IceNetworks Ltd. Thomas Meds. Euphoria Healthcare Pvt Ltd. JCM Dropship. Az Medicinal Shop. Farma Glow. Discount Pharmacy. MyRxAffiliate Program. Store Pills Network. Instabill ECS-Rx. One Online pharmacies legitimate Pharma. Worldwide Drug Store. Medicina Mexico. HA Stores, Ltd. CanAmerica Global. Additional marketing characteristics included whether internet pharmacies offered privacy assurances eg, discrete packaging or protection of health- or billing-related information or offered shipping within the United States.
We qualitatively analyzed the website marketing language by collecting texts from the homepages of all included internet pharmacies. After initially reading through the texts to identify the most common marketing language, we selected and defined 6 characteristics.
Texts were then screened to assess whether these six characteristics were discussed: 1 quality, 2 safety, 3 read article service, 4 reputability, 5 affordability, and 6 convenience. Quotes representative of each characteristic were collected by legitimacy of internet pharmacies.
Safety characteristics were selected based on previous literature and focused on internet pharmacies classified by LegitScript [ 11162223 ]. To allow a specific focus on US pharmacies, or those that should be compliant with US laws and regulations, safety characteristics were analyzed only for internet pharmacies that offered shipping within the United States.
Safety characteristics were compared across the legitimacy of internet pharmacies. Basic pharmacy-related characteristics included the requirement of a prescription and controls on the amount of Humalog or NovoLog insulin that could be ordered eg, restricting patients to a day supply or the quantity listed on their prescription.
Characteristics related to pharmacy services included whether there was an offer to speak with a pharmacist and whether medication information legitimafe drug-related warnings and precautions were displayed on the product page. Characteristics related to location included whether the pharmacy listed a physical location and onlinee website location listed matched the country of the IP address.
We screened websites and online pharmacies legitimate a total of 49 internet pharmacies that claimed to sell Humalog or NovoLog insulin. No illegitimate internet pharmacies advertised legltimate US location. None of the physical and server locations matched among the 18 rogue internet pharmacies. Traffic to internet pharmacies, as determined by SimilarWeb [ 20 ], differed depending on the legitimacy of internet pharmacies. Although illegitimate internet pharmacies were the most abundant in the search results, unique monthly visits to each site were comparatively lower for illegitimate internet pharmaciesthan to legitimate internet pharmacies The 3 US-based legitimate internet pharmacies received the highest volumes of pegitimate monthly traffic reported at Humalog and NovoLog insulin 3 mL pens and 3 mL cartridges were most often sold online pharmacies legitimate packages containing a quantity of 5, which is in alignment with product packaging available from brick-and-mortar pharmacies.
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Costs were similarly low in unapproved and unclassified internet pharmacies. Compared with illegitimate pharmqcies, GoodRx costs—representative of average costs at brick-and-mortar pharmacies—were also approximately 2 to 5 times more expensive.
The difference in costs per mL of Humalog and NovoLog insulin pens the most common dosage form in our analysis depending on the source is depicted in Figure 1. Rogue internet pharmacies differed from unapproved and legitimate internet pharmacies across several characteristics. This table does not include 13 internet pharmacies selling Humalog or NovoLog insulin that were not classified by LegitScript.
Marketing language from website homepages differed according to the legitimacy of internet pharmacies, particularly for quality, safety, and customer service. Differences in marketing language are also demonstrated through online pharmacies legitimate selection of quotes in Table online pharmacies legitimate.
The marketing language of illegitimate internet pharmacies tended to communicate a sense of urgency to purchase products and strongly emphasized the merits of the pharmacy.
For example, one quote from an illegitimate internet pharmacy appealed to reputation, affordability, and safety:. Rogue internet pharmacies differed from legitimate puarmacies pharmacies more substantially than unapproved internet pharmacies in terms of patient safety.
Drug-related information and warnings were not uniformly displayed for both rogue and unapproved internet pharmacies. Data were unavailable for one legitimate internet pharmacy regarding whether pharmacist services were offered where member registration was online pharmacies legitimate.
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Not ojline legitimate internet pharmacies were accredited through the NABP because of geography. However, legitimate internet pharmacies required or displayed characteristics consistent with best internet pharmacy communication practices, such as requiring pharmacists to offer individual, meaningful consultations [ 13 ].
Our https://health21viagra.com/7-canadian-drugstore-dyha.php demonstrates that both Humalog and NovoLog insulin are readily available from internet pharmacies onlline engage in online pharmacies legitimate sales of prescription drugs. Illegitimate internet pharmacies were found to be abundant using common search engines, outnumbering legitimate internet pharmacies. The widespread availability of illegitimate internet pharmacies poses pharacies threat to unsuspecting consumers and provides easy access to those seeking insulin without a prescription [ 9 ].
Incentives to purchase insulin from illegitimate internet pharmacies go beyond ease of access, as our analysis reveals that these internet pharmacies offer substantial price reductions as compared with brick-and-mortar stores and legitimate internet pharmacies.
Accessibility of Low-cost Insulin From Illegitimate Internet Pharmacies: Cross-sectional Study
In the United States, rising list prices on rapid-acting insulin analogs such as Humalog and NovoLog insulin have resulted in a substantial cost burden for patients with diabetes.
Llegitimate initiatives to curb insulin costs include, among others, setting out-of-pocket maximums and allowing personal drug importation. However, these reforms have only been trialed in some states, and the legality of the personal importation of insulin remains contentious [ 2829 ]. However, this out-of-pocket maximum is limited only to Medicare beneficiaries. Legittimate the relatively limited pharmaies from the federal government, manufacturers, and other key players in the United Letitimate pharmaceutical supply chain, high insulin list prices and out-of-pocket costs legtiimate many persist.
Many patients legitimatee to face insulin online pharmacies legitimate problems, particularly those who are uninsured, which in accounted for 8. With financial pharmaceis, some patients who need insulin to manage their diabetes have resorted to illegal activities such as borrowing insulin, importing insulin from lower-cost countries, or purchasing insulin from illegitimate internet pharmacies [ 8 ]. Our analysis, which focuses on the internet pharmacy marketplace, demonstrates that among pharmacies that ship within the United States, the per mL cost of Humalog and NovoLog insulin from illegitimate internet pharmacies was approximately 2 to 5 times cheaper than that offered by legitimate internet pharmacies or GoodRx.
Such substantial price differences raise concerns that illegitimate internet pharmacies may legitimaye to patients priced out of traditional means of acquiring insulin. Beyond offering lower prices, rogue internet pharmacies do not require prescriptions and also use marketing methods that appeal to cost-conscious consumers, such as offering bulk online pharmacies legitimate or coupons. In addition, illegitimate pharmacies appeal to affordability through language on phqrmacies homepages.
Although costs are lower for Humalog and NovoLog insulin from illegitimate internet pharmacies, they remain illegal because of the serious risks associated with their use. Humalog and NovoLog insulin are high-risk medications that require both therapeutic monitoring to ensure optimal short- and long-term outcomes and sufficient counseling for the prevention of adverse events such as hypoglycemia.
The American Diabetes Association recommends that patients treated with insulin who are unaware of hypoglycemia should be counseled on signs and methods to treat it [ 36 ]. Our analysis demonstrates that illegitimate internet pharmacies, particularly rogue internet pharmacies, do not offer pharmacy services that are on-par with those offered through legitimate internet pharmacies.
Further preventing communication with health care professionals, no rogue internet pharmacies made the offer to speak with pharmacists. On illegitimate internet pharmacy websites, patients were often left without medication information and drug-related warnings and precautions.
Illegitimate internet pharmacies, with rogue internet pharmacies being the worst offenders, allow patients to access Humalog and NovoLog insulin with minimal information, predisposing these patients to poor diabetes control and potential development of adverse events.
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There is also concern as to whether the quality of insulin obtained from illegitimate internet pharmacies is comparable with that obtained from legitimate internet pharmacies.
Low costs offered through illegitimate internet pharmacies could suggest less online pharmacies legitimate cold chain shipping methods or lower-quality medications. Although our analysis did not collect information on the quality of Humalog and NovoLog insulin obtained from illegitimate internet pharmacies, substandard and falsified medicines are globally prevalent [ 1237 ].
Studies have suggested that poor medication quality from illegitimate pharmacies could further increase patient safety at risk [ 38 ]. Illegitimate internet pharmacies, as evinced in our analysis of marketing language, often make claims touting the quality of their products. Ironically, this could amplify the risk of consumers inadvertently purchasing low-quality medications.
To address these risks, a multifaceted approach is needed to close illegitimate internet pharmacies, develop better search engine filters, raise public awareness of the dangers of illegitimate internet pharmacies, and address high insulin costs.
National organizations are combating the proliferation of illegitimate internet pharmacies. The NABP helps consumers identify legitimate internet pharmacies through their list of accredited digital pharmacies, as well as with a verification service through which legitimate internet pharmacies receive a dot-pharmacy domain [ 13 ]. The Center for Safe Internet Pharmacies also offers a verification service through its initiative Verify Before You Buy powdered by LegitScriptwherein consumers can search the URL of an internet pharmacy to check its legitimacy [ 41 ].
Regulatory and legal actions are ongoing against illegitimate internet pharmacies. Operation Pangea, an effort led by Interpol in conjunction with the FDA and US Department of Justice, has resulted in the removal of thousands of illegitimate internet pharmacies [ 43 ]. LegitScript has also collaborated with the FDA to identify and close illegitimate internet pharmacies [ 44 ].
However, illegitimate internet pharmacies persist by closing and reopening under new web addresses, requiring continued vigilance by regulatory authorities. Given that patients with diabetes are frequently counseled on the management of their disease, health care providers such as physicians and pharmacists are uniquely positioned to lead the charge in making consumers aware of the risks of acquiring insulin from illegitimate internet pharmacies.
The limitations of our study include the small sample size and the cross-sectional design. However, our screening methods were consistent with what US consumers purchasing insulin on the internet might experience. An additional limitation is that we did not analyze the quality of products available from internet pharmacies, precluding conclusions pertaining to medication quality.
We did not purchase medications from these websites because we questioned the ethical implications of financially supporting the operations of illegitimate internet pharmacies. We believe our results are even more relevant now as internet purchases have become commonplace in the United States [ 45 ]. Finally, we were unable to quantify the purchase volume of Humalog or NovoLog insulin from these internet pharmacies. The nonspecific, surrogate measure of unique monthly visits is representative of the overall traffic to these websites and is not necessarily indicative of interest in or purchases of Humalog or NovoLog insulin.
Despite these limitations, we contend that our analysis reflects the internet pharmacy marketplace for insulin in the United States as accessed through common search engines.
The relatively low costs of Humalog and NovoLog insulin from easily accessible illegitimate internet pharmacies place patients at risk. Although the elimination of illegitimate internet pharmacies would be the gold standard way to reduce their risk to patients, illegitimate internet pharmacies are elusive.
Governmental agencies should online pharmacies legitimate to pursue legal and regulatory measures with the intent of closing illegitimate internet pharmacies.
Search engines should work to filter their results better, decreasing the visibility of illegitimate internet pharmacies. Finally, although public awareness campaigns and provider-to-patient efforts can bring attention to the dangers of illegitimate internet pharmacies, they do not address the reasons that patients may visit these sites. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
BP was involved in the methodology, investigation, data curation, and writing of the original draft; LM was associated with methodology and writing, reviewing, and editing; HHC was involved with methodology, writing, reviewing, and editing; SE was involved with methodology, writing, reviewing, and editing; SO was associated with conceptualization, methodology, supervision, writing, reviewing, and editing. Edited by R Kukafka; submitted Skip to Main Content Skip to Footer.
Online pharmacies legitimate Authors Cited by Tweetations 3 Metrics. Original Paper. Table 1. Marketing characteristics of internet pharmacies selling Humalog or NovoLog a. Table 2. Types of marketing language used on the home pages of internet pharmacies. You need to go through only a few steps to quickly confirm and complete your order.
Table 3. Safety characteristics of internet pharmacies selling Humalog or NovoLog insulin in the United States. References Statistics about diabetes. American Diabetes Association. Insulin access and affordability working group: conclusions and recommendations. Diabetes Care Jun;41 6 Prices of generic drugs associated with numbers of manufacturers. N Engl J Med Dec 28; 26 Lilly reveals Humalog pricing details amid larger scrutiny over insulin costs.
BioPharma Dive. Cost-related insulin underuse among online pharmacies legitimate with diabetes. The underground exchange of diabetes medications and supplies: donating, trading, and borrowing, oh my!.
But many websites selling medicines are not registered as pharmacies, so buying from them is potentially unsafe. Medicine, such as Viagra for erectile. A legitimate pharmacy and/or pharmacy owner – including online pharmacies Below are two methods to verify the legitimacy of a Canadian online pharmacy.