Dr. Pusherman


Q: I’ve been buying my meds from an online pharmacy based overseas, which saves me oodles of cash. But I’m beginning to wonder whether my bargain hunting will someday land me in the clink. What’s the legal deal with these pharmacies?

The rules governing online drug purchases are murky, indeed. You’re almost certainly running afoul of federal laws, but consider your violations academic. The Food and Drug Administration is largely giving a free pass to consumers on the prowl for cyberdeals, a policy crafted of equal parts common sense and budgetary distress. Though prison isn’t in your future, however, don’t get too gung ho about stocking up on cheap meds—the universe of online pharmacies is replete with shady cats who’d sooner sell you sawdust than Celebrex.

At least technically, the vast majority of overseas pharmacies engage in illegal practices. Federal law prohibits the re-importation of drugs made in the U.S., except by the manufacturer itself. Also verboten is the importation of drugs produced in foreign factories, save for those few pill mills willing to register with the FDA (and thus endure periodic inspections). Always eager to cozy up to senior citizens, Congress has tried repeatedly to tweak these bans, most recently with the Medicine Equity and Drug Safety Act of 2000. But Health and Human Services Secretary Tommy Thompson nixed a key change on safety grounds, and the laws survived intact.

OK, now here’s where the legal mumbo-jumbo gets tricky. The FDA adheres to a “compassionate treatment” doctrine, which means the agency gives a tacit thumbs-up to seriously ill folks who import foreign meds not listed in the “Orange Book” of copacetic drugs. But it doesn’t really cover people who merely want cheaper Prozac or asthma fighters. Joe McCallion, an FDA consumer safety officer, laid down the law two months ago in FDA Consumer, the agency’s in-house magazine: “While we can appreciate the cost issue, saving money on prescription drugs isn’t one of the [acceptable] circumstances. The guidance doesn’t condone the use of buying foreign-made versions of drugs available in the United States.”

“Condone” is the operative, wishy-washy word in McCallion’s edict. The FDA will never come right out and urge you to poke around, of course. Nor has the agency been above seizing shipments at the border or sending the intended recipients scary letters. Still, with at least 2 million such shipments flowing in annually, your odds of having an order intercepted are pretty slim.

Political expediency has a lot to do with the FDA’s version of “don’t ask, don’t tell.” Nobody wants to piss off the American Association of Retired Persons, the geriatric lobby that’s only going to get stronger as boomers slide toward their golden years. Cheaper meds are a big AARP rallying cry, so a heartless turn by the FDA would mean re-election headaches for Dubya. Heck, even those wicked HMOs are playing along; biggies like Premera and Anthem now cover the cost of drugs purchased from abroad, so long as the meds contain FDA-approved ingredients.

Rightly favoring the harm-reduction approach, the FDA does offer a few guidelines. First and foremost, legit pharmacies should require you to fax or mail your doctor’s orders. And avoid operations that don’t offer toll-free access to a licensed pharmacist.

Let Mr. Roboto kick in a few more nuggets of pharmaceutical wisdom, starting with a caveat about pharmacies that obscure their location info. If an outfit’s dodgy about its home base, there’s a good chance it’s located in a corner of the globe where drug purity laws are, er, less than rigorous. Stick to pharmacies with verifiable addresses in Canada or Europe, where governments regulate meds with FDA-like precision.

Also to be avoided are pharmacies that hawk Viagra as their mainstay. The blue pill that recharged Bob Dole’s tool is perhaps the most counterfeited drug on the planet. Sure, you might get hooked up with something featuring a small dollop of sildenafil citrate, Viagra’s active ingredient. You might also wind up with a diamond-shaped hunk of compressed gravel, which does little to get the ol’ Evinrude cranking. Not that Mr. Roboto’s speaking from experience, mind you.

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