The U.S. Food and Drug Administration (FDA) has identified significant public health risks to consumers who buy drugs from illegal online pharmacies. Products may be counterfeit, expired, or contain dangerous ingredients; they may also contain too much, too little, or the wrong active ingredient. FDA’s Center for Drug Evaluation and Research (CDER) conducted a behavioral assessment survey to understand the knowledge, attitudes and practices associated with purchasing prescription medicine from online pharmacies in May 2012. The survey sample included 6,090 adults (age 18 and older) living in the United States who have made purchases over the Internet.1 Data were analyzed using descriptive statistics, cross tabulations and regression models.
The demographic breakdown of those surveyed is shown below:
- Population: 6,090 adults who have bought products over the Internet
- Gender: 43% male, 57% female
- Age Groups:
Age Groups 18 years old to 24 years old 13.1% 25 years old to 44 years old 34.3% 45 years old to 54 years old 18.3% Over 55 years old 34.3%
- Health Conditions:
Health Conditions poor 1.5% fair 11.7% good 41.4% very good 32.3% excellent 13.1%
Twenty-three percent of the surveyed adult Internet consumers reported buying prescription medicine online. Of those who reported buying prescription medicine online, the majority reported using an online service associated with their health insurance. Approximately 17 percent reported that they purchased from online pharmacies that were not associated with a local pharmacy or health insurance plan. This behavior may be risky because there are thousands of fake pharmacy websites on the Internet. While approximately 70 percent of surveyed Internet users felt that it was riskier to buy from an online pharmacy outside of the United States, 15 percent of those surveyed said they would consider purchasing from an online pharmacy based in a country outside the United States, of which 24 percent said they were in poor health. These responses support FDA’s concerns regarding online pharmacy consumer safety and the health risks of purchasing from illegal online pharmacies, and warrant interventions to raise awareness and educate consumers about the risks of buying medicines from online pharmacies.
Overall, survey responses indicated support for planned campaign tactics, including consumer education and the importance of health care provider and stakeholder outreach. For example, most of survey respondents reported that doctors and pharmacists are their trusted source for information about prescription medicine. Although state boards of pharmacy2 are responsible for the licensure and discipline of their state’s pharmacists and pharmacies, only 13 percent of survey respondents that reported purchasing medicines from an online pharmacy indicated that they checked an online pharmacy’s license with the state board of pharmacy before purchasing prescription medicine online. Survey data will be used to further target campaign strategies, shape communications and outreach regarding online pharmacies, assess the effectiveness of the FDA BeSafeRx campaign, and inform future public health efforts. The information will also be used to broaden FDA’s understanding of the scope of the online pharmacy problem and its relationship to the integrity of the U.S. pharmaceutical supply.
2 In some states, pharmacies may be licensed by an equivalent state agency.