The report investigates the ads that appear when a person enters search terms such as “generic meds” or “online pharmacy” into Bing. Of the 69 advertisers that the company investigated, only seven were deemed to be legitimate. The remaining 62 did not require a prescription, in violation of US law, did not have a US address or offered to ship drugs from outside of the US.
“We were able to get prescription drugs without a prescription, and some were counterfeit,” says John Horton, founder of LegitScript. LegitScript states that over 40,000 online pharmacies do not meet the certifications of the National Association of Boards of Pharmacy (NABP), which stipulate that companies must have a valid pharmacy license, a location in the US, and only dispense medicine with a valid prescription.
For certain drugs, federal law states not only that a user needs a prescription but also that the prescribing doctor must have a bona fide relationship with the patient, generally consisting of face-to-face contact and the sharing of medical information. The US Drug Enforcement Administration also prohibits certain controlled drugs from being imported into the US. The FDA also recommends that consumers buy pharmaceuticals online only from companies that are based in the US, require a prescription, and are licensed by the NABP. These regulations aim to prevent the abuse of prescription drugs and the dangers of taking unregulated medicine that may be adulterated, expired, or toxic.
Many of the pharmaceutical ads on major search engines do not comply with these standards, Bruen says. “Almost 90 percent of the pharmacy ads that we reviewed are for fake pharmacies. This has been going on for a while,” he adds.
The new report examined 10 online pharmacies in closer detail and confirmed through the websites’ FAQs or through live-chats that no prescription was needed to order prescription drugs. In two cases, the researchers purchased prescription drugs, one of which turned out to be counterfeit.
“If you look on the major search engines, you will find ads from pharmacies that are not legitimate, selling controlled substances,” says Susan Foster, vice president and director of policy research at the National Center on Addiction and Substance Abuse (CAMA) at Columbia University.
Bing, Google, and Yahoo all verify the legitimacy of online pharmacies by using PharmacyChecker, which covers overseas pharmacies in addition to US-based ones. For an online pharmacy to meet PharmacyChecker’s standards, it must be licensed with a pharmacy board, require prescriptions based on face-to-face doctor-patient meetings, comply with patient-privacy laws, and have valid contact information and sufficient online encryption.
PharmacyChecker also covers Canadian pharmacies, because they undergo a regulation process as rigorous as the FDA’s, according to Tod Cooperman, president of PharmacyChecker. “None of those 10 pharmacies [examined in the report] are approved members of the PharmacyChecker program,” says Cooperman. He was unable to explain why ads for unverified pharmacies showed up on Bing.
“They shouldn’t advertise any pharmaceuticals until they figure out ways to [regulate],” says Bruen. “They should require that anyone who uses specific drug names in their search criteria disclose their pharmacy license and brick-and-mortar location.”
To sell ads, search engines typically run an auction for certain search keywords, with popular search terms, such as “Viagra,” costing more. Every time a user clicks on a search ad, the seller pays the search engine a fee, ranging from a few cents to a few dollars, depending on the keyword. In this bidding system, Horton suggests that the abundance of illegal pharmacy ads may overwhelm legitimate ones. “If the drugs they’re selling are counterfeit or knockoffs, they have lower costs than legitimate pharmacies,” says Horton. “The rogue Internet pharmacies have more money to bid on advertising [and] drive up the auction rates, to the detriment of legitimate advertisers.”
Bruen, who monitors large, organized spam networks, also found that many online pharmacies are tied to spam groups. By looking at domain registration records, they found that some pharmacies were located in Russia, India, or Panama, despite stating that they were based elsewhere.
E. J. Hilbert, a former FBI agent and the head of online security for Epic Advertising, says that search engines shouldn’t allow advertisers to display one website address and then direct a user to a different one. “Why would you call it dailymedrx.com when it redirects to k2med.com, which is located in Russia?” he asks. Hilbert also suggests that search engines check the domain names of their advertisers to see where they are really based. “If an advertiser is bidding a lot higher for a keyword like “Viagra’ than others, it may be a red flag that they are illegitimate, he adds.
“The online advertising market is a multibillion-dollar business,” Hilbert says. “The profit model is in favor of ‘run the ads and buyer beware,’ versus being consumer conscious.”
Last year, NABP, the American Pharmacists Association, and CAMA wrote to major search engines expressing concern about fraudulent pharmacies. “We never heard back from Google and Yahoo,” says Foster. “We did eventually hear back from Microsoft [and] they indicated that they would look into the problem.”
Horton and Bruen say that they plan to investigate additional search engines.
Updated 8/6/09: A Microsoft spokesperson said in response to the report, “We take these claims very seriously and are currently investigating this issue.” Microsoft’s advertiser’s guidelines state that only pharmacies in the US and Canada can target the US market.
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