Copyright 1999 St. Louis Post-Dispatch, Inc.
St.
Louis Post-Dispatch
November 7, 1999, Sunday, FIVE STAR LIFT
EDITION
SECTION: METRO, Pg. C2
LENGTH: 883 words
HEADLINE:
OFFICIALS WARN THAT PATIENTS ARE AT RISK AT SOME WEB DRUGSTORES;
SOME
PHARMACIES WILL FILL PRESCRIPTIONS WITH ONLY AN ELECTRONIC CONSULTATION
BYLINE: Bill Bell Jr.; Post-Dispatch Jefferson City
Bureau
DATELINE: JEFFERSON CITY
BODY:
In June, "John Cunningham"
went shopping on the Internet.
After "John" filled out an online
consultation form and a liability waiver, a Texas doctor wrote a prescription
for 30, 1-milligram tablets of Propecia, a drug used to treat male pattern
baldness.
But "John" doesn't suffer from male pattern baldness, because
John is really Lisa Meiners, an assistant attorney general. The drug she ordered
may cause birth defects in unborn children. At the time, Meiners was 26 weeks
pregnant. The state used this and a similar sting operation to go after the Pill
Box Pharmacy, an online pharmacy at www.thepillbox.com that sold the Propecia to
Meiners.
Prescribing drugs after only an online consultation "is not
safe," Attorney General Jay Nixon said.
"It's not very hard to figure
out what to type into a computer to get whatever drugs you want," he said.
On Oct. 25, Nixon's office won a permanent injunction that bars the San
Antonio-based pharmacy and its owner from using the site to sell prescription
drugs to Missourians. Under a consent judgment, the Pill Box Pharmacy also must
pay restitution to Missouri customers who bought drugs through the company's Web
site from Jan. 1 to June 30, as well as $ 15,000 in penalties.
The suit
was based on the fact that the pharmacy and the prescribing physician were
unlicensed in Missouri.
Pill Box owner William A. Stallknecht did not
return phone calls last week. In an interview in July, Stallknecht said the
charges against him and his company were "ludicrous."
Gordon M. Goldman,
an obstetrician and gynecologist who practices in Chesterfield and Florissant,
applauded Nixon's efforts.
Goldman, president-elect of the Missouri
State Medical Association, called the prescribing of drugs over the Internet a
"time bomb waiting to explode."
Patients "ought to at least be dealing
with someone who knows us over time," he said.
The online physician
can't tell whether the customer is lying about his or her weight, medications or
dosages, and writing prescriptions without a personal consultation is "just a
poor substitute for medical practice," Goldman said.
Internet customers,
he said, would have a hard time knowing the credentials of an online physician.
Goldman said he also worries about the quality and accuracy of drugs sent
through the mail in such a service.
"There's a lot of drugs whose names
are very similar," he said. "Human error is still there."
Missouri is
one of a handful of states that have taken legal action against such online
pharmacies. Illinois Attorney General Jim Ryan filed four suits against such
companies Oct. 21.
The suits come as pharmaceutical Web sites are
"mushrooming," said Kevin Kinkade, the executive director of the Missouri State
Board of Pharmacy. One year ago, the sites were virtually unknown. Now, there
are about 400 sites based in and outside the United States. They fall into two
general categories:
* Legitimate sites, which offer to fill existing
prescriptions written by a doctor who has seen a patient in a face-to-face
visit. These sites also offer nonprescription items such as soap or razor
blades.
* Rogue sites, such as the Pill Box Pharmacy, which have a
relationship with a doctor who will write the customer a prescription without a
face-to-face visit. These sites typically feature drugs such as Viagra, which is
used to treat male impotence, and Xenical, a drug for the severely obese.
Nixon's office also is going after the Procare Clinic for Men, a
Houston-based company that offers Viagra, Propecia and other drugs after an
online consultation.
The owner, Kenneth N. Miles, said the drugs the
clinic offers are not dangerous. He said the company mostly serves men who would
be too embarrassed to see a doctor about problems with sexual performance.
Miles said the clinic offers a service that is no different from what
most doctors have done at some point in their careers. A doctor, for example,
gets a call from a longtime patient who has a visiting niece who needs a
prescription filled, Miles said. Doctors sometimes fill that prescription
without seeing the new patient, he said.
Doctors who criticize his
company are guilty of "professional protectionism," Miles said.
Physicians make money from people who have to make repeat visits to get
prescriptions filled, Miles said. Doctors' offices fail to do background checks.
"Tell me one doctor's office that requires identification to say who you
are," he said. "You can lie about your age, name, address and phone number and
get whatever you want."
The National Association of Boards of Pharmacy
has developed a way to certify online pharmacies. If the Web site meets 17
criteria, it gets a "Verified Internet Pharmacy Practice Site" seal of approval
from the association.
Only three Web sites have passed such muster:
drugstore.com at www.drugstore.com; Merck-Medco Managed Care Online at
www.merck-medco.com; and PlanetRx.com at http://planetrx.com.
Dennis
Joyce, director of marketing for PlanetRx.com, said customers using his
company's service must fax, mail or phone in prescriptions from their own
doctors. PlanetRx calls the doctor's office to verify the prescription.
"We do believe in the sanctity of the physician-patient relationship,"
Joyce said.
GRAPHIC: PHOTO (1) Graphic / Illustration -
PlanetRx.com is one of only three Web drugstores to be certified with the
circular blue "VIPPS" seal by the National Association of Boards of Pharmacy.
The Internet pharmacy fills prescriptions that have already been written by a
doctor and either mailed, phoned for faxed to the store. PlanetRx then checks
with the doctor's office to authenticate the prescriptions.
(2) Graphic /
Illustration - The Pill Box Pharmacy requires customers to only fill out online
forms and does not check with a person's doctor. It is barred from selling drugs
to Missourians, the result of a suit filed against it by the state. The Pill Box
must pay restitution to Missouri customers who bought drugs through the
company's Web site from Jan. 1 to June 30, as well as $ 15,000 in penalties.
LOAD-DATE: November 8, 1999
