A large share of medication that is imported by Americans for personal use from Canada and many other countries is ordered on the Internet. It’s not a secret that the pharmaceutical industry, U.S. chain pharmacies and the U.S Food and Drug Administration are not happy about it. But what they are doing about it is less well-known and even less well-understood. An important article published by Jeremy Malcolm of the Electronic Frontier Foundation last week called “How Big Pharma’s Shadow Regulation Censors the Internet” brings the situation into clear view. Multinational pharmaceutical companies and the FDA are funding non-profit groups, global initiatives, or private companies, ones that all work with each other, to make it harder, and may make it impossible, for Americans to buy medications online for personal import.
The ‘censorship’ about which Mr. Malcolm writes is subtle but no less real than more overt censorship. The censors essentially would like all international online pharmacies that sell to consumers in the U.S. to be shutdown. For the millions of Americans who can’t or struggle to afford medication, those websites are a lifeline and that censorship, if successful, would end it.
In the name of cracking down on dangerous rogue pharmacy sites, which is good for the public health, industry-funded and allied initiatives seek to rid the Internet of drug price competition. The groups and dynamics of their efforts to regulate the Internet to the disadvantage of consumers are the Alliance for Safe Online Pharmacies (ASOP), LegitScript, Center for Safe Internet Pharmacies (CSIP), and the National Association of Boards of Pharmacies (NABP).
Essentially, the online pharmacy verification programs of NABP and LegitScript have “white lists” of “legitimate” online pharmacies, and all other drug-selling websites, such as international online pharmacies in the PharmacyChecker.com Verification Program are not legitimate, even if the pharmacies dispensing the medication are licensed, require valid prescriptions and meet very high pharmacy practice standards, because they dispense medication into the U.S.. This paradigm of legitimacy is championed by the Alliance for Safe Online Pharmacies and Center for Safe Internet Pharmacies.
One of Prescription Justice’s core policy positions is that federal enforcement discretion against drug importation must be targeted tactically to prevent fake and compromised medication from getting into the hands of consumers, but not curtail access to lower cost imported medication. We recognize the technical illegality of most personal drug importation but, due to the crisis of high drug prices in the U.S., we staunchly believe that access to the safest international online pharmacies should remain as open as possible using rational, risk-based and compassionate enforcement discretion.
The American public is very angry about the cost of prescription medications and support several policies to make them more affordable, such as personal prescription importation. In the meantime, if safe international online pharmacies are helping them obtain medications at an affordable price, then censorship, in the open or in the shadows, is wrong.