fats and oils to the pharmacoeconomics of osteoporosis. Dr. D’Alonzo is the recipient of the Chancellor’s Medal from the University of Massachusetts, Amherst, in part, for his contributions to the development of new pharmaceutical agents. As both a patient and scientist, he has made a personal effort to increase the awareness of Chiari in the health care sector and to assist others afflicted with the syndrome.  He has published the story of his personal struggle with Chiari in a book, Contents Under Pressure, with 100% of royalties going towards Chiari education, awareness, and research programs.

April 20, 2006 -- We all know that you can buy a fake Rolex watch but did you know that you can buy fake drugs, drugs which do not contain any active ingredient or even toxic or harmful chemicals? Worldwide, the counterfeit drug business is a $35 billion thriving enterprise run primarily by organized crime and terrorist groups. In Africa, there is a greater than 50% chance that your prescription will be filled with a fake medication. In China, over 100,000 people have died from taking counterfeit medications. You say that you do not live in Africa or China. Well, not entirely true. In today’s world of Internet commerce, you can get your medications from Africa or China easier than you can go to the corner drug store. Since 2000, the number of investigations conducted by the FDA’s Office of Criminal Investigations on counterfeit drugs in the United States has risen nearly ten-fold (http://www.fda.gov/oc/initiatives/counterfeit/update2005.html).

There are many reasons why the problem with fake drugs is increasing. Criminals have discovered that it is highly profitable and carries relatively small criminal penalties compared to trafficking narcotics. Weaknesses in parallel trade practices provide opportunity for the introduction of unintended products. However, the greatest factor by far has been the explosion of Internet-based commerce.

The Internet is very much like yesterday’s Wild West, an unregulated land where anything goes. Most of the on-line pharmacies are not legitimate and about 80% of all drugs purchased through on-line pharmacies are fake. In addition to fake medications being sold over the Internet, authentic medications are often offered that are diverted. By diverted, I mean medications that are produced for one part of the world where they are priced at a low cost and transported and sold in another part of the world where the retail price is higher. The problem with this is that diverted drugs are often not stored under the proper conditions and as a result their potency may be compromised. Often times, diverted pharmaceuticals are expired but relabeled to appear as good. Then there are the illegal generic drugs. Generic drugs are a critical component of our health care system. They are manufactured according to strict government guidelines and they are very affordable. But, I am not talking about regulated legal generic drugs. I am talking about illegal generic drugs or generics that have not been specifically approved by the FDA for sale in the United States. Where do illegal generic drugs come from? They usually come from countries like India or China where the original product is not protected by patent law. If a drug is not patented in a country like India, it is perfectly legal for a company to manufacture it and sell it in India. However, unscrupulous parties get their hands on these generics and sell them in countries where they are not legal and have not been reviewed and approved by the proper regulatory authorities. Often times, these generics do not met the FDA’s standards as safe and effective medications and just like diverted pharmaceuticals their storage history is unknown.

Why is this particularly relevant to those who suffer from Chiari? Many patients with Chiari suffer from chronic pain and use strong pain medications for treatment. Also, many with Chiari are unable to work and battle insufficient income at the same time. Bogus on-line pharmacies deal mostly with pain and various psychotropic medications. They promise these drugs without the need for a prescription and at attractive prices. In short, many Chiarians are prime targets for on-line illegal pharmacies. No matter how attractive the offerings of illegal on-line pharmacies are they should be avoided.

However, you might say, “Many illegal on-line pharmacies appear legitimate and professional.  How can I distinguish a legitimate operation from a bogus one?” That is a very fair question so here are 12 characteristics of bogus on-line pharmacies.

1. Offering medications without the need of a valid prescription

2. Offering only a limited number of medications

3. Offering medications at low prices

4. Offering medications that are no longer available

5. Offering generics not approved by FDA

6. Offering dosage forms not approved by FDA

7. Advertising drugs for unapproved uses or indications

8. Showing images of the product that do not match the original

9. Claiming FDA approval for non-U.S. manufacturing facilities

10. Containing outrageous claims like “you can mix this medication with alcoholic drinks”

11. Use of incorrect English grammar – plurality rules are often violated

12. SPAM with misspelled drug names to avoid SPAM filters

Now that I have supplied you with tips for spotting bogus on-line pharmacies, how can you find legitimate ones? The answer is easy, look for the VIPPSTM (Verified Internet Pharmacy Practice Sites) mark from the National Association of Boards of Pharmacy (NABP). NAPB certifies on-line pharmacies that meet state licensing and inspection standards. For a list of VIPPSTM certified on-line pharmacies go to:

On-Line Pharmacies

To learn more in general about how to purchase medications safely I recommend visiting Safemedicines.org, a coalition of patient, physician, pharmacist, university, industry and other professional organizations committed to protecting the public from counterfeit or contraband medicines at www.safemedicines.org.

-- Ray D'Alonzo, Ph.D.

** If you would like to share your comments, thoughts, or ideas with Ray,  please send them to dalonzo.rp@fuse.net.  Due to the volume and nature of email received, individual responses are not possible. **

[Ed. Note:  The opinions expressed above are solely those of the author.  They do not represent the opinions of the editor, publisher, or this publication.  Mr. D'Alonzo is not a medical doctor and does not give medical advice.  Anyone with a medical problem is strongly encouraged to seek professional medical care.]    
 

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