“Dispense as Written” are the words found on prescriptions in the U.S. when the prescriber wants the patient to take the brand drug, not the generic. Many who read Katherine Eban’s new book – Bottle of Lies: The Inside Story of the Generic Drug Boom – will conclude that they would like to see “DAW” on their prescriptions.
Bottle of Lies teaches its readers that generic drugs are not as good as the FDA claims. It shows that poor manufacturing practices, mostly in India and China, but also in the U.S., are the leading cause of substandard drugs being sold in U.S. pharmacies and throughout the world. More ominously, India and China intentionally ship even lower quality and, in some cases, worthless drugs to poor countries in Africa and Southeast Asia where regulations are weak or non-existent.
Over 700,000 people died in the U.S. from a drug overdose between 1999 to 2017. That’s about 130 American deaths daily. At PharmacyChecker, we are dedicated to helping fight this epidemic by learning more about the crisis and spreading awareness. I recently obtained certification for The Opioid Crisis in America course offered by Harvard University.
According to a report published by the Substance Abuse and Mental Health Services Administration (SAMHSA), the main channels that people obtain opioid drugs illegally are from a friend or relative for free; buying from a friend or relative; or buying from a drug dealer or stranger.
As our main focus is often online pharmacy and importation, it’s notable that Harvard did not identify online pharmacy or importation as contributors to the opioid epidemic.
In their opposition to drug importation legislation, the myriad “non-profit” groups funded by drug companies often cynically invoke the evils of counterfeit drugs. We’ve seen this as recently as this week, when an importation bill triumphantly passed in Florida (Prescription Drug Importation Programs HB19). One such group, the Partnership for Safe Medicines, was called out by PolitiFact for essentially lying that the new state law would “allow” imports from China “without FDA inspection,” tacking on that “too many have already died from counterfeit drugs.”
The Florida drug importation bill builds in so many
regulatory checks that it may in fact make importation from Canada into Florida
safer than our “regular” drug supply chain, but that’s for another post. As it
happens, no one has ever been reported killed by a non-controlled prescription
drug imported from a pharmacy that required a valid prescription.
PolitiFact is right to call out PSM, but I’m sad to report
that, yes, there is a very real counterfeit drug problem in the United States.
But, unlike the fake counterfeit drug facts propagated by groups like PSM to
scare people away from buying lower-cost medicines online, it comes in the form
of illegal fentanyl ingredients used
to make counterfeit prescription narcotics.
According to the FDA, in 2017, 80% of the active pharmaceutical ingredients used to make our medicines are imported. I can’t remember how many times I’ve read (and written) that over the past decade or so. Almost every time I read that particular statistic in the news, it’s often a story about drug quality problems, in which foreign APIs are reported as a growing problem. Flashback to the FDA in 1998: as reported by the U.S. Government Accountability Office, the percent of active pharmaceutical ingredients used to make medicines for sale in the U.S. is about 80%.
This week Purdue Pharma settled with the state of Oklahoma for $270 million to avoid a trial charging the company with what I call opioid drug dealing. Purdue Pharma and members of the Sackler family–founders and managers of the company–are enmeshed in 1,600 cases throughout the U.S. They are accused of illegal marketing activities that led to over-prescribing and rampant distribution of Oxycontin, which paved the way for millions to the addiction of opioids, with hundreds of thousands dying over the last decade.
It was not just Purdue but many drug companies—and the entire
drug supply chain—that fueled the opioid death spiral. As drug companies and
their allies in the drug supply chain continue to use the opioid crisis as a
means to oppose prescription drug importation to lower drug prices in the U.S.,
we can only look on with amazement at their audacity.
International online pharmacies process orders for prescription drugs that are mailed across borders. That’s a simple definition for myriad websites, good, bad and in between, that can be found selling medicine on the Internet. Patients looking online for affordable medicine from another country want to know they will receive a lawfully-manufactured medicine that works. At PharmacyChecker, we believe we’ve developed a system of standards, rules and policies, for evaluating such websites to determine if they are safe and the businesses involved properly licensed. Those online pharmacies that are not only eligible but also willing to accept our monitoring and oversight are verified in our Verification Program. Verified means that an online pharmacy meets our online pharmacy standards of practice and agrees to our monitoring and oversight protocols. PharmacyChecker-verified online pharmacies are eligible to publish a PharmacyChecker seal on their websites and list their pharmacy information and prices on our website.