Inspections, Compliance, Enforcement, and Criminal Investigations
Krest Holdings, Panama S.A. 11/16/09
Department of Health and Human Services
|Public Health Service
Food and Drug Administration
|Silver Spring, MD 20903|
From: FDA Center for Drug Evaluation and Research
Date: November 16, 2009
TO: Krest Holdings, Panama SA
Calle Alberto Navarro No.9
El cangrejo, Panama City
UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES
FOOD AND DRUG ADMINISTRATION
ROCKVILLE, MD 20903
TO: Krest Holdings
FROM: Food and Drug Administration Internet Pharmacy Task Force
RE: Internet Marketing of Unapproved and Misbranded Drugs
DATE: November 16, 2009
The United States Food and Drug Administration (FDA) has reviewed your websites at approved-swiss-drugstore.com, swiss-meds.com, approved-refill-club.com, first-refill-online.com, rxpharm.ws, global-rx-pharm.com, refill-drugstore.com, generics-pharm.net, mediwax.com, discountwebmeds.com, approved-medical.com, allgenericpills.com, rxbynet.com, and pricedpills.com and has determined that you are offering products for sale in violation of the Federal Food, Drug, and Cosmetic Act (the Act). These products include, but are not limited to, "Acomplia (Brand)," "Acomplia (Generic)," "Rimonabant," "Viagra (Brand)," "Cialis (Brand)," "Prozac (Generic)," and "Levitra (Brand)." We request that you immediately cease marketing violative products.
These products are drugs under section 201 (g) of the Act, 21 U.S.C. § 321 (g), because they are intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease and/or because they are intended to affect the structure or function of the body. Your marketing and distribution of these drugs violate various provisions of the Act, as described below:
Unapproved New Drugs
Your firm offers many unapproved new drugs including, but not limited to "Acomplia (Brand)," "Acomplia (Generic)," and "Rimonabant." FDA is taking this action against your firm because of the inherent risk in buying unapproved prescription drugs. Unapproved drugs from unregulated sources do not have the same assurance of safety and effectiveness as drugs subject to FDA oversight and have been found to be contaminated, counterfeit, contain varying amounts of active ingredients, or contain different ingredients altogether. For drugs that are regulated by FDA, FDA protections include rigorous scientific standards for prescription drug approval and label review for accuracy and completeness, manufacturing procedures and testing performed under closely controlled conditions at FDA ;registered and inspected facilities. In addition, pharmacies and wholesalers who sell or distribute prescription drugs in the U.S. are licensed by the states.
Unapproved new drugs delivered to the American public from unregulated sources may not be safe and effective. Rimonabant (also marketed under the name Acomplia) was specifically rejected for FDA approval because it did not meet the statutory requirements for safety and effectiveness. In June 2007, the FDA Endocrinologic and Metabolic Drugs Advisory Committee unanimously voted not to recommend approval of the drug because of increased risk of neurological and psychiatric side effects including seizures, depression, anxiety, insomnia, aggressiveness, and suicidal thoughts among patients. Accordingly, the "Acomplia (Brand),· "Acomplia (Generic),· and "Rimonabant dispensed through your websites are "new drugs," as defined by section 201(p) of the Act, 21 U.S.C. § 321(p).
Under sections 301(d) and 505(a) of the Act, 21 U.S.C. §§ 331(d) and 355(a), a new drug may not be introduced or delivered for introduction into interstate commerce unless an FDA-approved application is in effect for it. Your sale of several products, including "Acomplia (Brand), "Acomplia (Generic)," and "Rimonabant" without approved applications violates these provisions of the Act.
Your websites offer products, including but not limited to "Viagra (Brand)," "Cialis (Brand)," "Prozac (Generic)," and "Levitra (Brand)," without requiring that the products be dispensed under a prescription from a duly licensed practitioner. Therefore, the drugs are misbranded under section 503(b)(1) of the Act, 21 U.S.C. § 353(b)(1), and are marketed in violation of sections 301(a), 301(b), and 301(k) of such Act, 21 U.S.C. §§ 331(a), 331(b), and 331(k).
Further, your websites offer products for sale and state that they are FDA-approved. As noted above, your products are not FDA-approved and are offered for sale in violation of the Act. Therefore, these products are misbranded under section 502(a) of the Act, 21 U.S.C. § 352(a), because the labeling of the drugs is false and misleading.
The introduction or delivery for introduction into interstate commerce of these misbranded products violates section 301(a) of the Act, 21 U.S.C. § 331(a).
This letter is not intended to identify all of the ways in which your activities might be in violation of United States law. It is your responsibility to ensure that all products marketed by your firm are in compliance with the Act and its implementing regulations. You should take prompt action to correct the violations noted above. Failure to correct these violations promptly may result in regulatory action, including but not limited to, seizure and/or injunction without further notice.
Please notify this office in writing within 15 working days of receipt of this letter of any steps you have taken or will take to correct the noted violations and to prevent their recurrence. If the corrective action(s) cannot be completed within 15 working days, state the reason for the delay and the time within which the correction(s) will be completed.
Your response should be sent to FDAInternetPharmacyTaskForce-CDER@fda.hhs.gov. Please direct any inquiries concerning this letter to FDA's Internet Pharmacy Task Force at FDAInternetPharmacyTaskForce-CDER@fda.hhs.gov or (301) 796-3110.
Deborah M. Autor, Esq.
Office of Compliance
Center for Drug Evaluation and Research
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