Buying medications online can be confusing. Here’s what to expect and how to know which online pharmacies are safe and legal.
With all that you do day to day, getting your prescriptions through the mail sounds like a no brainer. With a few keystrokes, you can order a single prescription or set up regular deliveries without leaving your home.
Filling a prescription on the Internet is a growing alternative to making a trip to a pharmacy for needed medications. The number of Americans who reported using the web to fill a prescription more than doubled from 13 million in 2007 to 28 million in 2018.
Aside from the convenience, patients may also go online to save money. Some websites, like Mark Cuban Cost Plus Drug Company, offer discounts by providing a service directly to patients. And patients may choose a web-based pharmacy to fill potentially embarrassing prescriptions like Viagra.
But there can be a catch. Not all online pill dispensers are safe to purchase from. According to the National Association of Boards of Pharmacies (NABP), a whopping 95% of the websites offering prescription-only drugs operate illegally.
Types of online pharmacies
To understand the potential risks, it's important to get familiar with the types of pharmacies that operate on the web:
Online outlets for retail pharmacies
They are operated by companies like CVS or Walgreens with brick-and-mortar pharmacies but involve patients going online, rather than to the store, and then receiving the drugs by mail.
Mail-order pharmacies that work with health insurance companies
Companies like Medco, Caremark, and Express Scripts work with insurers to keep their pricing down and manage large orders. They are as safe as using a local pharmacy and may let you renew online or get several months' worth of medication you take regularly.
Online pharmacies with no link to your insurance or a pharmacy brand
While these operations may be safe and legal, in some cases they are not. Some 40,000 websites don't follow the laws that licensed pharmacies do and may even sell counterfeit, expired, or unsafe medications.
Some of these so-called "rogue" pharmacies connect you with an unfamiliar or even a bogus doctor who determines if you are an appropriate candidate for a medication. In many cases, online pharmacies only have you fill out a questionnaire before sending you a requested medication, bypassing face-to-face interaction with a doctor or other health professional altogether.
"This practice undermines safeguards of direct medical supervision and physical evaluation performed by a licensed health professional," Jeffrey Shuren, MD, medical officer of the Office of Policy, Planning and Legislation of the Food and Drug Administration (FDA), told WebMD. "The internet makes it easy to bypass this safety net."
Other risks of doing business with these online pharmacies: They can expose you to fraud or identity theft or infect your computer with malware.
How to buy safely from online pharmacies
You may be able to use your health insurance to buy prescriptions over the Internet. Your insurer may recommend or even require you to use a particular online service. If not, consider the online service of a known pharmacy brand, such as Rite Aid or CVS. Keep in mind that you will have the same co-pay as you would with any pharmacy.
If you're not using your insurance, you can compare drug prices of different online offerings. But to be sure that an online pharmacy is legal and safe, use the databases VIPPS (Verified Internet Pharmacy Practice Sites) or LegitScript. (VIPPS is maintained by the NABP, and some online pharmacies display the VIPPS logo on their website.)
Think twice about online operations that don't require a doctor's prescription. Even if the website screens you with its own staff physician , it's smart to check in with your regular doctor about all medications you're taking. Your doctor knows your medical history and can warn you if a particular medication might be a bad choice because of other conditions or medications you're taking.
Signs of safe online pharmacies
To avoid potential hazards, the FDA's BeSafeRx program suggests looking for these signs of safe online pharmacies:
- Always require a doctor's prescription
- Provide a physical address and telephone number in the U.S.
- Have a licensed pharmacist on staff to answer your questions
- Are licensed with a state board of pharmacy
To check the pharmacy's license in the state's board of pharmacy license database, use the FDA's BeSafeRx website.
Warning signs of unsafe online pharmacies
The FDA also offers these signs that pharmacies aren't on the up and up:
- Do not require a doctor's prescription
- Are not licensed in the U.S. and by your state board of pharmacy
- Do not have a licensed pharmacist on staff to answer your questions
- Send medicine that looks different than what you receive at your usual pharmacy, or arrives in packaging that is damaged, in a foreign language, has no expiration date, or is expired
- Offer deep discounts or prices that seem too good to be true
- Charge you for products you never ordered or received
- Do not provide clear written protections of your personal and financial information
- Sell your information to other websites
Will Medicare cover medications from online pharmacies?
A better question might be, do online pharmacies accept Medicare? Cost Plus Pharmacy, for example, claims to only be able to achieve its rock-bottom prices by not contracting with insurance companies and pharmacy benefit managers.
Medicare drug plans have contracts with network pharmacies, which provide members of certain Medicare plans with discounted services and supplies. Some Medicare Part D or Medicare Advantage prescription drug plans may offer a mail-order program that allows you to get up to a three-month supply of your covered prescription drugs sent directly to your home. Find out about Medicare plans in your area with our easy-to-use Find A Plan tool.
- ClearMatch Medicare: Find a Medicare Plan
- FDA: FDA BeSafeRx
- National Association of Boards of Pharmacy: NABP.pharmacy
- National Library of Medicine: Trends and Characteristics of the US Adult Population's Behavioral Patterns in Web-Based Prescription Filling
- National Association of Boards of Pharmacy: Rogue RX Activity Report
- WebMD: Buying Drugs Online