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Online Pharmacies and Telemedicine

by Uneeb Khan
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Nearest Walmart

It is rare without our email inboxes not get filled with ads for prescription medications. A lot of these emails promise to ship drugs for all kinds via overnight couriers, without prescription. Nearest Walmart Although the internet is full of legitimate pharmacies as well as the use of telemedicine, or cyber-medicine is becoming more popular however, this new approach to the manner in which medicine is implemented is shaking the very foundations of medical practice. The ability to consult with an online doctor and have prescription medications delivered directly to your door by UPS is a broad concept with legal and social implications. The Internet allows access to drugs to people who might not be able to pay US costs, feel embarrassed to visit a doctor face-to-face or suffer from discomfort, that puts doctors directly in opposition to the “war on drugs,” but on the other hand, there is the issue of whether these pharmacies can make drugs accessible to recreational drug users , without the supervision of a licensed physician.

The Need for Alternatives

The medical system within the US is at a level that it is costly and indifferent, which has led the patient to become unhappy by the health establishment in general. Some examples include the vast difference in the prices of medicines that are available in US and Canada and the long waiting times at US pharmacies as well as poor service generally. Nearest Walmart Perhaps , they are aware of that, US customs appears to allow thousands of Americans who travel to Canada each year to purchase their prescriptions, because generally the ‘drug purchasers’ are seniors who are unable to afford the price of filling prescriptions here in the US.

Instead of having to travel in Canada instead of traveling to Canada or Mexico many Americans have turned to the Internet to meet their medical requirements. Telemedicine (or cybermedicine) gives consumers the possibility of chatting with a doctor online , and buy prescriptions on the Internet with a lower cost. The result is that consumers are choosing online pharmacies for their medical requirements and, in particular, pharmacies which have relationships with a physician. These permit the user to skip conventional bricks and mortar pharmacies and also having their doctor serve in the role of an intermediary for patient with the pharmacist. As per Johnson (2005) Johnson (2005), this happens due to consumers being dissatisfied with their experience when it concerns dealing with traditional brick and mortar pharmacy as well as medical professionals. According to Johnson states, “Consumers are more likely to know the name of their hairdresser than their pharmacist.” If Johnson (2005) evaluated the different professions in the health care system the pharmacists were found to have the lowest interactions with their patients than the other group. As a result from the fact that “consumers are buying 25.5 percent of their prescriptions online, opposed to 13.5 percent of which are picked up at a brick and mortar pharmacy” (Johnson 2005).

Drugs and Society

The reason for the adulation and focus to the online pharmacy is the fact that you can get nearly any drug without prescription. Most prescriptions are valid and that are purchased from an online pharmacy due to the fact that the customer is uncomfortable to see a doctor or due to any other reason like the lack of FDA approved medicines to the customer. These medications may contain steroids which, due to their abuse and being classified as in the category of three drugs which are rarely prescribed by doctors. They serve a beneficial function for those who suffer from any wasting illness like AIDS and also play an important role in the fight against aging (FDA 2004).

The Doctor Patient Relationship

A visit to the doctor is usually short, most of the triage is performed by a nurse, or a nurse practitioner, with the doctor visiting only for a few minutes or if they are there at all. Most of the time, the patient is examined by a nurse. Another argument in favor of the use of telemedicine, which in a more appropriate term , cyber-medicine, it is the fact that the medical professional doesn’t have a physical connection with patients, and therefore cannot diagnose the patient, which means that he cannot legally prescribe medication.

It is interesting to compare the process one goes through to speak with online physician and compares this to a face-to-face appointment with brick and mortar doctors it is evident that the online doctor is often the one who has a greater understanding of the patient’s medical situation than the physician who sees the patient. Most of the time, before an online doctor prescribes a kind of medicine, they will require a complete blood test. Sometimes, they need to have additional tests taken like.

The AMA and Federal government as well as a number of states assert that it is unlawful for doctors to prescribe drugs without a valid relationship between doctor and patient. Although there aren’t any laws in force that prohibit online pharmacies, several states have passed legislation or are currently passing legislation that would restrict a doctor from prescribing medications to patients who they haven’t met in person. Some states also require the physician who prescribes medications be licensed by their state. This is a major obstacle to the growth of cyber-medicine. As per William Hubbard (2004), FDA associate commissioner “The Food and Drug Administration says it is giving states first crack at legal action, though it will step in when states do not act” (FDA 2004).

Internet Pharmacies

The reason email boxes all over the world are filled with advertisements for various drugs at lower prices, with no prescriptions, and so on is due to the fact that people purchase these drugs, according to millions of dollars that pharmaceutical companies earn every year attests to. The Internet has become the online drug retailer of choice for many.

Categories of Internet Pharmacies

Internet pharmacies have been believed to be made up of five categories:

Internet pharmacies can be broken into five distinct categories. These are:

Online pharmacies licensed by the FDA with without medical affiliation.

Online pharmacies licensed by the FDA with an affiliation with a medical professional

Online pharmacies with no record (NRP)

International online pharmacies (IOP)

Compounded pharmacies that are licensed

The online pharmacies that are licensed and have no medical affiliations are , of course, Drugstore.com, CVV, and other. All require the prescription of a licensed doctor with whom is in doctor/patient relationship with. The prescription must be filled through the medical professional.

The online pharmacies licensed by the FDA with an affiliation with a medical doctor usually rely on brokers. The broker gathers your medical details and assigns your situation with one of their affiliated doctors. A majority of the networked doctors will prescribe painkillers because they believe it’s only by the use of these medications that people can lead a peaceful life.

An Government Accountability Office (GAO) Committee on aging held in June 2004 discovered it to be true that “Unlicensed international pharmacies do not require a prescription, and are generally located off shore.” There are no prescription-only pharmacies to be found throughout the globe. A number of these websites are in the news due to controversy because in some instances, all it takes to get the prescription sent to you via next day air is filling in a form on the internet.

A study carried out by Henkle in 2002 to determine the ease to get prescriptions over the Internet discovered the following “37 of the 46″ pharmacies needed a prescription from a licensed physician. The focus lies on prescriptions, rather than the physician. Henkle (2002) actually states that certain sites offer recommendations for doctors.” Henkle (2002) could obtain prescription medications from nine websites outside of the US in the course of his study without prescription.

Online pharmacies that have doctor affiliation

There are numerous pharmacies online, which have an affiliation to a medical institution, which make a great effort to distinguish from unlicensed foreign pharmacies. These pharmaciesinsist the fact that they’re “American located companies that offer customers with accessibility to FDA authorized online prescriptions on the Internet and quickly say the fact that “An online consultation could be exactly the same as an in-person appointment.” It’s important to remember that a lot of these pharmacies mention they “While they are committed to making access to online prescriptions easier, they believe that the Internet can not replace the importance of regular doctor visits to fully evaluate your health and any medical conditions.” The majority of these pharmacy online websites also offer a wide range of information on drugs on their web pages that allows consumers to learn more about the medicines that could be prescribed. The Internet can be used for all uses is quickly replacing brick and mortar doctor as the primary healthcare provider.

A sales pitch, yes but is it really? The majority of legitimate pharmacies online ensure that they are in compliance with federal and state laws. Doctors are licensed across all 50 states, and their pharmacies too. The legitimate Internet pharmacies are geared towards customers who want an affordable price. For some , it’s as simple as choosing to eat cat food and crackers to try to pay for their medication due to the pricey US cost of drugs. Some patients also turn to online medicine to avoid embarrassment dealing with a pharmacist or doctor which could be judgemental. A lot of these pharmacies online offer a consultation with a licensed and medical doctor via phone and prescribe the medication accordingly.

In the words of Henkel (2000) “More and more consumers are using the Internet for health reasons” and refers to the findings of a study conducted by a market research company Cyber Dialogue Inc., “that discovered that “health concerns rank as the sixth reason that most for people to visit the web” (Henkel 2000).).

For many, going to the pharmacy can be a hassle. In certain cases, the pharmacy could be in the nearest town, which could require a lengthy drive when one is in a rural area. Online pharmacies are a way that prescriptions can be handed out quickly and efficiently. Online pharmacies also allow the customer to shop around at the most affordable prices, which is essential when living on pension.

It is true that the Internet has also made an educated user. It’s not uncommon for consumers to conduct research on drugs via the Internet. One might have seen a television or magazine advertisement promoting the latest drug. The Internet gives the user the chance to establish an arrangement with a doctor that could in reality be more legitimate than a doctor who has a physical appearance. Further information on doctors that practice telemedicine can be found at

It is important to consider it has been mentioned previously that people are increasingly unhappy with the service and services they receive from brick and mortar pharmacies and pharmacies. Zanf (2001) refers to the study of Lang and Fullerton which “Identified four factors related to outpatient pharmacy services: professional communication, physical and emotional comfort, demographics, and location and convenience.” All of these are key reasons behind the reason why increasing numbers of consumers are opting for online medicine.

The Dark Side

There’s also a darker aspect of the Internet pharmacy. As we’ve explained, spam emails claiming the availability of every prescription drug you could need, even without a prescription something that is widely known to everyone. has reached epidemic levels.

From Ambien And of course Viagra to more potent drugs like Oxycontin and Oxycontin, you can get everything. Overnight shipping is offered in most cases according to the emails proclaim.In some cases, the spam from pharmacies comes from untrustworthy people who are not in the business of providing the drugs and are aware that very few would protest about the lack of delivery of a drug that is illegal via mail.

In other instances, the drugs are purchased without a prescription from countries in which that particular drug is legally sold without prescription or at the very least, the laws are less restrictive. Valium, for instance, is available over-the-counter in Taiwan.

Based on Crawford (2004) “Consumers who purchase drugs online thinking that they are they are getting the same drugs as they would from their local brick-and-mortar pharmacy are being misled, and as a result are putting their health, and eventually their lives at risk” Crawford gives instances of Internet pharmacies selling medications that were not strong enough as well as contaminated and incorrectly labeled (Crawford 2004).

In the words of Won (2005) Executives from the drug industry believe that executives from the industry believe that the Internet and mail-order services will be the most significant sources of fake drugs in 5 years time, as per an analysis released this morning from Ernst & Young. According to James G Dickinson (2005):

The federal government closed down an alleged illegal Internet pharmacy selling fake drugs. The government also issued a caution on other counterfeits discovered to have been sold at Mexican pharmacy chains to patients in the U.S. The Internet pharmacy was able to sell an estimated $7.7 million worth of illegal counterfeit Viagra along with other prescription drugs in the last five years, in the opinion of the San Diego Union-Tribune. The San Diego-based business required customers to fill out the $33 “doctor consultation” survey before receiving prescriptions. However, the questionnaire was never presented to a doctor to determine if a security risk was present, the report states (Dickson 2005).

In a separate move in a separate incident, the FDA issued a warning to Americans about fake versions of Merck’s cholesterol medication Zocor and Carisoprodol generic – used to treat musculoskeletal disorders which were brought from Mexico by individuals Americans (FDA 2005).

In the past year, people suffering from pain or other ailments for which they’re hesitant to visit an appointment with a doctor face-to-face have the option of visiting a doctor online. The possibility of consulting an online doctor, and to then receive medication due to it, has been the subject of much debate. It has in the main part occurred due to not properly screening the patient’s medical records and/or placing orders from pharmacies that are not regulated in the foreign market.

The Internet is a revolutionary method of advertising

However, not all Internet pharmacies are legitimate There are numerous pharmacies that can give the user an authentic prescription via overnight delivery. My last prescription was delivered via mail. The entire transaction was conducted via the Internet. It was a prescription my doctor had prescribed to me personally, but. What constitutes the doctor-patient relation is the core of the debate over online pharmacies. This has implications on what is an authentic prescription. What is an authentic prescription is a topic that is hotly debated.

The Future

As previously mentioned, the ability to speak with a doctor over via phone, and later get a prescription filled through the Internet pharmacy is a great option for many. Since the American population grows older increasing numbers of patients will face difficulties getting to the doctor’s office, in addition to taking a drive for a pharmacy. It is clear that safeguards are required in order to improve the quality of medical treatment accessible to Americans. The pharmaceutical industry online has taken several measures to ensure that customers are safe from unscrupulous online pharmacy providers, such as the accreditation of pharmacies that operate online.

In the words of Henkel (2000) “One way consumers can ensure the quality of an online pharmacy is to look for the Verified Internet Pharmacy Practice Sites (VIPPS) seal.” As per Henkel (2000) the website that has this seal has been through a rigorous set of quality inspections that make up the Verified Internet Pharmacy Practice Sites program. As Henkel (2000) says, “Because VIPPS certification is fairly new and voluntary, only a few sites have been certified so far.” Recognizing the dangers of ‘rouge’ pharmacies SquareTrade has also launched the program to protect customers from pharmacies that are ‘rouge. In the words of SquareTrade, “The Licensed Pharmacy program verifies that your business is a pharmacy in good standing. Verified pharmacies can display the Licensed Pharmacy Seal on their websites – distinguishing themselves from unverified and rogue pharmacies.”

If these safeguards aren’t up, or a law is passed making it illegal to purchase prescriptions from an online pharmacy on the basis of an online consultation and the illicit market for prescription drugs will continue to thrive. Customs, as it is admitted by itself only manages to catch around 2 percent of the illicit prescription drugs that are imported into the US Read more

Negating the reality that, with technology, it is possible to establish a doctor-patient relationship that is affordable. Security could be improved, which some have suggested could be achieved through the use of video cameras as well as biometric scanners, which could decrease the number of prescriptions that are fraudulently filled. Such measures could put the ease of accessing online pharmacies out of the reach of people without the necessary technology. It is also possible to prevent users from using off-shore online pharmacies. Although the FDA is currently working hard to persuade to convince the Canadian government to pass laws that prohibit the importation of drugs to Canada through mail, it seems that the revenue from the sale of these drugs causes the legislation to stagnate. According to one Canadian pharmacy owner said that “We will just move to the UK.”

The Canadians offer to crackdown in no way because of any issues related to the selling of drugs online however, they are doing so because Canada regulates the price of drugs which makes them much less expensive than the same drugs that is available in the US. The Canadian authorities plan to crack down “arguing that the system was created to help Canadians, not Americans.” The industry of drugs has even gone as far to list as black Canadian pharmacies that sell their products to American customers via the Internet. With all the fear and apprehensions related to terrorism, there’s an issue that any substance that is imported from a different country might be infected. There is no evidence that have been reported of a user receiving a drug that was contaminated from Canada (Matthews 2003).

In addition, and in stark contrast to all the discussion about the dangers of using drugs bought from abroad, some legitimate businesses are being required to purchase from other than US sources due to having been blacklisted by US drug manufacturers (Matthews 2003). Mathews (2003) continues to demonstrate this by pointing out “Canadian suppliers, in particular, that have been blacklisted, are now turning to sources in Europe.” Mathews (2003) states that for the vast part , these European sources are legal and provide a top-quality drug. In some cases, however Mathews et al. (2003) observe that pharmacies have to travel further afield in order to get the drug.

Conclusion

While we need controls to be implemented to control the practice of both in online pharmacies as well as Internet pharmacies, you must acknowledge that technology and science have aided our understanding of the field and the Internet can further enhance it.

The Internet could be a means of extending medical care for those who do not typically seek it or are too weak to visit a doctor’s office. Although the current trend seems to be making it illegal for doctors to prescribe medications without seeing patients face-to-face, there is a movement to create regulations and guidelines to assure that patients receive high-quality treatment over the Internet. The problem is that medicine and politics have become interconnected that doctors have accidentally become unwitting agents in the fight against drugs.

It is impossible to turn back the clock, however as per Larkin (1999) “At a July 30 US Department of Commerce hearing on the benefits and risks of ‘drugstores on the net’, the question was examined.” The primary concern was how to stop online pharmacies that are run by unethical individuals, yet sustaining legitimate business in online pharmacies so as to encourage commerce while protecting the customer (Larkin 1999). In the words of Larkin (1999) “What’s new here is not the practice of pharmacy, but the way we communicate with and inform customers.”

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