Availability of prescription-only drugs and lack of clinical
oversight
A number of studies have shown that nearly every major category of prescription drug is available
online without a prescription (58–65). In 2009, French researchers investigated the online availability
of treatments for psoriasis (62). They discovered that it was a facile process for consumers without
significant Internet expertise to find Internet pharmacies selling the majority of available treatments
without requiring a prescription; even the newest and most expensive products (e.g. biological agents)
were readily available.
Even more worrisome, other groups of researchers have found it surprisingly easy to purchase the class
of medications called opioids over the Internet without a prescription (65). Opioids are used medically
as painkillers, but their use can also lead to dependence and serious side-effects such as respiratory
depression. In 2006, Forman and colleagues (60) conducted 47 Internet searches for a range of opioids.
Searches using terms such as “no prescription codeine” and “Vicodin” yielded more than 300 web sites
offering to sell opioids without a prescription.
Perhaps one of the easiest drugs to find online without a prescription is the drug sildenafil. While sildenafil
is used for treating pulmonary arterial hypertension (WHO Group I) (Revatio®), it is much better known
for its use to treat erectile dysfunction (Viagra®). In one of the earliest studies looking into the sale of
Viagra® online, researchers conducted a systematic search of the Internet to identify all sites selling
Viagra® directly to consumers between 14 April and 28 April 1999. Of 4400 potentially eligible sites
returned by the search engines, 86 offered to send Viagra directly to the buyer without needing to see a
doctor. Of these 86 sites, 55% required the customer to complete an online medical questionnaire, 5%
offered but did not require a questionnaire, and 40% did not offer any type of evaluation (58).Review of the literature
23
The online sale of sildenafil has not changed much in a decade. A more recent study conducted in 2010
found that 34% of Internet pharmacy sites offered to sell Viagra® to consumers in the United Kingdom
without any form of medical consultation (61). The researchers were unable to determine whether the
medical questionnaires offered by 59% of sites were required to be completed prior to purchase.
Availability of prescription-only drugs and lack of clinical
oversight
A number of studies have shown that nearly every major category of prescription drug is available
online without a prescription (58–65). In 2009, French researchers investigated the online availability
of treatments for psoriasis (62). They discovered that it was a facile process for consumers without
significant Internet expertise to find Internet pharmacies selling the majority of available treatments
without requiring a prescription; even the newest and most expensive products (e.g. biological agents)
were readily available.
Even more worrisome, other groups of researchers have found it surprisingly easy to purchase the class
of medications called opioids over the Internet without a prescription (65). Opioids are used medically
as painkillers, but their use can also lead to dependence and serious side-effects such as respiratory
depression. In 2006, Forman and colleagues (60) conducted 47 Internet searches for a range of opioids.
Searches using terms such as “no prescription codeine” and “Vicodin” yielded more than 300 web sites
offering to sell opioids without a prescription.
Perhaps one of the easiest drugs to find online without a prescription is the drug sildenafil. While sildenafil
is used for treating pulmonary arterial hypertension (WHO Group I) (Revatio®), it is much better known
for its use to treat erectile dysfunction (Viagra®). In one of the earliest studies looking into the sale of
Viagra® online, researchers conducted a systematic search of the Internet to identify all sites selling
Viagra® directly to consumers between 14 April and 28 April 1999. Of 4400 potentially eligible sites
returned by the search engines, 86 offered to send Viagra directly to the buyer without needing to see a
doctor. Of these 86 sites, 55% required the customer to complete an online medical questionnaire, 5%
offered but did not require a questionnaire, and 40% did not offer any type of evaluation (58).Review of the literature
23
The online sale of sildenafil has not changed much in a decade. A more recent study conducted in 2010
found that 34% of Internet pharmacy sites offered to sell Viagra® to consumers in the United Kingdom
without any form of medical consultation (61). The researchers were unable to determine whether the
medical questionnaires offered by 59% of sites were required to be completed prior to purchase.
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