Illegal online pharmacies: how endemic are they?

Illegal pharmacies are defined as those that operate without certification, prescribe drugs without adhering to legal guidelines, or knowingly distribute counterfeit medicines. In recent years, increased interest in e-commerce and the anonymity offered by the internet has led to illegal online pharmacies taking hold. According to The Alliance for Safe Online Pharmacies (ASOP) 100% of online searches for the phrase “buy medicine online” return links for illegal online pharmacies.  A report from The Centre for Safe Internet Pharmacies claims that each month, 600 new illegal online pharmacies are launched; taking advantage of this ever-increasing market that has generated a staggering $11bn.

Not all online pharmacies are illegal; many adhere to the regulations for the selling and distribution of prescription drugs. However, a random sampling of 10,000 online pharmacies by the FDA found 97% of them to be illegal or not conforming to the regulations. Despite this, it was also found that one in four American consumers buy their prescription medicines online. For the consumer, differentiating between the illegal and legal online pharmacies can be difficult due to a lack of awareness about the issue, and the similarity in appearance between legal and illegal outlets.

While the illegal or black market trade of pharmaceuticals is not a new issue, the presence of illegal online pharmacies has grown in recent years. Part of this growth is due to increased awareness and visibility; as illegal pharmacies have moved onto the internet, they are much easier for consumers to find and access. It has been estimated that there are approximately 40,000 illegal online pharmacies. The fact that there is such a large number of these organisations is due to a combination of two major factors.

First, at $560bn, the prescription drug market dwarfs other illicit drug markets many times over, offering hugely lucrative opportunities. One group reportedly made sales of £55m ($72.9m) over a 12–15 month period through their illegal online pharmacy.

Second, despite the fact that these pharmacies are illegal, the detection and prosecution of the organisations running these pharmacies is extremely difficult, with the Medicines and Healthcare products Regulatory Agency stating that it was completely impossible to control online pharmacies, due to the sheer number of them present on the internet. This has given rise to a perfect storm of high reward and low risk, which has fuelled the growth of illegal online pharmacies.

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