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Internet Drug Sales Attacked
by Kansas Attorney General

Attorney General Carla J. Stovall announced at a news conference today that her office has filed five consumer protection lawsuits against numerous companies and individuals selling prescription drugs via the Internet. The Attorney General has also obtained restraining orders that temporarily prohibit the parties named in the suits from doing business in Kansas.

The lawsuits, filed in Shawnee County District Court in Topeka, are against seven companies selling prescription-only medication, some of which are controlled substances, on the Internet; six doctors who are not licensed by the State Board of Healing Arts to practice medicine in Kansas, but are prescribing these medications; four individuals doing business under fictitious names and three out-of-state pharmacies that are dispensing the drugs to Kansans without being registered by the Kansas Board of Pharmacy. The Board of Healing Arts has filed a lawsuit in one of the cases for the unauthorized practice of medicine, and the Board of Pharmacy has filed lawsuits in four of the cases for the unauthorized practice of pharmacy.

The Internet companies and pharmacies named in the lawsuits are DVM Enterprises, Inc.; Home Prescription Services, Inc.; Confimed, L.L.C.; Focus Medical Group, Inc.; Senior Care Pharmacy, Inc. formerly LTC Pharmacy, Inc.; and Viapro, Inc. Two individuals doing business as Male Clinic and one individual doing business as Community Drug of Pittsburgh and one individual doing business as Stivercorp and Online Physicians were also included in the lawsuits, as well as out-of-state doctors who prescribed the medications.

"It is unfortunate that State action is necessary to stop these illegal activities, but I will not allow these companies to continue to endanger the health and welfare of Kansans,especially our children," Attorney General Stovall said.

According to the Attorney General, some of these companies sold the prescription-only medication Viagra, in addition to other drugs. One company sold the diet drugs Meridia and Phentermine, both controlled substances that can have serious side effects and are not recommended for people with certain conditions and using certain medications.

During an investigation conducted by the Attorney General's Consumer Protection division and the Kansas Board of Healing Arts, a Board of Healing Arts agent, consumer protection agents, and a 16-year-old boy acting under the direction of one of the agents, made online purchases of prescription-only medications. The minor was able to purchase the diet-drug Meridia, a controlled substance, from DVM Enterprises, and Viagra from the two companies, Confimed and Male Clinic, using his true age and his mother's credit card. The companies did not require parental consent and no examination by or consultation with a physician was conducted. Attorney General Stovall said:

This should greatly alarm and be yet another enormous red flag to parents regarding the importance of always monitoring their childrens' Internet activity. I urge children to stay away from these web sites and parents to vigilantly supervise their children's exploration of the world wide web. Frankly, I believe it is only a matter of time before someone, possibly a child, dies from taking prescription-only medications they purchased over the Internet. Without a doctor consulting, examining and evaluating us to see if we truly need these medications or have any pre-existing conditions that would put our lives in danger while taking the medications, we put ourselves at risk by purchasing medicine this way.

The Federal Trade Commission is also concerned about online pharmacy sales. On July 30, 1999, the director of its Bureau of Consumer Protection, Jodie Bernstein, told a Congressional subcommittee:

Like other health care promotions on the Internet, the availability of prescription drugs via online pharmacies offers potential benefits to consumers, including convenience and value. Many online pharmacies appear to operate in essentially the same manner as mail-order pharmacies and in keeping with standards of state licensing authorities. Nevertheless, our review of the current practices of some online pharmacies and of some physicians that provide online prescription services indicates the potential for serious consumer injury. Significant potential for injury exists when prescriptions are issued without adequate review of the consumer's medical history or when unapproved drugs are sold to consumers over the Internet by overseas pharmacies. The Commission has limited anecdotal evidence of specific occasions where consumers have, in fact, received a prescription drug via the Internet that would be clearly inappropriate or even dangerous because of the age, health, or other drug use of the consumer.

The rapid growth in online sales of prescription drugs and the increase in the practice of online prescribing, both of which are occurring across state and even international borders, present significant technological and logistical challenges to the traditional regulatory framework. State medical boards and state pharmacy boards have both expressed concerns that their existing enforcement tools are not adequate to police the online medium. In many cases it can be difficult, without extensive investigation, to identify the name; location; and state of licensure or registration for the physicians, pharmacies, and website operators involved in these practices. Our review of almost 100 sites found that very few provided adequate identifying information. Even when parties can be located, it can be difficult and costly for a state medical board or a state pharmacy board to pursue law enforcement against an out-of-state physician or pharmacy prescribing or dispensing prescription drugs inappropriately via the Internet. . . .

The Commission's monitoring activities have led to a few preliminary investigations. In one situation, staff completed two mock online consultations in order to obtain the prescription drug Viagra®. For one of these consultations, staff described a number of factors in the "patient's" medical history that should have raised serious concerns about the appropriateness of issuing a prescription for Viagra, such as bypass surgery, obesity, family history of heart disease, and the absence of any information about other medications. In both cases, staff was issued a prescription without question and was able to purchase the Viagra online. This investigation led to referrals to the relevant state medical and pharmacy boards.

In February 1999, the National Association of Boards of Pharmacy announced that it was developing a voluntary Verified Internet Pharmacy Practice Sites (VIPPS) program. To earn the right to display the VIPPS logo, companies will have appropriate licensure and use appropriate, written policies and procedures for drug utilization review, patient counseling, patient confidentiality, and quality improvement programs.

In July 1999, the FDA announced its plan to help curb illegal prescription drug marketing on the Internet and posted tips for buying drug products online. The agency now lists warning letters sent to companies engaged in illegal sales through Internet.

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This article was revised on December 19, 2000.