Case Overview, Internet Prescriptions

This document provides background information and summarizes the debate over the regulation of internet prescriptions. The links to the left will lead you to public documents that we have found.

           Since access to the Internet became widespread, new businesses offering consumers new options for purchasing goods and services have flourished. Some Internet companies, such as the online auction site eBay, represent fundamentally new ways of doing business. Most online businesses, however, encompass web sites that offer quicker or cheaper options of buying the same goods that could be purchased if one got in the car and drove to a local store. In most areas of commerce this has caused little controversy. The best seller purchased at is the exact same book that can be purchased at the bricks-and-mortar Walden Books at the mall.
           Prescription drugs have constituted one of the thornier policy issues involving commerce over the Internet. The prescription drug that one person takes may extend his or her life; taken by mistake by another person, it can create serious problems. Three types of online drugstores have emerged to take advantage the enormous market for medicines and supplements. Some sites, like, fill orders that are sent to them by individuals who have a prescription from their own doctor. They offer the convenience of not having to travel to the drugstore, important for those with limited or no mobility, as well as lower prices on at least some of their drugs. Second are bona fide online drugstores in other countries, notably Canada, that also fill orders for those with a legitimate prescription. Third, are online drugstores that actually prescribe to those who request a particular medicine. Theoretically, such prescriptions are filled by doctors and pharmacists working for the websites, who would review an order and ensure that the recipient does not have a medical condition that makes the drug inappropriate or even dangerous.
           When the 106th Congress began to confront the issue of the online drugstores, it was the third type of these websites that they were most concerned about. A congressional staffer said it was an "eye opener" for legislators to learn about how some of these prescribing websites worked with their automated, computerized review of consumer orders. He recalled,

[Some of these sites] are pretty lame even in the goofy filtering systems that they [use] to make themselves look legitimate. You know, "fill out this questionnaire, we'll send it to a doctor." In a few examples, reporters had typed in information that should denied them Viagra or should have denied them the drug that they were seeking, and they got it anyway. I mean one actually said, "I am Buddy. I am a cat. I weigh 15 lbs and I am neutered." You know, "any medical condition we should be aware of? Neutered." And the cat got it. Other instances are "when were you born? 1898, and I have a heart condition, and I want Viagra." He shouldn't have been able to get it under any circumstance.

           Another issue with these online prescribers, many of which operated outside of the United States, was the integrity of the drugs themselves. Some shady operations sell imitations of drugs that are not manufactured correctly and in the worst case, may not be a real drug at all, just something that looks the real thing.
           Despite the seriousness of this problem, Congress was initially hesitant to act. Republicans in particular, were hesitant to regulate the Internet as they believe strongly in free market principles that should result in consumers having broader choices and lower prices. Republicans also for the most part advocated allowing state governments to deal with the problem, since regulation of pharmacies is covered under state laws. Democrats were more outspoken in favor of additional federal regulations to ensure consumer protection. Work began in the 106th with hearings, and a bipartisan compromise bill that contained some elements favored by both Democrats and Republicans was introduced just before Congress adjourned for the 2000 elections. Unfortunately for backers of the bill, there was little time left in the session and few strong believers in the feasibility of the bill's goals. The bill was introduced, but never acted upon.
           A similar bill was introduced in the 107th Congress, and again in the 108th Congress, but in each of these sessions members of Congress focused more attention on the issue of prescription affordability, and regulation of internet prescriptions was never acted upon.