Battling the Epidemic of Illegal Online Drug Sellers and Counterfeit Medicines

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For nearly two centuries, USP has helped secure the quality of the American drug supply. USP’s drug standards are enforceable in the United States by the U.S. Food and Drug Administration (FDA), and these standards are used in more than 140 countries.

Despite the efforts of USP and other pharmacopeias to establish strong pharmaceutical quality standards worldwide, the problem of counterfeit medicines and the illegal online drug sellers that peddle these dangerous products is urgent and rampant.

Illegal Internet drug sellers often operate overseas, from countries such as Russia, China, India, Mauritius, and Turkey, and mask their identities to prevent detection by law enforcement. Many illegal drug sellers generate tens of millions of dollars annually—often avoiding prosecution by exploiting the global anonymity the Internet provides.

Battling an Epidemic

Of the 35,000-50,000 active online drug sellers, 97 percent do not comply with U.S. laws and 50 percent of medicines sold online are fake or counterfeit, according to the Alliance for Safe Online Pharmacies (ASOP Global), an international non-profit headquartered in Washington, D.C. with operations in Europe and Asia.

These counterfeit medications are often manufactured in unsafe conditions; contain too little, too much or no active pharmaceutical ingredients; and, in many cases, have been found to contain dangerous substances like floor wax, rat poison, concrete, chalk, boric acid, road tar, paint, anti-freeze, and other toxins. This means that consumers worldwide are just a click away from buying products that may cause harm, treatment failure or even death.

recent report by the National Association of Boards of Pharmacy® (NABP®), the impartial professional organization that supports state boards of pharmacy in protecting public health and a Voting Organizational Member of USP, revealed that the threat posed by illegal online drug sellers underscores the need for consumer education:

  • Of the 10,965 ‘pharmacy’ websites that NABP® reviewed, 96.2% (10,544) were found to operate out of compliance with U.S. pharmacy laws. These sites are listed in NABP’s report as ‘Not Recommended’.
  • Approximately 62% of NABP’s ‘Not Recommended’ sites did not provide a valid physical location, and nearly 50% offered drugs that were either foreign or not approved by the FDA.
  • 88.4% of sites that were ‘Not Recommended’ were selling prescription drugs without requiring a valid prescription. 
  • Of the ‘Not Recommended’ sites, 91% were traced to larger affiliate networks of rogue Internet drug outlets.

Raising Awareness

Since it was founded in 2009, ASOP Global has been singularly focused on and united in its mission to combat illegal online drug sellers, ensure access to safe medications and protect patient safety.  USP proudly joined ASOP Global in 2014 and now serves on its Board of Directors.

The proliferation of illegal online drug sellers and the dangers they pose to global public health was the impetus for ASOP Global’s #BuySafeRx public awareness campaign, launched in May with the goal of educating consumers about potentially life-threatening health and financial risks associated with buying prescription medicines online.

The #BuySafeRx campaign includes an ASOP Global Overview Video; a new Share Your Storypage on ASOP Global’s website to collect patient stories about their real-life experiences with online drug sellers; a nationally distributed Multimedia News Release; and an aggressive social media campaign on LinkedIn and Twitter, in which USP actively engaged.

The campaign also included comprehensive print, broadcast and online media outreach; participation in a nationally syndicated podcast; and interviews with national and international media including ABC’s 20/20, USA Today and International Business Times. To learn more about the #BuySafeRx campaign or to join ASOP Global, visit

NABP, an ASOP Global observer, has been working to educate consumers about rogue ‘pharmacy’ websites and how to identify safe sources for purchasing medications online since 1999 through its Verified Internet Pharmacy Practice Sites (VIPPS) accreditation program.

The Association has been able to expand the reach of this important message through itsAWARXE Prescription Drug Safety Program that seeks to educate the public about proper medication use, safely buying medicine online and proper medication disposal.

Most recently, NABP launched its .pharmacy Top-Level Domain (TLD) Program, which provides an even easier way for consumers to identify safe and legal online pharmacies. If a website has “.pharmacy” at the end of its web address, consumers can rest assured that online pharmacy is operating legally.

Unlike .com and other domains, only legitimate Internet pharmacies and pharmacy-related websites are awarded .pharmacy domains. Applicants are thoroughly vetted by NABP and, where applicable, local authorities, to prove legitimacy of the online pharmacy.

Everyone Has a Role to Play

While USP, ASOP Global, NABP and many other public and private organizations will continue to lead efforts to protect people from illegal online drug sellers, everyone has a role to play.

Policymakers, law enforcement officials, pharmaceutical companies, non-profits, Internet commerce companies, and domestic and international organizations need to work together to help educate consumers about the risks of bypassing legitimate channels for prescription medicines and advocate for effective means to safeguard them from illegal online drug sellers.

Finally, resources must continue to be dedicated to collective work in research, education and international policy to effectively stem the tide of counterfeit medicines online.

To learn more about USP’s involvement in the battle against counterfeit medicines, read about some of its regional and global intiatives as well as its partnership with Fight the Fakes movement.

About the Guest Authors

Libby Baney is the Founder and Executive Director of the Alliance for Safe Online Pharmacies (ASOP Global). A lawyer by training and health advocate by nature, Libby’s work spans multiple continents, regularly engaging with diverse audiences on issues at the intersection of Internet technology and healthcare.

Carmen A. Catizone, MS, RPh, DPh, is the executive director of the National Association of Boards of Pharmacy® (NABP®) and serves as secretary of its Executive Committee. Catizone is involved in a variety of leadership roles with several other pharmacy organizations. He has also acted as a reviewer on several advisory boards, in addition to providing expert witness testimony and consultation in the areas of pharmacy practice and regulation.