The Trouble With Online Pharmacies

by Dr. Marv Shepherd

More than one-quarter of all U.S. children and teens take medication on a regular basis. In fact, in 2009, nearly seven percent of those children and teens were taking two or more medications. Given this fact, it is important for parents to know about the growing global counterfeit medicines crisis and how so-called medicines of unknown origin and content could make their way into the U.S. through fake online pharmacies.  

Unfortunately, many parents are unaware that, in reality, so-called “online pharmacies” are fraudulent, and often dispense counterfeit, substandard and tainted medicines to unsuspecting consumers.  In fact, the National Association of Boards of Pharmacy (NABP) found that 96 percent of 8,034 online pharmacies are not compliant with U.S. pharmacy laws.

The consequences of these counterfeit medicines are very real. For example, tragedy struck Nigeria in 2009 when 84 children between two months and seven-years-old died after taking a teething medicine that had its sweetening agent replaced by counterfeiters with a cheaper but deadly chemical commonly found in antifreeze and brake fluid. 
While counterfeit medicines present dangers to consumers of any age, it is an especially important issue for children. Medically speaking, the safe medication dose for a child is sometimes higher, or, far lower than for an adult because of the way children’s bodies metabolize medicine. There is a science to prescribing and dispensing medicines to children that doctors and pharmacists carefully consider.

Of course, counterfeiters do not take the patient’s age, weight, or development into consideration when selling fake or substandard forms. Moreover, they are not interested in whether the child is taking other medications or if the combination of them will result in an adverse reaction. Nor are these sellers concerned that the products sold to treat children for important diseases aren’t effective. They simply do not care that what they are selling is known to harm, not heal, because making money – not real medicines – is their business.
Currently, parents can largely avoid counterfeit medicines by steering clear of these fake online pharmacies. Parents that choose to order online, can do so safely by ensuring they are using an online pharmacy certified by the NABP. The NABP accredits pharmacies that comply with licensing and inspection requirements as Verified Internet Pharmacy Practices Sites (VIPPS) (For more information about safely purchasing medicine online:

Fortunately, the United States has a closed system that has been effective in largely preventing counterfeiters from injecting potentially lethal counterfeit medicine into our medicine supply.  In fact, today in the U.S. less than 1 percent of medicines in our distribution system are estimated to be potentially counterfeit.  Meanwhile, the World Health Organization estimates as much as 40% of medicines in some developing countries might be fake.  

However, federal policymakers have proposed opening up our own trade in medicine due to a misguided belief that drug importation would lower the cost of medicine.  In reality, importation legislation could unintentionally compromise America’s safeguarded, tightly regulated medicine supply chain and bring heightened risk of more counterfeit drugs entering the U.S. and potentially endangering our kids.

To learn more, a recent report from the Partnership for Safe Medicines provides an overview of the emerging problem of fake medicine and fake pharmacies, the threat posed by drug importation, and a discussion of why parents must be vigilant in order to protect the health of their children. The full report can be found by clicking here.


About The Author: 
- Dr. Marv Shepherd is the Director of the Center for Pharmacoeconomic Studies and Chairman of the Pharmacy Administration Division at the University of Texas at Austin's College of Pharmacy.  He also serves as the President of the Partnership for Safe Medicines