Unregulated internet a minefield for medicines

Antibiotics are available without prescription in nearly 50% of online pharmacy websites surveyed by UK researchers

Online pharmacies that provide medicines without a script may be contributing to antibiotic resistance and also pose a direct safety risk to consumers, argue researchers from Imperial College London.

In a recent study the researchers analysed 20 online-only pharmacies that UK citizens had access to.

Those that showed evidence of operating from within the UK (25%) were found to require a script for antibiotic purchase and were appropriately registered.

However online pharmacies unclear about the location they were operating from (50%) had variable prescription requirements and no evidence of appropriate registration.

Furthermore, 45% of online pharmacies did not require a prescription prior to purchase of antibiotics.

For 80% of the online pharmacies, the decision for antibiotic choice, dose and quantity was consumer driven.

Dr Sara Boyd, co-author and Academic Clinical Fellow in Infectious Diseases at the college, says the findings “are a real concern, and raise several important issues regarding antibiotic resistance and patient safety with online pharmacies”.

In Australia the TGA has run a campaign warning consumers about the dangers of buying medicines online.

The Australian Competition and Consumer Competition’s Scamwatch web resource also warns consumers to be aware of fake online pharmacies.

“Fake online pharmacies operate through websites or emails offering you cheap healthcare products and medicines – sometimes without needing a prescription,” says Scamwatch.

Customs also keep an eye out for medicines being sent to Australia from overseas.

However the internet is, by its nature, a worldwide resource that is difficult for regulatory bodies to police.

A quick search by the AJP, using the same terms the UK researchers used (“buy antibiotics online”), shows several options for antibiotics purchase by Australian consumers.

These include rxdownunder.com, buyantibioticsaustralia.com and cialisaustralia2014.com.

An exclusive offer from an online pharmacy.

The above websites did not require a prescription to order antibiotics through their websites.

One website even offered free Viagra pills with every order.

Shifts in consumer behaviour over the past decade mean increasing numbers are now opting to purchase products online, warn the UK researchers.

“The availability of antibiotics online, or products being sold as such, poses a serious threat to patient safety and national antibiotic stewardship initiatives.”

There is an “urgent need to improve the surveillance of online antibiotic sales,” they say, adding that “antibiotic distribution through online channels should be mandatory to report”.

But the issue remains, as with all facets of the internet, as to how such practices can be regulated and laws enforced.

The study was published in the Journal of Antimicrobial Chemotherapy.

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