How to know whether an online pharmacy sells legitimate medications
Fake pills posing as genuine prescription drugs are dangerous and can be a serious threat to personal health and safety. Most are shaped and colored to look like the real thing and can be nearly impossible to tell apart.
Many people search online for prescription drugs because they are less expensive: “Some oncology drugs can be thousands of dollars per month, and even with good insurance the costs add up fast. I can’t blame patients for looking for cheaper alternatives because I’d want to do the same thing,” admits Megan Menon, PharmD, BCOP, CPPS, Executive Director of Pharmacy at Roswell Park Comprehensive Cancer Center.
While there have always been counterfeit drugs, the Internet and rise of online pharmacies has made it much harder to track what’s a real, authentic medication and what isn’t, Menon adds. The Alliance for Safe Online Pharmacies maintains that of about 35,000 current online pharmacy websites, approximately 95% do not comply with applicable laws and pharmacy standards.
The good news is that there are resources to help you determine where to buy safe prescription drugs online.
A booming counterfeit pill industry
In 2023 the counterfeit drug trade was estimated at more than $4 billion a year. The World Health Organization categorizes these fake drugs as either “substandard” or “falsified” medical products. Substandard products may be expired or have failed to meet quality standards. Falsified products are deliberately fraudulent and may contain less active ingredients than they should, no active ingredient at all – or contain dangerous ingredients such as lead or opioids. For example, a fake tablet may say it contains 400 mg of an active ingredient but actually contains only 40 mg or none at all.
“When you have a new drug that comes out and it’s amazing, it may cost the price of a car,” Menon says, explaining that some of the new oral cancer therapies can cost more than $30,000 a month. “If you don’t have insurance that pays for it, it can be very tempting to go to an online pharmacy that advertises it for only a couple of hundred dollars a month.”
Fake drugs and cancer treatment
For cancer patients, taking a counterfeit drug can be especially harmful – and potentially more costly in the long term. “If the counterfeit drug has harmful or toxic ingredients it could cause additional suffering,” Menon warns. “The completely falsified products could actually make you sicker, and you could actually end up in the hospital.”
Counterfeit cancer drugs mimic some well-known FDA-approved oral therapies such as Gleevec (Imantinib) and Xeloda (capecitabine), and intravenous (IV) therapies such as Abraxane (paclitaxel), Avastin (bevacizumab) and Keytruda (pembrolizumab). And, according to the World Health Organization, trafficking networks have become increasingly sophisticated about exploiting the demand for affordable medications.
While anyone can purchase a counterfeit drug online, young adults and marginalized populations are most at risk. The most common classes of counterfeit drugs are anti-cancer drugs and opioid medications. Opioids like oxycodone and fentanyl are used to treat pain in cancer patients, but are at the heart of a nationwide opioid addiction epidemic. The DEA reported a 430% increase in the number of counterfeit fentanyl pills seized from 2019 to 2021 – with lab testing revealing that two out of every five counterfeit pills with fentanyl contained a potentially lethal dose.
Most counterfeit pills are manufactured overseas – in Russia, China, India and Pakistan, among other locations. But they can be purchased online from anywhere. "Public awareness is essential to make sure people know the risks of buying drugs from unauthorized or disreputable sources," Menon says.
How can I tell if an online drug is safe?
Before making any purchase from an online pharmacy, check the National Association of Boards of Pharmacy website to see if the pharmacy is accredited. Other websites with information about which digital pharmacies sell legitimate prescription drugs include
- Drug Enforcement Agency (DEA)
- Food and Drug Administration (FDA)
- Alliance for Safe Online Pharmacies
If the website is not listed as a legitimate pharmacy, do not buy from it. "If it seems too good to be true, it probably is,” Menon advises when investigating the good, bad and ugly of online pharmacies. "Any pharmacy that doesn’t require a prescription from a provider for a medication that is not over the counter (OTC) should be considered suspicious.”
Curbing the availability of counterfeit drugs
Reducing the availability and sale of counterfeit prescription drugs is a massive undertaking that will require more robust regulatory systems and international collaboration. “We need to prevent the manufacturing of the counterfeit drugs, and we need good systems to be able to detect substandard and falsified products in the supply chain,” advises Menon.
If the cost of cancer therapy becomes too burdensome, Roswell Park has financial support options that may be able to help, and may also be able to help with prior authorization from your insurance company.
Roswell Park Pharmacy
Find out more about the services, hours and locations of our pharmacy, staffed with uniquely trained oncology pharmacists.
“We can help to ensure you are getting your medications from a reputable pharmacy,” Menon says. This includes online pharmacies your insurance company may require you to use. “Insurance companies generally only contract with licensed pharmacies, but if you have any questions or concerns you can always let your care team know. We will work with you and ensure that the pharmacy you are using is a legitimate pharmacy.”
Roswell Park also has its own pharmacy on the main campus and at the Scott Bieler Amherst Center that can fill prescriptions. “Our retail pharmacies only purchase drug inventory from licensed wholesalers or direct from drug manufacturers and carefully inspect all shipments to ensure product integrity,” says Menon.
