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Spam may be synonymous with male enhancement drugs, but new research shows that Americans are far more likely than buyers in other countries to turn to spam-advertised pharmacies to obtain pills to treat serious ailments—a trend that reflects differences in government health care and prescription drug policies.

Researchers at the University of California, San Diego, have collected the first data showing which drugs consumers most often buy from spam advertisements, and how much they spend at shadowy online apothecaries.

“People are going to them when they’re either too embarrassed to talk to a doctor, or when it would be far too expensive to buy these drugs otherwise,” said Chris Kanich, a PhD candidate at UCSD’s computer science department, and lead researcher of the study.

Previous estimates of monthly worldwide revenue from spam have varied dramatically, from $300,000 to more than $58 million. The UCSD researchers found that the largest rogue Internet pharmacies generate between $1 million and $2.5 million in sales each month, although they caution that their estimates are conservative.

Kanich says the figures show that although the spam-advertised market is substantial, it is not nearly as big as some have claimed, and falls short of annual expenditures on technical anti-spam solutions by corporations and ISPs.

“We were trying to make a lowball estimate,” Kanich said. “A lot of previous estimates have been from people who are making rough estimates and have incentives to push the numbers one way or another.”

The researchers arrived at their dollar estimates by mining transaction data from seven of the top spam-advertised pharmacies. By making targeted “buys” from each pharmacy brand, they discovered that each of the pharmacy assigns sequential order numbers to individual purchases. Thus, from any pair of purchases, the UCSD team could determine the total transaction volume for the interval between their two purchases by subtracting the first order number from the second.

To learn which products customers bought from spam-advertised pharmacies, the researchers exploited a hidden feature in the websites used to promote the largest organization in the industry—EvaPharmacy. They discovered that two-thirds of EvaPharmacy affiliate Web sites “outsourced” the hosting of images to compromised third-party servers.

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