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A Skeptic's Guide to Canadian Online Pharmacy Safety

October 22, 2019

online pharmacy safety

American prescription drug prices are out of control — that much no one can dispute. On average, prescription drugs cost 56% less in other developed countries like France, Japan and Canada than in America. And for many drugs, American manufacturers jack up the price much more. It's not just for cutting edge medicine, either. Insulin, an old drug that's cheap to manufacture and reliable (and necessary) treatment for many diabetics, costs $450 per vial in the US. In Canada, it's $21.

As a result, millions of Americans have to put off or go without needed treatment, A recent report by the Center for Disease Control (CDC) shows that 1 in 5 Americans — over 40 million people — can't afford crucial medical services, such as prescriptions, medical treatment or even eyeglasses. Others are having to ration care, going without their full required dose with often tragic results.

In this situation, many Americans are turning to Canadian online pharmacies. A full 19 million Americans, or 8 percent of the population, currently save money by filling prescriptions through online pharmacies. That's a huge number, particularly considering the first thing most consumers see is a set of frightening warnings about online pharmacy safety.

Are Online Pharmacies Safe? A View From the Browser

If you've tried to order drugs online, you've probably seen the warnings. A typical Google search for "are online pharmacies safe" looks innocuous at first, with advice for buying medicines safely. But the advice is far from reassuring.

Are online pharmacies safe search result

The top site, safe.pharmacy, a site that is run by the National Association of Boards of Pharmacy (NABP), says that, "Out of almost 12,000 websites reviewed by NABP, nearly 95 percent operate out of compliance with NABP patient safety and pharmacy practice standards, or applicable laws." It advises patients to look for the ".pharmacy" domain, which it implies are the only safe online pharmacies.

The next site, from no less a source than the FDA, sounds even more restrictive. Although their warning signs have sound advice on avoiding "rogue online pharmacies," such as avoiding pharmacies that dispense prescription medicine without a prescription, they also warn users to avoid any pharmacies that "are located outside of the United States or ship worldwide."

Another FDA site collects Internet Pharmacy Warning Letters, and advises consumers not to buy drugs from a list of pharmacies that have received their warning letter.

Many legitimate non-US based online pharmacies have received warning letters for reasons that may have little to do with patient safety. In some cases, it's because they have offered a drug that had yet to receive approval from the FDA even though they'd been rigorously tested and approved by health regulators in other highly developed countries. In other cases, the FDA has issued warning letters to non-US based online pharmacies for the sole reason that they supply the very same drugs available in the USA but sourced from other countries (which is how online pharmacies offer drugs that are less expensive.)

Even in cases where the online pharmacy promptly addressed and complied with the request in the FDA's warning letter and received a "close out letter" from the FDA indicating compliance, the FDA continues to list such online pharmacies as "rogue online pharmacies." This can harm the pharmacy's reputation and scare off consumers years after the pharmacy has attained compliance.

What's going on here? Is the FDA calling out dangerous "rogue" pharmacies or responsible businesses? Does ordering from the ".pharmacy" domain really make you safer? Are online pharmacies safe for Americans? And if the top sources aren't telling you the truth, where can you get it?

Safe Online Pharmacies: Bing and the NABP

As the most popular search engine in the world, Google's take on online pharmacy safety may have the biggest effect on American consumers, but its portrayal is mild when compared to Bing.

Bing actually pops up a warning you have to click through, not only for reputable Canadian pharmacies, but even for some sites that check and rate pharmacies. The site advises viewers that, "the National Association of Boards of Pharmacy (NABP) includes this site on its Not Recommend list," and shares resources it claims will help "verify your pharmacy before making online health purchases."

The only way to access the site from search is to click through the warning. You can see ours below:

northwest pharmacy search result

The same site that dominates Google search for "are online pharmacies safe," has its own special warning label on Bing.

Have you ever seen a special warning label applied to a site in search before? There are certainly plenty of products available on the Internet that could be dangerous, but to the best of our knowledge, Bing does not give other products special warning labels.

Does that mean online pharmacies are especially unsafe, and if so, is the NABP the best authority to decide what is a safe pharmacy and what isn't? And what's the role of the FDA in all of this? Well, it's complicated.

Who is the NABP?

The National Association of Boards of Pharmacy is an organization that works with pharmacy boards in the US and Canada, with the stated goal of "[assisting] its member boards and jurisdictions for the purpose of protecting the public health." In America, they play a role in testing pharmacists and pharmacy schools, as well as offering accreditation services.

The NABP also runs the Verified Internet Pharmacy Practice Sites (VIPPS), which accredits pharmacy sites and of course, earns fees for doing so.

VIPPS is not the only pharmacy accreditor out there, nor does it have jurisdiction over which pharmacies are considered safe in Canada — or anywhere else for that matter, because neither VIPPS nor NABP are regulators. For example, NorthWestPharmacy.com is certified by CIPA, the Canadian International Pharmacy Association, despite not being verified by VIPPS. CIPA approved pharmacies have maintained a perfect safety record for more than 15 years since CIPA was founded.

We're also verified by IPABC (the International Pharmacy Association of British Columbia), another organization with a perfect safety record, which certifies Canadian pharmacy websites that dispense prescription drugs through pharmacies based in British Columbia and regulated international pharmacies. According to the strict safety standards of both organizations, our website, products and practices are as safe as any other reputable pharmacy.

So why is the NABP attacking safe online pharmacies?

The short answer: money

Why the NABP Suppresses Canadian Online Pharmacies

The NABP is closely aligned with the big pharmacy chains like CVS, who pay fees as members of their VIPPS program. Competing against foreign pharmacies hurts their profits, so naturally these pharmacies (and the NABP) work to eliminate that competition.

The organization is also close with the pharmaceutical industry, and has received funding for projects that target foreign online pharmacies from big pharmaceutical manufacturers like Pfizer, Merck and Eli Lilly, as well as industry groups like ASOP — the Alliance for Safe Online Pharmacies.

American law is structured to suppress foreign competition from lower priced pharmaceuticals, enabling drug makers to charge higher prices in America. Spreading false and misleading claims about online pharmacies protects the profits of these companies, enabling them to charge sky-high prices to American consumers without having to compete with Canadian pharmacies.

NABP is also protecting its own interests. It created the ".pharmacy" domain and, as noted above, runs its own online pharmacy accreditation program, through VIPPS. Preventing Americans from using safe online pharmacy websites not accredited through VIPPS protects their power and influence over the industry — but it does so at the expense of American consumers.

The FDA and Online Pharmacies

The root of the FDA's current opposition to online pharmacies goes back to an intellectual property initiative in 2010. In an age of easy digital duplication and overseas manufacturing, intellectual property theft has become costly for American companies, so the Obama administration was working with industry groups to protect American IP.

Framing its agenda around safety and IP security, ASOP pushed its own plan to stop international online pharmacies from selling drugs by pressuring search engines and domain registrars to act as "effective gate-keepers" to prevent the sale of prescription drugs by online pharmacies.

Search giants were already cracking down on banned pharmacy ads under legal pressure, with Google being forced to pay a $500 million settlement for displaying ads illegally selling prescription drugs. The search industry was eager to cooperate and avoid further legal trouble. The United States government also largely accepted pharma's plan for fighting so-called "rogue pharmacies," which means the FDA isn't likely to counteract the industry's narrative.

The FDA itself is reportedly plagued by regulatory capture, suggesting it often puts the interests of the industries it's supposed to regulate ahead of protecting consumers. FDA agents often go on to very lucrative careers in the private sector, so it's been said that it is in their personal interests to make those companies happy.

This cozy relationship between the FDA and pharma has contributed to practices like FDA agents stopping medical providers from dispensing safe drugs manufactured for international use — just so their manufacturers can sell identical versions of the drugs for a higher price to Americans! Even some FDA agents have complained about having to do the bidding of large pharmaceutical companies, rather than serving American consumers.

The Threat to American Consumers

Not only does this approach to regulation seem to have failed to protect Americans from unsafe online pharmacies, in many cases, it's actually increased the risk. The NABP and Bing are pretty good at finding and targeting legitimate Canadian online pharmacy websites like NorthWestPharmacy.com, because we're legitimate. Our customers are happy with our authentic products and exceptional service, so our sites stick around, year after year. They're not nearly as good at targeting the fly-by-night illegal pharmacies that pop up daily on the Internet.

Many of these companies sell counterfeit drugs and dispense prescription medications without a prescription, putting consumers at risk and violating the law. When they're shut down, they just throw a new site up and go right back into business. By warning consumers away from safe pharmacies while missing dangerous ones, Bing may be steering consumers towards buying unsafe, counterfeit drugs.

Additionally, for many Americans with inadequate insurance and expensive medications, domestic pharmacies simply aren't an option. Without safe online pharmacies, they're unable to afford their medicine at all, putting their health and even their survival in jeopardy. Online pharmacies aren't a perfect solution for all of America's health care ills, but they do make life-saving medication available to millions of Americans who wouldn't be able to afford it otherwise. It's important for those Americans to have the tools to safely purchase drugs online.

How to Choose a Safe Online Pharmacy

America has strong standards for drug manufacturing and dispensation, but they're not unique. Medication sold in Canada and other countries is every bit as safe and effective as the same medication sold in America.

Indeed, manufacturers already supply and ship drugs internationally, and governments, industry and organizations like the International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH) are pushing for more unified laws and standards for the use, research and testing of drugs around the world. There's no reason why there couldn't be a single resource that enables patients to check practically any pharmacy, anywhere in the world, to make sure it's safe.

Unfortunately, that's not where we are right now. There are an array of different organizations that certify different international pharmacies, and more than a few unsafe fake pharmacies trying to trick consumers into purchasing their products. To verify the safety of a pharmacy, you need to do a little research.

Safe Canadian Online Pharmacies

The good news is that there are organizations that do have rigorous certification processes that vouch for their member pharmacies and certified websites. We recommend looking for national or regional-based recommendations from organizations like CIPA and IPABC in Canada. Because these two organizations focus on Canadian and BC-based pharmacies respectively, they're able to provide stronger oversight than a group that aims to certify online pharmacies worldwide.

If you find a pharmacy that claims to be certified, always double-check with the organization that provides the certification. Rogue pharmacies may fraudulently copy seals from certification sites, but the certifier itself should have a certification checker tool you can use.

Check the certification provider's standards before you order for the first time. CIPA certification requires an online pharmacy to operate by essentially the same standards as any brick-and-mortar pharmacy, including:

  • Requiring a prescription
  • Maintaining patient records to prevent harmful drug interactions
  • Having a licensed pharmacist on staff
  • Following all the privacy and safety procedures required by American pharmacies.
  • Not selling controlled substances

That's enough to ensure you're safe with a CIPA approved online pharmacy. If you opt for a site that isn't a CIPA approved online pharmacy, make sure that they're licensed by organizations with the same high standards.

You should also expect your pharmacy to conduct itself in the same way a brick-and-mortar store does in their communication practices. If a pharmacy sends you spam emails or shares your contact information with other sites, you should look for a more reputable company.

Other Signs of a Safe Online Pharmacy

You should also make sure your pharmacy's customers vouch for the business. Ordering internationally can pose delays, and prescriptions are occasionally turned away at the border (although this happens very rarely). You need a site that stands behind their customers, and is willing to address issues promptly and make sure you get your medication in a timely manner.

Review sites provide a great way to confirm your pharmacy's customer service standards. That's why we integrate multiple review sites directly into our website, and encourage all our customers to leave reviews. NorthWestPharmacy.com has a 4.8-star rating on TrustPilot, and 5 stars on Shopper Approved, with literally hundreds of thousands of customer reviews.

Finally, as with any online retail site, make sure your pharmacy is secure. Businesses with sloppy or negligent security practices can put you at risk of identity theft and fraudulent charges, which can be a nightmare to repair. We take security seriously, which is why we're verified by Trust Guard and backed by Norton Security's Norton Shopping Guarantee.

The Most Reviewed Canadian Online Pharmacy

NorthWestPharmacy.com has more reviews than any other pharmacy online worldwide, with overwhelmingly positive ratings across multiple review sites. Our reputation is backed up by multiple certifications and a perfect safety record. And with our lowest price guarantee, you'll receive the same high quality medication at a fraction of what you'd pay for an American pharmacy.

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