Fears as patients flock to buy drugs on internet
Carmel Egan
February 25, 2007
FRUSTRATED by delays and over-regulation in the public health system, patients are side-stepping their doctors and local pharmacists to buy cut-price prescription medicines on the internet.
The online global dispensaries are in direct competition with the highly regulated national retail system of chain pharmacies and local chemists.
The internet pharmacies ask subscribers to mail their doctors' prescriptions to a postal address, most often in Canada, and facsimiles and photocopies are not accepted.
They claim the bulk of their Australian customers are ordering medicines for chronic conditions such as high cholesterol, type 2 diabetes, osteoporosis, high blood pressure and benign enlarged prostate glands.
But customers are also buying experimental drugs not yet approved for sale in Australia, cheaper generic products banned by local patent laws and drugs not subsidised by the Pharmaceutical Benefits Scheme.
The online services further threaten local pharmacies by offering discount deals for generic prescription medications, free shipping for bulk orders and over-the-counter goods such as herbal medicines, vitamin supplements, personal care items, cosmetics and even pet products.
Unlicensed commercial importation of prescription medicines is illegal, but there is nothing to stop individuals importing medicines for their own use or for close family members.
A spokeswoman for the Therapeutic Goods Administration admitted that consumers and technology had outflanked the government authority charged with policing which pharmaceuticals are sold in Australia. One of the world's largest internet pharmaceutical suppliers, *****, claims to have registered hundreds of Australian customers since recently expanding into the Asia-Pacific region.
"As time progresses and as the laws change to meet the reality of international pharmacy, I am confident that our Australian patient base will continue to grow," said ***** lawyer Troy Harwood-Jones.
"It does not appear that there is any particular pattern to their medication purchases such as primarily purchases of cancer treatments.
"It appears that *****' Australian patients are the same as any other international patients: individuals whose therapies are best served by purchasing their maintenance medications from a safe, affordable, international prescription pharmacy provider."
But the president of the Pharmacy Guild in Victoria, Dipak Sanghvi, has attacked internet dispensing as dangerous.
"The Pharmacy Guild of Australia does not support that way of dispensing," said Mr Sanghvi. "We believe every patient needs to be counselled."
Mr Sanghvi said the guild was concerned about the interaction of different drugs that patients might be taking and reactions to drugs they were prescribed.
"The problems come in that there are a lot of products not available in Australia and it takes a long time for assessment of a new drug by the Australian Government, when it assesses here and takes in the side effects," he said. "There have been a lot of cases where internet drugs in Europe are not the right drugs. There can be tampering. It is really dangerous.
"It is a question of whether you want to save money or avoid problems."
TGA spokeswoman Kay McNeice warned that patients also risked buying counterfeit products.
"What often happens, particularly when they buy products such as Tamiflu over the internet, is that it can be counterfeit," Ms McNeice said.
"There is not a lot we can do about it except to say don't buy over the internet because there is no guarantee the product is real.
"It is a way around the system, but it is a matter of buyer beware."
Alex Broom, a specialist in medical sociology and internet use at the University of Queensland, said that internet patients were often also looking for complementary alternative medicines, experimental treatments "and things that are banned or not provided by the mainstream system".
In his research with prostate cancer patients who used the internet for information and to buy medicines, Dr Broom said there were traps for the unwary. "Sometimes (the patients) are partially right," he said.
"They are buying treatments that are seemingly efficacious but are complicating treatment in the long run."
Dr Broom said global communication networks now allowed Australian patients to visit chat rooms and join self-help groups to find out about new drugs.
TREAT YOURSELF
AMONG the 10 best-selling drugs listed on ***** are three not subsidised by the Pharmaceutical Benefits Scheme in Australia:
- Diovan (valsartan): A blood pressure-lowering medication also used in treatment of Type 2 diabetes manufactured by Novartis. Unavailable in Australia. Cost: $US108.30 for 84 40mg tablets
- Flomax (tamsulosin): An alpha blocker manufactured by Sigma prescribed for men with benign prostatic hyperplasia, non-cancerous enlargement of the prostate gland. Brand available in Australia at $US108.53. Generic product $US71.52 for 90 tablets.
- Fosamax (alendronate sodium): Used in the treatment of osteoporosis and Paget's disease of the bone, often prescribed for post-menopausal women. Available for some treatments through the PBS from April. Retails for $US114.46 for 12 tablets in Australia, available in generic alternative for $US102.21 on internet.
