Information about internet pharmacy law





 

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About Online and Mail-Order Pharmacies:
What You Need to Know
Benefits and Risks

Types of Online and Mail-Order Pharmacies
Controlled Substances and Online Pharmacies

PharmacyChecker.com Verification Program
PharmacyChecker.com Seal

U.S. Drug and Pharmacy Regulations
Foreign Online Pharmacies

Counterfeit Medication
A Note on Intellectual Property Rights

BENEFITS AND RISKS:
Using an online or mail-order pharmacy (referred to below as online
pharmacy) can save you a great deal of money and provide other
benefits. However, there are also potential risks.

BENEFITS:
Lower prices — Lower drug prices in other countries, lower
 overhead costs compared to bricks and mortar pharmacies, and lower
 price mark-ups by discount and wholesale pharmacies often result
 in savings compared to local pharmacy prices. You can quickly shop
 around for the lowest prices online. Click here to compare prices
 across verified online pharmacies.

Privacy/Anonymity — You may feel more comfortable purchasing or
 asking questions online (or by fax or phone) regarding certain
 medications. However, privacy can be compromised if an online
 pharmacy uses your information for unauthorized purposes so it is
 important that the online pharmacy has an appropriate privacy
 policy; this is one of the things that PharmacyChecker.com checks
 for you.
Convenience — If you find it physically difficult to make it to
 the pharmacy, live in a remote rural area, or have a very busy
 schedule, online and mail-order pharmacies enable you to avoid
 travel and can save you time. Many online pharmacies will also
 remind you when you can order a refill to help you maintain your
 regimen.

Medical information — Some online pharmacies provide useful
 information about medications and diseases as well as links to
 medical resources such as universities, government agencies, and
 health associations.
RISKS:

Some online pharmacies do not dispense drugs through licensed
 pharmacies. It is essential that you use pharmacies that are
 licensed. Licensed pharmacies require safe dispensing practices
 and the oversight of licensed pharmacies. Purchasing drugs from an
 unlicensed pharmacy greatly increases your chances of buying
 counterfeit and/or substandard products. PharmacyChecker.com
 verifies that a site is, or fills orders with, a licensed
 pharmacy.
Some online pharmacies do not adequately protect your personal and
 financial information. It's important for an online pharmacy to
 include a privacy policy, one that promises not to share your
 personal information with third parties. Online financial
 transactions should be secured by the online pharmacy through
 adequate use of encryption technology. PharmacyChecker.com
 verifies whether privacy is promised and transmittal of financial
 information is secured.

Some online pharmacies do not give their address and/or telephone
 number. If in the course of purchasing drugs from an online
 pharmacy you have a problem, question, or complaint, then it
 becomes very important to contact the company using its telephone
 number or address. Also, studies have shown that online pharmacies
 that do not publish adequate contact information are more likely
 to sell counterfeit products. PharmacyChecker.com verifies contact
 information and provides it in the Profile of each online pharmacy
 listed on this site.
Additional fees are typically added to the drug price. There is
 almost always a shipping fee and there may also be a medical fee,
 order fees, and/or an account set up fee. PharmacyChecker.com
 shows you these fees and compares total costs. Compare drug prices
 at http://www.pharmacychecker.com/ListingAlpha.asp.

Prices can change quickly. Online pharmacies are continually
 changing their prices. Lowball prices are common in order to
 attract new customers, but these prices don't always last.
 PharmacyChecker.com regularly updates all prices.
Some online pharmacies don't adequately safeguard your health. By
 failing to require a prescription, some online pharmacies might
 send you medication that could be dangerous to you.
 PharmacyChecker.com verifies that online pharmacies require a
 prescription.

Some online pharmacies may sell medications that can be extremely
 dangerous, if not taken under medical supervision. In the U.S.,
 these drugs are known as controlled substances, such as
 hydrocodone, valium, or xanax. You should never order from a
 website offering to sell you controlled substances without a
 prescription or to write you a prescription for them based on your
 responses to an online questionnaire. Other drugs, known as
 restricted distribution drugs, such as such as accutane, mifeprex
 or thalomidare, while not controlled substances, are also very
 dangerous if taken without the appropriate medical supervision.
 For a list of these drugs see:
 http://www.fda.gov/Drugs/ResourcesForYou/ucm077252.htm. See the
 section below on controlled substances for more information.
To help you stay clear of "rogue" websites, PharmacyChecker.com checks
for you whether online pharmacies are licensed, offer security and
privacy of your information, provide an address and phone number,
require a valid prescription and your medical information.

In addition, PharmacyChecker.com maintains a list of Rogue Pharmacy
Websites. By no means a complete list, these sites are known to not
follow safe online pharmacy practices.
TYPES OF ONLINE AND MAIL-ORDER PHARMACIES:

Online pharmacies, also called Internet pharmacies, are businesses
that sell and market prescription drugs and other pharmacy products
over the Internet and send them to consumers by mail.
PharmacyChecker.com estimates that there are 300-400 U.S., Canadian
and other legitimate online pharmacies that market and sell their
products throughout the United States. These are licensed pharmacies
and their affiliates that accept prescription orders online and
require a valid prescription from the customer.

Prescription Requirements
Online pharmacies fall into different categories based on their
prescription requirements:

Traditional (Rx based on in-person examination)
Remote Consultation (Rx based on an online or phone consultation)

None (Rx not required to order prescription medication. These are
 "rogue" sites)
Traditional Online Pharmacies

Most legitimate online pharmacies require you to provide your original
prescription -- the one obtained from an in-person examination with
your doctor. Prices at online pharmacies that have a traditional
prescription requirement are often lower than at online pharmacies
that offer or accept prescriptions based on remote consultations (as
described below) or that require no prescription at all. Pharmacies in
this category include major national chains, neighborhood pharmacies
in the U.S. and Canada, and large mail-order prescription fulfillment
centers. Most pharmacies with a traditional prescription requirement
carry the full stock of prescription drugs you would find in your
neighborhood pharmacy.
Remote Consultation Online Pharmacies

Some consumers wish to purchase prescription drugs without having to
visit their physicians to obtain a prescription. There are online
pharmacies, generally known as online consultation pharmacies, remote
consulting pharmacies, or prescribing pharmacies, that work with
physicians who review a patient’s self-reported medical history and
then write a prescription if deemed appropriate. Often this is done
for medications referred to as "Lifestyle" drugs that are
non-addictive and less likely to require physician monitoring.
As an advisory, the American Medical Association and the U.S. Food and
Drug Administration have issued statements asserting that remote
consultations are a substandard medical practice when there is no
prior doctor-patient relationship, one established by an in-person
physical exam. However, a Mayo Clinic study found that remote
consultations done properly for erectile dysfunction are as safe or
safer than traditional medical consultations (see
http://www.mayoclinicproceedings.com/content/83/8/890.full?sid=a5819934-f4bc-4390-929f-9a9a2072a165).

U.S. states have different laws on what constitutes a valid
doctor-patient medical consultation. Many states do not prohibit
remote medical consultations as a basis for prescribing while a
handful of states do. Two states have passed laws or granted express
permissions that are directly supportive of remote medical
consultations. A 2009 state law in Hawaii makes it expressly legal for
a doctor to prescribe non-controlled drugs based on a remote medical
consultation, as long as the consultation is conducted in real-time,
such as by phone or video conference. The State of Utah has granted
express permission for certain companies to offer remote consultation
for the prescription of a limited number of non-controlled medicines.
Except where expressly permitted by law, the PharmacyChecker
Verification Program will not approve remote consultation online
pharmacies.

Federal law prohibits remote consultations as a basis for prescribing
controlled substances. See more information on controlled substances
below.
No-Prescription Required Mail-order and Online Pharmacies

Some rogue websites will sell you prescription medication without
requiring any prescription at all, which can be extremely dangerous.
Other websites that offer to sell you drugs without a prescription
pose as online pharmacies for the purpose of stealing your credit card
information. Ordering from such sites is exceedingly risky to your
health and could lead to unauthorized use of your credit card and/or
identity theft. See our list of Rogue Online Pharmacies for more
information.
CONTROLLED SUBSTANCES AND ONLINE PHARMACIES: USE EXTREME CAUTION

Unlike regular prescription drugs, which are regulated by the U.S.
Food and Drug Administration (FDA), most products with a high
potential for addiction and abuse are regulated by the U.S. Drug
Enforcement Agency (DEA) and called controlled substances. U.S.
pharmacies that sell controlled substances must have a license to do
so, which is issued by the DEA. For a list of controlled substances
go to http://www.usdoj.gov/dea/pubs/scheduling.html .
Unfortunately, some U.S. and foreign “rogue pharmacies" sell
controlled substances to consumers who don't have a prescription.
Americans with a valid prescription may legally order controlled
substances from a website that are dispensed from a licensed U.S.
pharmacy. Reputable Canadian and other non-U.S. pharmacies will NOT
ship controlled substances to Americans. The PharmacyChecker.com
Verification Program does not accept online pharmacies that sell
controlled substances filled by foreign pharmacies.

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (“Ryan
Haight Act”) regulates the practice of online pharmacy at the federal
level as it relates to controlled substance by making it “unambiguous
that it is a per se violation of the Controlled Substances Act for a
practitioner to issue a prescription for a controlled substance by
means of the Internet without having conducted at least one in-person
medical evaluation.” (Federal Register/Vol. 74 No. 64, April 6th,
2009, p. 15599).
The PharmacyChecker.com Verification Program requires, and verifies,
that online pharmacies abide by the requirements of the Ryan Haight
Act.

While all websites that sell controlled substances are subject to the
Ryan Haight Act’s ban on prescribing controlled substances solely
based on a remote medical consultation, only those sites that sell
products in the schedule II category, the most highly addictive drugs,
must include specific disclosures on their websites and apply for a
special modification of their DEA registrations. To learn more about
the specific requirements see the following page:
https://www.pharmacychecker.com/sealprogram/websitedisclosure.asp.
Information on controlled substances: Drug Enforcement Agency (http://www.usdoj.gov/dea/index.htm).
Range of Medications Sold By Online Pharmacies

Not all online pharmacies sell the broad range of prescription drugs
that you would expect to find in your neighborhood pharmacy. The
product range of online pharmacies typically falls into one of the
following categories:
"Full" range of medication, including prescription and
 over-the-counter products, as well as testing supplies and other
 health and beauty products just as you would find in a large
 pharmacy.

"Over 500 drugs" includes almost all prescription medication sold
 at your neighborhood pharmacy.
"Between 250-499 drugs" covering those medications representing
 the majority of prescription sales.

"Popular" medications, the 10 to 50 top-selling prescription
 drugs.
"Lifestyle" medications, such as those used for sexual
 enhancement, hair growth, contraception, weight loss, herpes, and
 smoking cessation.

"Specialized" medications for a single purpose, such as for pain,
 or specific medical conditions.
THE PHARMACYCHECKER.COM VERIFICATION PROGRAM

PharmacyChecker.com verifies information about three types of entities
that participate in online pharmacy: 1) Pharmacies (retail, wholesale,
and veterinary), 2) Affiliate websites, and 3) Referral Sites.
Pharmacies have a bricks and mortar presence (a walk-in pharmacy), in
which the bricks and mortar pharmacy and the website are one and the
same company, or operate under the same holding company. An Affiliate
website does not have a bricks and mortar pharmacy presence but refers
orders to a licensed pharmacy. An online pharmacy Referral site simply
links to drug-selling websites on which the drug order is actually
placed. Note that sometimes a pharmacy will provide the option to have
your prescription filled by another licensed pharmacy in a different
country so that you can take advantage of lower international prices,
in which case they operate as both Pharmacy and Affiliate.
All online pharmacies must have specific qualifications for approval
in the PharmacyChecker Verification Program and to publish the
PharmacyChecker.com seal on their websites. PharmacyChecker.com
verifies the following qualifications:

Pharmacy license (with applicable pharmacy board or licensing
 authority)
DEA-issued license for controlled substances (for U.S. pharmacies
 only - non U.S. pharmacies are not permitted to ship controlled
 substances into the U.S.)

Prescription is required (based on an in-person examination, with
 exceptions where expressly permitted by law)
Privacy policy (one that affirms a consumer's information will not
 be shared with third parties)

Financial and personal information is secure (encryption required
 on web pages where financial and personal information is
 transmitted)
Contact information (mailing address and phone number)

Additionally, to ensure compliance with the Verification Program
prescription requirements, PharmacyChecker.com conducts periodic
“mystery shopping,” by posing as a consumer attempting to purchase
medication without a prescription. PharmacyChecker.com also works with
pharmacy experts to inspect licensed pharmacies in certain foreign
countries to be sure that they adhere to high standards of pharmacy
practice.
The PharmacyChecker.com Seal

PharmacyChecker.com advises consumers to look for the
PharmacyChecker.com seal (clickable image below and at
http://www.pharmacychecker.com/sealprogram/choose.asp) before ordering
prescription medication from a website, especially if the company is
not generally well known. Online pharmacies are only authorized to
publish the seal if they have met the criteria mentioned above. Just
as important, to make sure a seal is valid, consumers should check
that it links to a page hosted on www.pharmacychecker.com and provides
a profile of the site.
 

To safeguard the marketplace, Microsoft, and Yahoo! use the
Verification Program to help them qualify online pharmacy advertisers
for their search marketing programs. These programs may require
additional qualifying criteria. For information on search engine
requirements for online pharmacy advertisers use the following links:
Yahoo Search Marketing
Microsoft adCenter

PHARMACEUTICAL AND PHARMACY REGULATIONS
U.S. Drug and Pharmacy Regulations

In the U.S., the Food and Drug Administration (FDA), a division of the
U.S. Department of Health and Human Services, is responsible for the
regulation and safety of America's drug supply. New drug reviews,
post-market surveillance, and drug recalls are carried out by the FDA.
Pharmacies and pharmacists are regulated and licensed by the states.
Pharmacy regulations differ a little from state-to-state but all
require the presence and management of licensed pharmacists, strict
enforcement of safe dispensing practices and safe storage
requirements. The regulation of controlled substances, drug products
with stronger and addictive ingredients (discussed in detail above),
is the responsibility of the Drug Enforcement Agency (DEA). Pharmacies
must have a DEA-issued license to sell controlled substances.
The National Association of Boards of Pharmacy (NABP) (www.nabp.org),
the umbrella trade group for state pharmacy boards, created the
Verified Internet Pharmacy Practice Site (VIPPS) program in 1999
responding to public concerns about websites selling drugs without
abiding by federal and state laws. As of October 2009, there were only
16 VIPPS-certified pharmacies: Approximately half of these were
pharmacy benefit management companies that operate online pharmacies,
which are only available to their members. Other VIPPS members are
national chain pharmacies, larger U.S. online pharmacies, and one
specialty online pharmacy. The NABP VIPPS program is not open to
Canadian pharmacies that serve the American market.

For people living in the U.S., the potential benefits of buying from a
U.S. online pharmacy rather than a foreign online pharmacy often
include:
Lower prices on generics — in fact generic prices at some U.S.
 online pharmacies are often half the Canadian price due to greater
 competition in the U.S. market,

Acceptance of prescription drug insurance to purchase drugs,
Lower shipping charges,

Easier recourse to legal action if you are wronged by the online
 pharmacy, and
Generally strong pharmaceutical and pharmacy safety regulations,
 although many other countries have similarly strong regulations.

If you do not have insurance, or your insurance does not cover the
drugs you need, U.S. online pharmacies are almost always more
expensive than their foreign counterparts — except for generic drugs
and "lifestyle" drugs, such as Viagra.
Click here for a list of online pharmacies verified by
PharmacyChecker.com.

FOREIGN ONLINE PHARMACIES: IMPORTS ARE GENERALLY PERMITTED BUT NOT
TECHNICALLY LEGAL
Personal Drug Importation:
Over the past decade, millions of Americans who do not have health
insurance, adequate drug coverage, or any drug coverage, as well as
those seeking critical medications that are not available
domestically, have purchased medication from Canadian and other
foreign online pharmacies. This process is known as personal drug
importation. The U.S. government generally does not stop individuals
from importing medication for their own use (up to a three-month
supply of non-controlled drugs), however it is technically illegal. We
know of no instance when the FDA has taken legal action against an
individual for personal drug importation of a non-controlled
substance.

Despite the technical illegality, the FDA provides regulation for
government officials in the form of personal importation guidelines
(see the FDA Coverage of Personal Importations policy at
http://www.fda.gov/ForIndustry/ImportProgram/ucm173751.htm).
While it happens infrequently, less than one percent of international
prescription orders are confiscated. In these cases you will usually
be informed by the FDA that your drug order has been seized. There is
a greater prevalence of drug import seizures from non-Canadian
countries, especially from less developed countries

If you are buying medication from a foreign country, you want to know
that the dispensing source is regulated and licensed by the
appropriate governing authority. For this reason, PharmacyChecker.com
acts to verify the licenses of pharmacies in foreign countries. Just
several years ago, most non-U.S. pharmacies selling prescription drugs
to Americans were Canadian. Today, pharmacies in other countries, such
as Australia, Barbados, Curacao, Fiji, India, Israel, Italy, New
Zealand, Singapore, South Africa, Switzerland, Turkey, and the United
Kingdom play a larger role in meeting this demand. To better educate
our visitors, many of whom are looking to foreign pharmacies for lower
drug prices, below is an overview of the agencies and the laws that
regulate drugs and pharmacies in some foreign countries.
Multiple Countries: Different Pharmaceutical Regulatory Systems

The growth in demand for lower cost prescription drugs among
Americans, and the supply problems faced by Canadian international
pharmacies, largely a product of restrictive selling practices of drug
companies, has led to an increasing number of countries entering the
industry. While the FDA usually does not prevent Americans from
importing medication for personal use, consumers should use good
judgment in determining from which countries they feel most
comfortable ordering medications.
The information below might be useful in determining from which
countries you are willing to purchase medication. Countries with the
most advanced and safe systems for regulating pharmaceuticals possess
the following:

1) An agency that approves drugs for the national market through a:
Review of scientific evidence from clinical trials.

Post-market surveillance to monitor unforeseen effects of drug
 utilization.
2) National laws and standards for labeling of drug products and
distribution.

3) A national system and/or state/provisional systems for regulating
pharmacies that:
Require pharmacy practitioners to have a top-level education and
 rigorous training;

Mandate safety requirements for the handling and dispensing of
 medications;
Requires a doctor’s prescription for drugs that are determined to
 have potentially serious side-effects.

Regularly inspects pharmacies.
4) Drug manufacturing laws that require all approved products to be
produced under Good Manufacturing Practices.

Overview of Pharmaceutical Regulation: By Country
CANADA:
Drug and Pharmacy Regulation in Canada
Canada’s systems for regulating drug products are very similar to
those in the United States. At the federal level, the Therapeutic
Products Directorate - an agency of Health Canada that regulates
Canada's drug supply - is Canada's counterpart to the U.S. Food and
Drug Administration. All drug products sold in Canada must be approved
by the Therapeutic Products Directorate. Pharmacies in Canada are
regulated by the provinces; a similar system to the U.S. in which
states regulate pharmacies.

To operate a pharmacy in Canada, the premises must be licensed by the
provincial pharmacy board, managed by a licensed pharmacist, and meet
stringent standards for the storage and disbursement of medication.
A report written for the State of Illinois in 2003 found that Canadian
pharmacies in Manitoba were as safe if not safer than those in
Illinois, and that the U.S. and Canadian systems for ensuring safety
and efficacy of drug products are comparable.

Useful links
The National Association of Pharmacy Regulatory Authorities
 (NAPRA): www.napra.org

Health Canada: www.health-canada.ca.
Drug Importation From Canada “Report On Feasibility Of Employees
 and Retirees Safely and Effectively Purchasing Drugs from Canadian
 Pharmacies.” State of Illinois, Department of Central Management
 Services. October 27, 2003.

Online Pharmacy Regulation in Canada:
In 2003, the National Association of Pharmacy Regulatory Authorities
(NAPRA), Canada's counterpart to the NABP, introduced the VIPPS
program but, as of October 12, 2009, there are no participating
pharmacies.
Click here for a listing of online pharmacies currently verified by
PharmacyChecker.com, including Canadian sites.

PharmacyChecker.com has published several interesting reports on price
differences between the U.S. and Canada. These are found at
http://www.pharmacychecker.com/News.asp.
FOREIGN COUNTRIES OTHER THAN CANADA

AUSTRALIA:
In Australia drugs are regulated by the Therapeutic Goods
Administration, Australia's counterpart to the U.S. Food and Drugs
Administration. Australia uses the same standards as the European
Union for the regulation of prescription drug products.

Like in Canada and the United States, pharmacies are registered at the
state/province level, and pharmacists must be registered in the states
in which they practice. The state boards are incorporated in a
federation called the Pharmaceutical Society of Australia that guides
and proposes policies and standards for the safe practice of pharmacy.
Over 80% of Australia’s pharmacies belong to an organization called
the Pharmacy Guild of Australia. Its role is to support its pharmacy
and pharmacist members on workplace issues and training. The Guild
also negotiates on behalf of its members with the government and drug
manufactures, wholesalers, and other organizations responsible for the
provision of health products.

Useful Links
Therapeutic Goods Administration, Department of Health and Aging:
 http://www.tga.gov.au

The Pharmacy Guild of Australia: http://www.guild.org.au/
The Pharmaceutical Society of Australia: http://www.psa.org.au/

BARBADOS:
The Government of Barbados allows and licenses qualified companies to
operate as international mail-order pharmacies. Such licensure can be
granted to pharmacies that are inspected by the Barbados Drug Service,
a division of the Barbados Ministry of Health, and meet all
requirements of the Pharmacy and Drug Services Act. These
international mail-order pharmacies operate in a free trade zone.
Among the requirements is that a licensed pharmacist is on the
pharmacy premises and oversees the dispensing process.

While pharmacies operating in a Barbados free trade zone are subject
to the same requirements of licensed pharmacies in the home
jurisdiction, they import prescription products outside the national
drug supply. For approval in the PharmacyChecker Verification Program,
international mail-order pharmacies can only import from licensed
wholesale pharmacies based in countries with acceptable pharmaceutical
regulation standards.
Pharmacies in free trade zones must undergo a rigorous inspection by
PharmacyChecker.com before approval in its Verification Program.
Additionally, PharmacyChecker.com verifies the licenses of exporting
wholesale pharmacies that supply these pharmacies.

CURACAO:
The Government of Curacao permits qualified companies to operate
international mail-order pharmacies in a free trade zone. Such
pharmacies are under the regulation of the Inspectorate of Public
Health, Inspector of Pharmaceutical Affairs, and must employ licensed
pharmacists to oversee the dispensing process.

While pharmacies operating in a free trade zone are subject to the
same requirements of licensed pharmacies in the home jurisdiction,
they import prescription products outside the national drug supply.
For approval in the PharmacyChecker Verification Program,
international mail-order pharmacies can only import from licensed
wholesale pharmacies based in countries with acceptable pharmaceutical
regulation standards.
Pharmacies in free trade zones must undergo a rigorous inspection by
PharmacyChecker.com before approval in its Verification Program.
Additionally, PharmacyChecker.com verifies the licenses of exporting
wholesale pharmacies that supply these pharmacies.

INDIA:
The Central Drugs Standards Control Organization (CDSCO), a division
of the Indian Ministry of Health and Family Welfare, is responsible
for drug approval and regulation, as well as for the licensure of
pharmacies in India. CDSCO is responsible for approving new drugs for
the Indian market, post-market surveillance, and enforcement actions
to protect the Indian drug supply.
Under the CDSCO, the Drugs Control Administration is responsible for
regulating pharmacies. They do so through the State Drug Control
Offices, also called Food and Drug Administration offices, which
inspect and license pharmacies, and enforce the Pharmacy Act of 1940,
which require pharmacies to meet rigorous safety standards.

Pharmacies in India must comply with similar regulations as those in
the U.S., such as having a licensed pharmacist on the premises during
hours of operation, safe storage of drugs, particularly those with
special requirements (such as insulin), and safeguarding of controlled
substances. However, India's enforcement standards are generally lower
than in the United States.
While in many respects economically disadvantaged compared to the U.S.
and countries of the European Union, India has a very large and highly
sophisticated pharmaceutical industry. In fact, a sizable portion of
the world’s pharmaceutical active ingredients are manufactured in
India. These ingredients are then exported to other countries such as
the U.S. and the EU for the manufacture of final drug products. In
addition, India exports finished medications for retail sale to the
U.S. and many countries. The FDA has approved hundreds of Indian drug
products that are sold in U.S. pharmacies.

Many drugs in India are manufactured in FDA-approved or inspected
facilities. In fact, the U.S. Food and Drug Administration inspects
more drug manufacturing plants in India than any other country outside
the U.S. However, the drug supply in India is not as strongly
regulated as it is in the U.S. and some other economically developed
countries, such as Canada and the United Kingdom. Consequently, it has
a higher rate of counterfeit medication.
Useful Links

Central Drugs Standards Control Organization: http://cdsco.nic.in/
Pharmacy Council of India: http://pci.nic.in/

ISRAEL:
The Pharmaceutical Division of the Israeli Ministry of Health
regulates that country’s drug supply, pharmacists and pharmacies.
Israel’s system for pharmaceutical regulation is strongly based on
both U.S. and EU pharmaceutical regulations.

Israeli regulations require that drugs approved for sale in that
country must be manufactured using U.S. or EU standards for Good
Manufacturing Practices (GMP) and USFDA or equivalent European
Standards. Additionally, drugs approved for use in Israel are
generally approved for use in the U.S. or EU. Israeli pharmaceutical
companies are major suppliers of generic drug products to the United
States.
Pharmacies are licensed by the Israeli Ministry of Health. Under
Israeli law, drug labels must be in Hebrew and English.

Useful Links
Pharmaceutical Administration, Israeli Ministry of Health:
 http://www.health.gov.il/english/PagesE/default.asp?maincat=10

ITALY:
As a full and founding member of the European Union, Italy is a highly
developed county with strong pharmaceutical and pharmacy standards.
The Italian drug regulatory authority, a division of the Ministry of
health, parallels that of fellow EU-members requiring that drug
product approvals are based on rigorous scientific evidence and
clinical trials to show safety and efficacy. The European Medicines
Evaluation Authority is an agency of the European Union charged with
evaluating the safety of new products for members of the EU. Drugs
that are approved by the EMEA can be sold throughout Italy and the
rest of the EU.

Unlike in the United States only pharmacists can own a pharmacy.
Pharmacies are subject to similar regulations regarding prescription
procurement, storage, and dispensing, as in the United States.
Useful Links

Federfarma: https://www.federfarma.it/
Italian Ministry of Health: Azienda Sanitaria Locale.

NEW ZEALAND:
The drug supply of New Zealand is regulated by Medsafe, that country’s
counterpart to the U.S. Food and Drug Administration. Medsafe
determines which drugs will be used by citizens of New Zealand: it
administers the application process for new drugs and is charged with
post-market surveillance. Under the Medicines Amendment Act 2003,
Medsafe is also responsible for issuing pharmacy licenses. Pharmacies
in New Zealand are held to similar standards of practice as in Canada,
the United Kingdom, and the United States.

The Pharmaceutical Society of New Zealand is the professional
pharmacist’s association. It provides education, training, and career
development of pharmacists to achieve high standards of pharmacy
practice. The Pharmacy Council is the national regulatory body for
licensing pharmacists.
Useful Links

Medsafe: http://www.medsafe.govt.nz
Pharmaceutical Society of New Zealand: www.psnz.org.nz/

Pharmacy Council: http://www.pharmacycouncil.org.nz/index.asp
Pharmacy Guild of New Zealand: http://www.pgnz.org.nz/

SINGAPORE:
Singapore is among the most economically developed countries, one with
exceedingly strong regulations in all industry sectors, on a par with
the United States, the United Kingdom, and the countries that comprise
the European Union. It has very high pharmacy and pharmaceutical
regulatory standards. Singapore is recognized by the World Health
Organization Collaborating Centers in the areas of Transfusion
Medicine, Drug Quality Assurance and Food Contaminants Monitoring.

Pharmacies in Singapore are licensed at the national level by the
Health Sciences Authority (HSA), a division of the Ministry of Health.
As in the United States, pharmacies must meet stringent standards
before licensure is granted. Pharmacies must be under the management
of a licensed pharmacist registered with the Singapore Pharmacy
Council. Among other requirements, safe dispensing equipment and
storage facilities, requisite professional reference materials, and an
adequate system for record keeping are all checked for legal
compliance before a pharmacy is licensed in Singapore.
The regulation of drug products in Singapore is the responsibility of
the Therapeutics Products Division, which operates as part of the
Health Sciences Authority. Only products licensed by the Health
Products Regulation Group are approved for the market. The drug
approval process takes nine months, unless the product is already
approved in the United States, European Union, and Australia, in which
case there is an expedited process.

Some retail pharmacies in Singapore are also licensed to operate as
exporters. However, the Therapeutics Products Division does not
guarantee the safety of exported products and they may not be approved
for sale in Singapore. PharmacyChecker.com verifies the licenses of
exporting wholesale pharmacies that supply these pharmacies.
Useful Links

Health Sciences Authority (Registration of Pharmacies):
 http://www.hsa.gov.sg/publish/hsaportal/en/healthproductsregulation/GMP/auditlicensingpharmacies/certificateofregistration.html
Singapore Pharmacy Council:
 http://www.spc.gov.sg/html/SPBHome.htm

Therapeutics Products Division:
 http://www.hsa.gov.sg/publish/hsaportal/en/healthproductsregulation/westernmedicines.html
SOUTH AFRICA:

The Medicines and Related Substances Control Act, 101 of 1965,
mandated the establishment of the South African Medicines Control
Council (MCC). The MCC is responsible for the registration and control
of pharmaceuticals for the purpose of public safety. Members of the
Council are appointed by the Minister of Health.
Like the FDA in the United States, the MCC decides which drugs are
safe and effective based on scientific evidence, either that presented
by an applicant (drug manufacturer), through testing or both. The
Medicines and Related Substances Control Act stipulates the guidelines
and procedures by which a drug is approved in South Africa, including
the requirements for clinical trials, adverse drug reactions, and
reporting to the MCC by pharmaceutical companies.

The Pharmacy Act of 1974 set the requirements for establishing a
pharmacy in South Africa, and mandated the responsibility of licensing
pharmacies to the South African Pharmacy Council. As in the United
States, pharmacy standards in South Africa require a licensed
pharmacist to exercise control over acquisition and storage of
medicine, chemical and hazardous substances, public access to
medicines, and a pharmacy's cleanliness.
The South African Pharmacy Council is also mandated with fostering,
through advocacy, education and career development programs, the
highest standards of pharmacy practice throughout South Africa.

Useful Links
Medicines Control Council: www.mccza.com

South African Pharmacy Council: www.pharmcouncil.co.za
SWITZERLAND:

The counterpart to the U.S. Food and Drug Administration in
Switzerland is called Swiss Medic. All prescription drugs sold in the
Swiss Market must first be approved as safe and effective by Swiss
Medic, using a similarly rigorous review process to that used in the
United States. Switzerland is also under the regulation of the
European Medicine Agency (EMEA), and all products approved by EMEA are
approved for the Swiss market.
Switzerland is comprised of regional government bodies called Cantons
(like states in the U.S.). Cantons are responsible for licensing and
regulating retail pharmacies in Switzerland. Pharmacies in Switzerland
must be under the management of a licensed pharmacist who oversees the
dispensing process.

Useful Links
Swiss Medic: http://www.swissmedic.ch/

The European Medicines Agency: http://www.emea.eu.int/
TURKEY:

According to the World Health Organization, Turkey's drug licensing
standards closely resemble the countries of the European Union.
However, unregistered generic products remain a problem in the rural
and eastern region of the county, and PharmacyChecker has not
permitted pharmacies from such areas to participate in its program.
As guided by The Law of Pharmaceutics and Medical Products, drugs sold
in Turkey must be approved by a division of the Ministry of Health,
called Drugs and Pharmacy General Management, which is Turkey's
counterpart to the FDA. The process for drug approval is administered
by the Advisory Commission For the Registration of Medicinal Products
For Human Use, a Commission of the Ministry's Scientific Advisory
Board. The Commission is comprised of pharmaceutical research experts,
clinicians, a pharmaceutical technologist, a pharmacologist, and a
Ministry of Health representative.

Unlike in the United States, where most prescription drugs are
generic, a large majority of drug products sold in Turkey are brand
name, and most of those produced by well-known international
manufacturers. In fact, with first class manufacturing facilities,
Turkey has become a major player in the manufacture of drug products,
and Turkey has the world's 15th largest pharmaceutical market.
Under the Pharmacists and Pharmacies Law, Turkey mandates, at the
national level, that all pharmacies meet high standards of pharmacy
practice, such as having a licensed pharmacist on the premises during
hours of operation, safe storage of drugs, and a clean, sanitary area
for dispensing.

Useful Links
World Health Organization: Regional Office For Europe — Turkey

UNITED KINGDOM:
Drug products sold in the UK are regulated by the Medical and
Healthcare Products Regulatory Agency (MHRA) and the European
Medicines Evaluation Agency (EMEA). The MHRA is the United Kingdom’s
counterpart to the U.S. Food and Drug Administration and decides which
drugs are safe and effective for citizens of the UK. The EMEA is in an
agency of the European Union charged with evaluating the safety of new
products for members of the EU. Drugs that are approved by the EMEA
can be sold throughout the EU.

On a national level, pharmacists and pharmacies are registered with
and regulated by the Royal Pharmaceutical Society of Great Britain
(RPSGB). Pharmacies must be operated by a licensed pharmacist,
maintain safe storage conditions and a sanitary dispensing area.
Useful Links

Medical and Healthcare Products Regulatory Agency (MHRA):
 http://www.mca.gov.uk/
The European Medicines Agency: http://www.emea.eu.int/

Royal Pharmaceutical Society of Great Britain:
 http://www.rpsgb.org.uk/
COUNTERFEIT MEDICATION

Counterfeit medication is a global problem and the risks that you can
be hurt by them are greater if you are buying drugs through the
Internet from developing countries and/or those with poor regulations.
Counterfeit medicines include those with wrong ingredients, no active
or insufficient active ingredients, dangerous ingredients, as well as
those with the right ingredients but fake packaging.
The World Health Organization reports that 50% of drugs ordered online
from websites that don’t publish a physical address are counterfeit.
It is not clear on what study this statistic is based but its warning
should be heeded. One of PharmacyChecker.com’s requirements is that a
website publishes a verifiable mailing address and phone number. One
article in Foreign Policy Magazine based on a recent research project
suggests that the risks are minimal if you purchase from verified
websites (see
http://www.foreignpolicy.com/articles/2009/08/19/aprescriptionforsafety).

For more detailed information on counterfeit medication see the
following document published by the World Health Organization:
http://www.who.int/medicines/services/counterfeit/en/.
A Note on Intellectual Property Rights

Countries have different laws for protecting the intellectual property
rights of drug companies. For example, the United States allows the
sponsor of a new drug to have exclusive sales and marketing rights for
that product for 20 years. After that time, other companies may
manufacture, market, and sell a generic version of that drug. Other
countries might only protect the patent of a new drug for 10, 5, or no
years at all.
Some international online pharmacies sell generic versions of drugs
that are still under patents in the U.S. and, therefore not available
for sale in the U.S. As such, these products are viewed as
unauthorized drugs by the U.S. Food and Drug Administration.

For information from the U.S. Food and Drug Administration on patents
see www.fda.gov/cder/ob/faqs.htm.
To find out more about intellectual property rights go to the website
of the World Intellectual Property Organization at www.wipo.gov.

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