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ing access to and quality of health care," says Bernard S. Bloom, PhD, research professor at the Department of Medicine of the University of Pennsylvania School of Medicine and lead author of the article. "But you often don't know what's in the drug you order, who made it, where it came from, where the online physician is who is prescribing the drug or even if he is a physician at all." According to Bloom, people who buy drugs on the Internet should ask themselves if they are willing to pay more for easier access and convenience to obtain the medication and the physician consultation but be exposed to uncertainties about the prescribing physician, the appropriateness of the prescription and the actual medications they're getting.

Food and Drug Administration (FDA) officials, in an accompanying editorial, describe how a patient in the U.S. traditionally obtains a prescription drug for the first time. The patient sees a licensed health care practitioner, who issues a prescription for an appropriate, FDA-approved drug that the patient gets from a registered pharmacist working in a licensed pharmacy. "Current laws provide safeguards against injuries from unsafe drugs and from the improper practice of medicine and pharmacy," says Jeffrey E. Shuren, MD, JD, of the FDA team. "Illegitimate Web sites undermine this safety net."

The FDA editorial cites potential problems with some Internet sites, such as sale of prescription drugs inappropriate for the patient (e.g., diet pills for an anorexic), dangerous drug interactions, contaminated drugs, drugs with subpotent strengths, counterfeit drugs and undelivered products. The risk of such outcomes is greater when buying from an illegitimate foreign company. The FDA advises consumers interested in buying drugs online to check with the Verified Internet Pharmacy Practice Sites (VIPPS) of the National Association of Boards of Pharmacy (www.nabp.net) to see if the phar
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Contact: Susan Anderson
215-351-2653
American College of Physicians
28-Sep-1999

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