General Warnings

Online Pharmacies: Types, Benefits, Risks, Safety

What is an online pharmacy?

An online pharmacy is an internet-based pharmacy that includes both legitimate and illegitimate pharmacies. Independent Internet-only sites, online branches of “brick-and-mortar” pharmacies, and sites representing partnerships among pharmacies fall under the purview of “online pharmacies.

Globalization has led to a surge in E-commerce, and the proliferation of online shopping for prescription and nonprescription medicines. The concept of online pharmacies and the online sale of medicines continues to grow worldwide. According to Statista, revenue in the online pharmacy segment is projected to reach US$20.83bn in 2022 and with an annual growth rate of 13.24%, the projected revenue from the online pharmacy market is expected to hit a volume of US$38.78bn by 2027.

Online pharmacies offer several benefits. The ease of being able to compare many sites to find the best prices and products, greater convenience and access to a wide variety of products, easier access to written product information, and references to sources other than what you would typically find in traditional storefront pharmacies are among the many benefits of patronizing online stores.

However, while many online shops that sell medicines are entirely legitimate, some online shops sell medicines illegally. There is no control over the manufacturing processes or sale of illegal medicines. This means there is no way of knowing what is in the medicine and how it works. If you buy illegal medicines, at best you risk spending money on something that might have no effect, at worst the medicine has serious side effects or puts your life at risk.

Types of online pharmacies

There are different types of online pharmacies and the ability to distinguish between the various types of medical online sites is helpful in understanding where to shop online. Generally, the three types of online pharmacies are:

Websites that offer traditional pharmacy services online only

 These pharmacy-only based sites will only dispense medicine to a consumer who has first obtained a prescription from a doctor and then submits it to the online pharmacy. Pharmacy-only sites are the least controversial because they do not actually initiate the drug sale. These sites merely process valid prescriptions which have already been obtained from a licensed practitioner. The most significant legal problem with these sites occurs when the pharmacy fails to obtain the appropriate license for each state where it intends to do business.

Prescription-based online pharmacies

 These sites often employ both pharmacists and doctors. However, they should be distinguished from the websites that also may employ doctors and pharmacists, but only offer medical advice or health-related information. The latter type includes thousands of online medical sites. Usually, the prescribing-based sites will provide an online doctor visit either through a medical questionnaire or a simultaneous video conference between the doctor and patient. For this “consultation,” a fee is charged that can range from $30-$150. After the patient enters the information and the doctor reviews it, a prescription may be issued which is then processed at an online pharmacy. Some prescribing-based sites are comprised exclusively of physicians who, upon issuing a prescription, contract with an online pharmacy to actually dispense the medicine. In many cases, the doctor, pharmacy, and patient are all located in different states. The strongest criticism of these sites is that an online form or questionnaire, no matter how detailed, simply cannot substitute for a physical exam. Without an actual face-to-face exam, critics contend that patient warning signs which might easily be detected by touch could go unnoticed, posing a potential risk to the patient. For this reason, prescribing-based websites are highly controversial and are the subject of most of the current actions discussed in this comment.

Online drug shops

The third type of online pharmacy is referred to as an online drug shop. This is an appropriate description because these websites are primarily engaged in the sale of drugs. Here, essentially all a consumer needs to do in order to obtain a controlled substance or any other prescription drug, is simply go to the site, pick out the drug of choice, and make the purchase with a credit card. With these sites, no examination is necessary and no medical questionnaire needs to be answered. Online drug shops often operate from foreign countries and are therefore usually beyond the reach of U.S. authorities. Although many consumers do not realize it, online drug shops are considered illegal by most law enforcement agencies.

 Authorities consider these sites to be the most dangerous because of their willingness to sell potentially dangerous controlled substances, including narcotics, to virtually anyone.  In addition, online drug shops often sell fake drugs and medications that are unapproved for medical use in the United States. The anonymous nature of the Internet, combined with the fact that many of these pharmacies are foreign-based, make them very difficult to stop. In fact, the few online drug shops that are discovered and shut down often reappear the next day under a different name or address, ready again to do business.

Are online pharmacies safe?

No, not all online pharmacies are safe. This includes online pharmacies that sell pet medications and veterinary medicines. According to the FDA, some of these sites may infect your computer with viruses or sell your personal information to other rogue websites and Internet scams. If you buy medicine from a fake online pharmacy, you also risk being harassed by repeated emails and phone calls or being charged for products you never ordered or received.

How to safely buy medications online

With medications seemingly just a click away, it can be tempting to just hit the Online pharmacy near me to place an order. However, the Food and Drug Administration (FDA) recommends against buying prescription medicines from other countries because the regulation of drug manufacturing may be laxer, or the pharmacy may be a fake. And, if you order a prescription drug without a prescription, your package could be seized.

If you do decide to order a medication from a pharmacy online, make sure to follow the FDA recommendations. Check into licensure, and look for the National Association of Boards of Pharmacy’s (NABP) Seal, also known as the Verified Internet Pharmacy Practice Sites™ VIPPS® Seal. To find the best online pharmacy store you need to check the reviews of the top online pharmacy Apps like RiteAid, NowRx, PillPack, NetMeds, and OptumRx

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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