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Verified Internet Pharmacy Practice Sites
(VIPPS™)
Most Frequently Asked Questions
VIPPS™ PROGRAM
What is the VIPPS
Program?
The Verified Internet
Pharmacy Practice Sites™ (VIPPS™) program and its accompanying VIPPS seal
of approval identifies to the public those online pharmacy practice sites
that are appropriately licensed, are legitimately operating via the
Internet, and that have successfully completed a rigorous criteria review
and inspection.
How does NABP
verify the sites?
Internet-based
pharmacy practice sites wishing to become VIPPS-certified submit a
detailed application to NABP, which includes the pharmacy’s policies and
procedures addressing the VIPPS criteria. Licensure information is
verified with applicable state boards of pharmacy. The VIPPS team reviews
the application, policies, and applicant’s Web site, and performs an
on-site inspection of the pharmacy’s facilities. Once the policies and
procedures as well as the operations of the pharmacy appear to meet the
intent of the VIPPS criteria, permission to display the VIPPS Seal is
granted and the verified information about the pharmacy is posted on the
VIPPS Web site. Clicking on the VIPPS Seal links the user to the VIPPS Web
site that then verifies that the Seal is indeed posted on a
VIPPS-certified site. If so, the user is then shown pharmacy-specific
information, including licensure information.
Does NABP regulate online
pharmacies?
NABP does not regulate
online pharmacies. Regulation of pharmacy practice, whether online or not,
is primarily the jurisdiction of the state boards of pharmacy with some
federal oversight. The VIPPS program is a voluntary certification program
for which Internet pharmacy practice sites may apply. The value of the
program to the patient and the Internet pharmacy is that it provides
members of the public with a means to assure themselves that the Internet
pharmacy they choose is a bona fide, fully licensed facility exercising
competent Internet/interstate pharmacy practices.
When was the VIPPS program developed?
In 1999, NABP became aware of the need for
this program when consumers contacted several state pharmacy boards to
complain about illegal Internet prescribing and dispensing sites posing as
legitimate pharmacies. The Association developed the VIPPS program in
response to public and regulatory agency concerns regarding safety of
Internet pharmacy practices in order to provide a means for the public to
distinguish between legitimate and illegitimate online pharmacy practice
sites.
Isn’t the number of
Internet sites far too large to monitor and control?
No. NABP and the regulatory framework of state
boards of pharmacy, federal agencies, and the medical community have been
working together for several years now to achieve this goal.
Online Pharmacy Questions
How many online pharmacies are out
there?
It is difficult, if not
impossible, to answer this question accurately, but it is probably fewer
than you would think. Illegitimate pharmacies (usually those that offer
online prescribing) open and close on a daily basis. One company posing as
a legitimate pharmacy may have many URLs or Web addresses, creating the
impression that there is a greater number of Internet pharmacies than
actually exists. In addition, pharmacies may only register with select
search engines. If these search engines are not utilized when performing a
search then all pharmacies may not be counted.
How many prescribing sites are out
there?
The number of prescribing
sites, using patient questionnaires and fee-based cyberspace
consultations, as well as sites that sell prescription medications and
controlled substances without requiring a “consult,” is difficult to
estimate. NABP’s research indicates that the number of such rogue
operators is less than the number of legitimate online dispensing
pharmacies.
What’s wrong with
using a prescribing site to get Viagra® and Xenical®? I don’t have to see a doctor and can obtain the
medicine with increased privacy and confidentiality; and it’s
cheaper.
First, the Food and Drug
Administration (FDA) restricts the distribution of certain drugs to a
prescription-only basis because in certain medical situations they can be
dangerous if not taken with ongoing medical consultation. Most regulatory
authorities and professional organizations regard online prescribing to be
unprofessional, and in some states it is illegal, unless it is done
pursuant to a valid, ongoing patient-prescriber relationship that has
included an in-person physical examination. Completing only an online
questionnaire does not establish a valid patient-prescriber relationship.
Moreover, without a physical examination you could receive inappropriate
medication and worsen an underlying, undiagnosed, serious medical
condition.
As for increased privacy and confidentiality, evidence
appears to indicate that illegitimate prescribing sites frequently sell
their customer lists to other illegitimate online pharmacy operators and
owners of Internet scam and pornography sites. By buying drugs from an
illegitimate site you may be designating yourself as someone who is a good
target for rip-off schemes.
Frequently, deceived consumers notify
us of non-receipt of medications they ordered, and/or credit card charges
that illegitimately operating pharmacies refuse to remove. Many also
complain that they are unable to contact the pharmacies: phone lines are
disconnected or no one answers.
Can I get really cheap prices from pharmacies outside
the US?
First, the FDA generally
prohibits the importation of foreign-made versions of prescription
medications that are commercially available in the US. The safety and
efficacy of these medications cannot be guaranteed. Many countries’ drug
research and control programs are not as safety oriented as those in the
U.S. Though some of the drugs advertised by foreign sites may be
manufactured by the same name brand international drug manufacturer as you
are used to, they usually are not manufactured in FDA inspected facilities
that have met FDA standards. Further, sometimes the medications have been
subjected to storage conditions that compromised their potency or safety.
Can I get cheap prices from
legitimate online pharmacies?
Yes, and
more. One of the great benefits to shopping online to fill your
prescriptions is the ease with which you can comparison shop. Many
pharmacies offer price comparisons between their charge and that of other
legitimate pharmacies. This is one way to stretch your health care dollar.
Many online pharmacies accept prescription benefit insurance coverage as
well. In addition, legitimate online pharmacies often offer valuable
health care information in a searchable format. VIPPS-certified pharmacies
are required to offer their customers free phone consultation with a
pharmacist, and many offer free ask-a-pharmacist e-mail service as
well.
What are the main
advantages of ordering medications online?
Convenience is a major advantage that online pharmacies
provide over some of their pharmacy competitors. Consumers’ ability to
order and receive medications without leaving their home is a tremendous
time-saver. Often, drug information and price information may be accessed
via the pharmacy’s Web site, or this information may be requested via
e-mail so the consumer does not have to wait on the phone for an answer or
travel to the pharmacy to ask for this information in person.
In
addition, online pharmacies may provide more privacy than traditional
brick-and-mortar pharmacies. Consumers who are too embarrassed to purchase
certain medications or health care products from the local pharmacy may
find greater anonymity by ordering these products from an e-pharmacy where
staff may not be able to put a “face to a name.”
Laws/Regulations
Who regulates online pharmacies?
The state boards of pharmacy have primary responsibility
for regulation of online pharmacies. Regulatory authority is mainly
exercised by the state board of pharmacy of the state in which the
pharmacy is physically located. In addition, most states protect their
citizens by licensing “out-of-state pharmacies” that ship medications to
patients in their jurisdictions. The same regulations that apply to
traditional brick-and-mortar and mail-order pharmacies typically apply to
online pharmacies. Federal agencies, such as the FDA and Drug Enforcement
Administration (DEA), are also partners with the state boards of pharmacy
in this regulatory process. The FDA, however, mainly regulates
foreign-based sites and practitioners.
How do I set-up an online
pharmacy?
When pharmacists are
thinking about setting up an online pharmacy, we encourage them to do
their homework and work in conjunction with the state boards of pharmacy.
The VIPPS criteria may serve as a solid guideline when an organization
plans to expand into interstate/Internet pharmacy practice and seeks to
address issues of quality, verifiable relationships, regulatory
compliance, and good pharmacy practices.
How does NABP work with government agencies that
regulate online pharmacies?
NABP has
strong working relationships with the state boards of pharmacy and the
federal agencies. Inspector training programs and the VIPPS “Report a Suspicious Site” programs are examples of
ways in which NABP helps regulatory agencies monitor and investigate
illegitimate pharmacy Web sites.
How are international online sites
regulated?
As mentioned earlier,
online sites located outside the United States pose the greatest
challenges for state and federal regulators. Cooperation with other
nations and their regulatory agencies has been and continues to be the key
to regulating online international pharmacy sites. NABP is working with a
number of international regulatory agencies to establish VIPPS programs
for their online pharmacies.
What organization can I contact regarding regulations
and online pharmacies?
Your first
contact should be the local state board
of pharmacy . You may also subscribe to NABPLAW®, NABP’s state
pharmacy law and rules database, which allows users to research subjects
one state at a time or across all 50 states. Annual subscriptions include
two updates to assure users’ access to the most accurate information
possible. For more information contact NABP’s Publications Desk, or e-mail
NABP at comm@nabp.net.
What if I believe an online pharmacy
has dispensed the wrong medication or labeled the medication
incorrectly?
Please report these
incidents to your local state board of pharmacy as well as the board of
pharmacy in the state where the pharmacy is located. You should also
contact the pharmacy that mistakenly dispensed the medication. VIPPS
pharmacies are required to document, track, and analyze these types of
incidents to determine what went wrong and to prevent recurrences.
What are the signs of a
suspiciously operating pharmacy?
First, e-pharmacies are suspect if they dispense
prescription medications without requiring the consumer to mail in a
prescription, and if they dispense prescription medications and do not
contact the patient’s prescriber to obtain a valid verbal prescription.
Further, online pharmacies are suspect if they dispense prescription
medications solely based upon the consumer completing an online
questionnaire without the consumer having a pre-existing relationship with
a prescriber and the benefit of an in-person physical examination. State
boards of pharmacy, boards of medicine, the FDA, as well as the AMA,
condemn this practice and consider it to be unprofessional.
Second, online pharmacies should have a toll-free phone number as
well as a street address posted on their site. If the pharmacy merely has
an e-mail feature, so that the sole means of communication between the
consumer and the pharmacy is via e-mail, this is a suspect site.
Third, legitimate sites allow consumers to contact pharmacists if
they have questions about their medications. If a site does not advertise
the availability of pharmacists for medication consultation, it should be
avoided.
Many suspiciously operating e-pharmacies have limited
numbers of medications that they sell, particularly “lifestyle”
medications that treat such conditions and diseases as impotence, obesity,
herpes, pain, and acne. Although pharmacies may not sell every medication
available in the US, those online pharmacies solely selling lifestyle
medications may not be operating legitimately.
What if I believe that an online pharmacy may be
operating suspiciously?
Please report
suspiciously operating pharmacies to NABP by using the “Report-a-Site” feature in the VIPPS section of our Web
site. You may do so anonymously. We also encourage you to report such
sites to your local state board of pharmacy, especially if you or a loved
one has been harmed. NABP forwards information regarding suspiciously
operating sites to the most appropriate regulatory
authorities.
What organization
covers the security of patient information for online
pharmacies?
Security, confidentiality,
and privacy are among the chief concerns of patients and health care
professionals regarding online pharmacy services. State and federal laws
such as the Health Insurance Portability and Accountability Act (HIPAA)
protect patient identifiable information. VIPPS and other voluntary
certification programs require participating organizations to adhere to
and post their privacy policies. In addition, NABP has published
guidelines regarding the confidentiality of patient health care
information. Please contact NABP, 847/698-6227, for information about
obtaining a copy of these guidelines.
Prescriptions/Prescribers
Can a prescription be faxed to the online pharmacy,
or does the pharmacy need the original prescription? Does the online
pharmacy verify the prescription with the prescriber?
Generally state laws require faxed prescriptions to be
received directly from the prescriber (not the patient) to be valid.
Online sites that do not protect the integrity of the original
prescription, or that do not verify the authenticity of suspect
prescriptions may be in violation of the law. In addition, VIPPS-certified
pharmacies must have policies and procedures in place that address these
issues. Before you entrust your health to anyone online, look for the
VIPPS Seal, and click to verify.
Disclaimer
Last modified: 12-31-01 |