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Standards for on-line drug sales may soon be issued
February 9, 1999

USA Today

By Rita Rubin

BETHESDA, Md. -- The National Association of Boards of Pharmacy this spring expects to begin issuing "seals of approval" to on-line pharmacies, the group's executive director announced Monday.

Since the impotence pill Viagra was approved 10 1/2 months ago, dozens of Web sites have begun selling prescriptions for the drug and the drug itself. In addition, a growing number of on-line pharmacies are competing with drugstores for sales of a variety of prescription drugs. Because of the Internet's worldwide reach, these new sites represent a regulatory nightmare for state and federal agencies.

Pharmacy boards are concerned that most on-line pharmacies have not been properly licensed, says Carmen Catizone, the national association's executive director.

About 40 states require licensure for all pharmacies that dispense drugs to their residents, says Catizone, who spoke at a Food and Drug Administration meeting about on-line prescribing and sales of prescription medications. Michael Friedman, deputy FDA commissioner for operations, says the agency has neither the staff nor the authority to deal fully with on-line prescribing and sales.

So far, state pharmacy boards in New Mexico, New York, Ohio, Texas and Wisconsin have investigated on-line pharmacies for violating licensing laws, he says. The Ohio pharmacy board has issued cease-and-desist orders for several such Web sites, he says.

Medical doctors aren't the only ones writing Viagra prescriptions on-line, says Cynthia Culmo of the Texas Department of Health. She says her department has discovered that podiatrists, chiropractors and dentists also are involved.

Some on-line pharmacies are trying to circumvent the need for prescriptions by calling themselves wholesalers, but they're illegally selling the drugs directly to consumers, not to retailers, Culmo says. She says her department is investigating two such sites.

Catizone says his group will be meeting with representatives of the FDA and state medical boards to draw up standards for on-line pharmacies and will post those that meet the criteria on its own Web site.

"We want to send a clear message to the public," he says, adding that state pharmacy boards are cooperating with their medical counterparts in investigating the sites.

Prescribing drugs to patients sight unseen over the Internet is unethical behavior, says John O'Bannon III, a member of the American Medical Association's Council for Ethical and Judicial Affairs. He says the council plans to add a statement to that effect to the AMA's ethics code.