How Online Pharmacies Work
An online pharmacy, internet pharmacy, or mail-order pharmacy is a pharmacy that operates over the internet and sends the orders to customers through mail or shipping companies.
Online pharmacies might include:
- Pharmacy benefit manager – A large administrator of corporate prescription drug plans
- Legitimate Internet pharmacy in the same country as the person ordering
- Legitimate Internet pharmacy in a different country than the person ordering. This pharmacy usually is licensed by its home country and follows those regulations, not those of the international orders.
- Illegal or unethical internet pharmacy. The web page for an illegal pharmacy may contain lies about its home country, procedures, or certifications. The “pharmacy” may send outdated (expired shelf life) or counterfeit medications and may not follow normal procedural safeguards.
Conventional stationary pharmacies usually have controlled drug distribution systems from the manufacturer. Validation and good distribution practices are followed. Home delivery of pharmaceuticals can be a desirable convenience but sometimes there can be problems with uncontrolled distribution.
The shipment of drugs through the mail and parcel post is sometimes a concern for temperature-sensitive pharmaceuticals. Uncontrolled shipping conditions can include high and low temperatures outside of the listed storage conditions for a drug. For example, the US FDA found the temperature in a mail box in the sun could reach 136 °F (58 °C) while the ambient air temperature was 101 °F (38 °C)
Shipment by express mail and couriers reduces transit time and often involves delivery to the door, rather than a mail box. The use of insulated shipping containers also helps control drug temperatures, reducing risks to drug safety and efficacy.
Risks and concerns
- Illegal or unethical pharmacies sometimes send outdated, substituted, or counterfeit medications
- Sometimes an online pharmacy may not be located in the country that is claimed. For example, one study of drug shipments claiming to be from Canada revealed many actually originated in several different countries and were often bogus medications
- Minors or children can order controlled substances without adult supervision
- Other concerns include potential lack of confidentiality, improper packaging, inability to check for drug interactions, and several other issues.