What's in a Name?
Rogue Drug Sites Sound Like the Real Thing and Look Like the Real Thing but Pose Real Risks for Consumers
Special to Consumer Reports WebWatch
Last month, a California woman wanted to learn more about Diflucan, a popular new prescription medicine used to treat yeast infections. So she turned to the most convenient and discreet research tool available — her Web browser.
When she typed the name-brand drug into a search engine, the top link to emerge was not the official site (www.Diflucan.com, from drug-maker Pfizer), but an information-rich site called "Diflucan to Treat Vaginal Yeast Infections" (www.diflucan-vaginal-yeast-infections.com).
There, next to the Diflucan logo, were detailed lists of side effects, precautions and even suggested alternatives to Diflucan. The site also allowed her to order the drug online after answering a lengthy medical questionnaire about her surgical history and sex life and providing her credit-card number.
"As I began to read information about the drug and the advice that was posted there, I became suspicious of the site's credibility," said Angie, a Consumer Reports WebWatch reader who asked that her full name not be used. "There was a lot of misplaced text and tense [confusion], as though things had been pasted in. I was also surprised by the option to purchase Diflucan on the Internet, since I was aware that it was a prescription-only medicine."
Was this site legitimate, she wondered, or a trap to collect and sell personal information?
A Consumer Reports WebWatch examination of www.diflucan-vaginal-yeast-infections.com, similar sites dedicated to Diflucan, and drug vending sites in general revealed a pattern that doesn't inspire much confidence. When users type "Diflucan" into major Web search engines, a preponderance of the results comprises drug vending sites run by anonymous operators — what state and federal regulators call "rogue" sites. (For an overview of the opportunities and obstacles to buying prescriptions online, click here.)
That's equally true of searches on any major prescription drug brand name, such as Lipitor and Prilosec — and thus bad news for consumers who'd like to use Google or Yahoo to research the latest cure-all. In addition to worrying federal regulators and state medical boards, rogue drug sites now clog the Web with vast amounts of unattributed, and perhaps unreliable, medical information.
The www.diflucan-vaginal-yeast-infections.com site has an FAQ section and plenty of advice, but no reference to where any of this text came from. More suspicious, the "About Us" and "Contact Us" pages offer no information about the company — just a promise that it will issue prescriptions after buyers' medical questionnaires are reviewed by "what we believe to be the best medical practitioners and pharmacists in the health care industry." (Still, would-be buyers have to complete two online waivers absolving the site of any responsibility for what happens after the drugs arrive.)
So who's running this show? Looking up the site name on whois.org (a step consumers should never have to resort to) yielded a Blountville, Tenn., address with a disconnected phone number and an e-mail address. The site operator didn't answer several Consumer Reports WebWatch inquiries, nor did the company that processes its online orders, Secure Medical of Phoenix, Ariz.
Unfortunately for cautious consumers who might simply move on to the next site, it's not an isolated case. At least 24 sites that use the Diflucan name in their Internet addresses (such as www.diflucan-rx.com) do not reveal any corporate information such as physical location, medical staff or ownership. Additional search results for Diflucan on Google or Yahoo — several dozen online drugstores such as prescriptions.org — also offer no identifying information whatsoever.
Eventually, would-be buyers will find that many of these sites lead to the same few destinations — toll-free customer services centers that serve as a middleman between consumers and the rogue pharmacies that issue the online prescriptions.
For example, if visitors place an order on www.buy-diflucan-online.biz, the site takes them to MyMedicure.com, which provides no corporate information and offers only a toll-free phone number (888-232-8086). The same happens with www.buy-order-diflucan-on-line.com, which takes users to the anonymous MD-Pillstore.com, which gives the same number. The number surfaces again with several of the generic "pharmacies" spouted by search engines, such as www.pharmacy-prescriptions.com and www.prescriptionfiller.com.
This phone number leads to RX Customer Care, a nom de phone of Customer Care Inc., a Florida-based company that told Consumer Reports WebWatch it fulfills prescription orders to 262 online pharmacies. According to a manager who declined to give his name, the company has no role in evaluating online medical questionnaires or in writing prescriptions, and he would not discuss identities, practices or credentials of its pharmacy partners. Dozens of the Web sites that list the toll-free customer service number also refer buyers to an e-mail address, firstname.lastname@example.org, whose Internet domain is registered in Thailand.
The U.S. Food and Drug Administration and state medical boards have warned consumers of the risks in buying medications from Web sites whose doctors prescribe drugs without meeting patients. The risks are even greater when the people running the drug vending sites are anonymous.
"The problem with the Internet is that you may think you are ordering drugs from an American or Canadian pharmacy," says Laura Bradbard, an FDA spokeperson. "But actually they are often coming from Thailand, India, Sri Lanka or the Caribbean, and sometimes they're not the approved drugs or they're the wrong strength. These are business people who set up in warehouses and such, and they find drugs wherever the can and they market them. There's nobody to make sure it's safe."
Online buyers thus have no way of knowing whether anonymous sellers are violating federal law by shipping prescription drugs across U.S. borders. Worse, there's also a good chance buyers are receiving illegal, or possibly counterfeit, drugs.
According to the Federation of State Medical Boards, 27 states have medical board policies or state laws requiring a direct relationship (usually, a face-to-face evaluation) between a doctor and a patient before a drug can be prescribed. Enforcement actions are increasingly common: In January, California's medical board fined six out-of-state doctors a total of $45 million for prescribing drugs over the Internet.
Online consumers have legitimate alternatives to rogue drug sites. Drugstore.com, for example, requires patients have an existing relationship with a doctor who verifies the prescription. In addition, the National Association of Boards of Pharmacy (NABP) offers a list of online pharmacies that meet safety and licensing standards.
Because the discounts and convenience of Internet prescription drug sales will continue to lure tens of thousands of consumers, regulators urge would-be buyers to do themselves a favor by steering clear of mystery merchants.
"If a consumer can't establish by looking at a site where the pharmacy is, who its physicians are, where they're located and what their license number is, they really should just stay away," says Carmen Catizone, NABP's executive director. "And they should never provide personal information to an unknown source and never sign a waiver. If the drug is harmful, you've waived your right to sue."
Robertson Barrett, a media consultant and writer, was a founder and managing editor of TIME.com and ABCNEWS.com. He was also vice president and general manager of The FeedRoom, a nationwide broadband news network in partnership with NBC and Tribune, and of Channel One Interactive, the educational television network's new media division.
He's written about spyware and Internet "washers" for Consumer Reports WebWatch.