Online Pharmacy Ratings Undermine WOT Credibility and Uninsured Americans

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PharmacyChecker
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Online Pharmacy Ratings Undermine WOT Credibility and Uninsured Americans

Post by PharmacyChecker » Tue Jun 28, 2011 3:49 pm

Online Pharmacies and Web of Trust (WOT): Undermining WOT’s Credibility and American Consumers

WOT shows a poor reputation score for the most reputable international online pharmacies, thus calling into question its system for helping people determine which sites they can and cannot trust. Poor reputations on WOT of reputable international online pharmacies are not the result of their disgruntled customers but of a handful of Platinum raters that support the position of the pharmaceutical and U.S. pharmacy industries against personal drug importation. We hope that the information below encourages WOT’s raters to revisit online pharmacy reputation ratings to correct misperceptions and reputations in this area to bring some justice to the WOT environment. For full disclosure, I am the vice president of PharmacyChecker.com, an independent, private company, that evaluates online pharmacies, including international ones, and our website has fallen victim to similar low reputation ratings, even though we’re not a pharmacy. <!--break-->

In asking WOT’s reviewers to objectively approach the online pharmacy area, it’s important to define a “reputable international online pharmacy”. We believe that a reputable online pharmacy is one at which orders placed for prescription medication will be filled by a licensed pharmacy, under the supervision of a licensed pharmacist, prescriptions are required, personal and financial information is protected, verifiable phone number and mailing address is published on the website, and genuine medication is dispensed. Empirical studies and customer experience show that properly verified online pharmacies, foreign and domestic, sell genuine medication and require a prescription, and that such online pharmacies provide an ethical service are “reputable” (See: http://www.plosone.org/article/info:doi ... ne.0012199).

WOT’s credibility is not the most important thing at stake here, although that, too, especially to all of you in the WOT community, is important. Since reputable international online pharmacies sell the same brand name medicines found in the United States at a much lower price, they are often a lifeline for uninsured Americans who highly value and sometimes desperately need those services. What are the consequences of WOT’s ratings when they lead an uninsured American not to trust an affordable online pharmacy that should be trusted?

On the lighter side, although still unfortunate, Americans looking to save money online for prescription drugs could be scared away from ordering from a safe online pharmacy because WOT gives it a poor rating and end up paying more from a neighborhood or chain pharmacy. On the darker side, misleading WOT ratings may discourage an uninsured American – who is unable to afford the prices at a U.S. pharmacy – from purchasing safe and affordable medication online, resulting in that person not taking needed medication; that person could get sick and even die. In fact, drug affordability is a major national health crisis in the U.S. that gets far too little attention. According to the U.S. Centers for Disease Control and Prevention, 25 million Americans did not take their prescribed medication in 2009 due to cost (See: http://www.msnbc.msn.com/id/41629551/ns ... alth_care/). Reports have shown that one hundred and twenty-five thousand Americans die each year because they do not take their prescribed medications. Reports also show that 20% of hospitalizations and about $300 billion in healthcare dollars (according to the FDA) are attributed to Americans not taking their medication each year (See: http://www.federalregister.gov/articles ... erence-u18). Since, as the government has asserted, adherence to prescription drug regiments is affected by prices, when Americans are deterred from access to safe and affordable medication their health is put at risk.

How and Why Are WOT’s Ratings of International Online Pharmacies Misleading?

There are several reasons, all interrelated, why WOT’s ratings are wrongly skewed against reputable international online pharmacies. WOT has teamed up with LegitScript.com as a trusted “third party” that verifies online pharmacies and therefore lends more weight to LegitScript.com’s ratings. LegitScript.com considers as “unapproved” all non-U.S. online pharmacies that sell to Americans, not necessarily on the basis of safety or trustworthiness but because of U.S. laws that proscribe the practice of importing prescription drugs. What does this mean in the real world? A licensed Canadian pharmacy that meets the highest standards of online pharmacy safety, which serves Americans who have only had great experiences with the pharmacy service, would receive an “unapproved” status from LegitScript.com.

The National Association of Boards of Pharmacy (NABP), which is now the conventionally recognized authority on online pharmacies, publishes a Not Recommended List of online pharmacies that considers all non-U.S. online pharmacies, regardless of their credentials as “rogue”. The “blacklist” contains mostly dangerous, “real rogue” online pharmacies but it also includes reputable international online pharmacies. Real rogue online pharmacies sell real or fake drugs without requiring a prescription, steal personal and financial information, and sometimes, partake in organized crime. In complete contrast, reputable international online pharmacies safely sell genuine medication at an affordable price and require a prescription. This categorization is unfair to American consumers who are looking online for affordable medication and will wrongly believe that all NABP’s Not Recommended sites are “rogues”.

LegitScript.com and NABP’s position on why they include otherwise safe online pharmacies on their blacklists is that federal laws prohibit buying drugs from Canada or other countries. Equally as important, they are also clearly influenced by the agenda of big pharmaceutical and U.S. pharmacy companies. Let’s be clear – it is technically against the law in the United States to personally import medication. The reason I write “technically” is because the FDA does not take enforcement actions against individuals who personally import non-controlled medication for their own use. In practice, the millions of Americans who have ordered non-controlled prescription drugs from licensed Canadian and other foreign pharmacies almost always receive their medication and, to my knowledge, in accordance with FDA policy, are never prosecuted. Even when the FDA seizes a shipment from time to time it is usually released to the patient.

The global pharmaceutical and the U.S. pharmacy industries are against personal drug importation, or any pharmaceutical importation that undermines their profits. This is very straightforward business. When an American buys Flovent online from Canada for $41 instead of $108 from a U.S. pharmacy, GlaxoSmithKline makes less money, and that is one less sale for a U.S. pharmacy (if the American would have been able to afford the $108). Interestingly, GlaxoSmithKline still makes money on the sale but less so. The one benefiting most from the international purchase is the uninsured American who saves 62%. And what about safety? The drug was manufactured by Merck and sold in Canada. It’s stupid to argue that GlaxoSmithKline is selling a dangerous version of Flovent in Canada.

How are the NABP and LegitScript.com Guided by Corporate Interests?

The NABP’s Internet Drug Outlet Identification Program, which blacklists all international online pharmacies, was sponsored in 2008 with a grant from Pfizer, the world’s largest drug manufacturer (See: See: http://www.nabp.net/news/nabp-names-79- ... -practice/). Pfizer has spent many millions of dollars opposing the legalization of personal drug importation. Pfizer and other large pharmaceutical companies, often through the Pharmaceutical Researchers and Manufacturers of America (PhRMA) fund groups that operate as non-profit organizations to bring the message to the public, media, and policy-makers that all non-U.S. online pharmacies that sell prescription drugs to Americans are dangerous.

The NABP also represents the interests of U.S. pharmacy boards, who are generally opposed to personal drug importation as it means lower sales for U.S. pharmacies. So NABP is tied to the pharmaceutical and U.S. pharmacy industries. LegitScript.com, generally, is connected to the pharmaceutical and U.S. pharmacy industries as a founding member of Alliance for Safe Online Pharmacies, in which NABP has “observer status” as well. LegitScript.com also has or had pharmaceutical clients that seek to shutdown any online pharmacy, safe or not, that undercuts its profits. Now LegitScript.com also works for the U.S. Food and Drug Administration to assist it with issues relating to online pharmacy. While this last point doesn’t prove LegitScript’s ties to the pharmaceutical industry, it’s well-known that the FDA is more lock-step right now with the corporate pharmaceutical agenda. Also, LegitScript.com issues misleading reports that attempt to discredit reputable international online pharmacies that are then cited by groups funded by the pharmaceutical industry as valid research. It should be known LegitScript.com’s reports and efforts have also resulted in the shutdown of truly rogue online pharmacies, which we all support.

Several prominent WOT raters, such as g7w, shazza, and Tompo2000 have adopted the NABP’s and LegitScript.com’s position about all non-U.S. online pharmacies. Using their ability to rate reputations in bulk, using the Mass Rating Tool, such Platinum raters have been able to rate all, or almost all, 7000 websites on the NABP’s Not Recommended List (See: http://www.mywot.com/wiki/Mass_rating_tool). Several of the sites listed are safe and reputable online pharmacies, as defined above. Such Platinum raters have been accused of operating as shills for the NABP or LegitScript.com but there is no concrete evidence to support such accusations. Nonetheless, we find that international online pharmacies are all given poor reputations because a few prominent Platinum raters admittedly give the lowest ratings to any online pharmacy that is “unapproved” by Legitscript.com, or on the NABP’s “Not Recommended” list. Some also comment that Americans ordering from international online pharmacies are breaking the law, indicating that that’s the reason such websites have poor reputations.

The facts remain that some international online pharmacies offer mail-order pharmacy services equal to those offered in the United States, and that such pharmacies are needed by uninsured Americans to afford their medications. Those sites are maligned on WOT by some prominent reviewers, not because they are untrustworthy or unsafe, but because they support the positions of the NABP and LegitScript.com, which are firmly aligned with the commercial interests of the pharmaceutical and U.S. pharmacy industries. WOT’s credibility is undercut when a whole class of trustworthy sites, especially pharmacies, are wrongly painted black. Much worse, it seriously disadvantages Americans searching for safe and affordable medication online. We hope that the WOT community will analyze and review international online pharmacies in a fair and balanced manner; and oppose reviewers when their reviews do not reflect a websites’ trustworthiness but do reflect what is clearly a corporate agenda. In doing so, the WOT community will better serve the larger arena of consumers who look to WOT for help, such as uninsured Americans struggling to afford their medication.

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Tue Jun 28, 2011 4:17 pm

and if after that you still feel like reading.
From Public Library of Science One
http://www.plosone.org/article/info%3Ad ... ne.0012199

Note the mention in "Introduction" paragraph 3 (three)

Read all carefully!

Here is a statement from PLoS One:
Political Discussion and Conclusions

This study demonstrates that there are many website pharmacies, including those from overseas, from which it is almost certainly safe to procure medicines; indeed, [green]all of the pharmacies approved by both NABP and PharmacyChecker.com passed the authentication spectrometry tests undertaken in this study.[/green]

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Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Tue Jun 28, 2011 4:43 pm

Confirmed. pharmacychecker.com
[red]Is not listed[/red] on the NABP’s Not Recommended list, as stated they were on a scorecard comment.
http://www.nabp.net/ip2.asp

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Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Tue Jun 28, 2011 5:04 pm

An excerpt from that study that SF linked to may be pertinent for consumers:
  1. "Even assuming all substitutes were bioequivalent copies (i.e. generics), risks remain for unwary purchasers of drugs over the Internet"
Now, whether you choose PharmacyChecker, NABP, or LegitScript for your guideline may be the determining factor for your purchases, but at the end of the day, it comes down to "risk" about safety and the report's caution that "risks remain for unwary purchasers of drugs over the Internet".

So, the task for each consumer is to decide not only which guideline entity to use (and I guess I should put WOT in there too) but also how to minimize risk and balance it with cost.

From what I've seen, the general guideline is:

The higher the cost, the lower the risk.

The lower the cost, the higher the risk.

BUT, let me quickly point out . . . the above two statements are not always true (which is why I used the phrase "general guideline" . . . it is by no means universal or to be considered a "rule").

EDIT: This is a touchy subject since it concerns two hotbutton issues that are not always balanced for consumers: your pocketbook and your safety. And "legal" considerations is a whole 'nother issue for consumer consideration.

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Tue Jun 28, 2011 5:20 pm

As I stated on the scorecard, use commonsense and your gut instinct.
I'll personally will keep going to my local pharmacy, and even then folks read your scripts and validate you have received what the doctor prescribed.

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Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Tue Jun 28, 2011 7:44 pm

@ PharmacyChecker =

Dear sir or madam , I left you a pm , which now is open to any one that says
In reference to a post left for a rogue pharmacy
R156-83-306. Drugs Approved for Online Prescribing, Dispensing, and Facilitation.

In accordance with Subsection 58-83-306(1)(c), the following legend, non-controlled drugs are approved for prescribing by an online prescriber:

(1) finasteride;

(2) sildenafil citrate;

(3) tadalafil;

(4) vardenafil hydrochlorid;

(5) hormonal based contraception (except injectable or implantable methods); and

(6) varenicline.

Non Controlled !
That was to the remarks left in scorecards by you and others that you could sell this medications w/o prescription !
[cite]Undermine WOT Credibility and Uninsured Americans[/cite]
Your lack of credibility is what is in question
Good day !

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Wed Jun 29, 2011 4:40 am

@ PharmacyChecker,

Looooong rant, but stimulates a worthwhile debate anyway.

Though I think I might have left the "Undermines WOT Credibility" stuff out of there. That dilutes your arguments . . . I mean, that's like going onto an IE forum, arguing that FF is better and then ending the argument with "IE is crap". You've put a lot of members in this forum on the defensive and shifted the debate to emotional issues on an already touchy subject.

IOW, you've lit a distracting fire (mentioning "Undermine WOT Credibility") under an already brightly burning topic.

While you are certainly entitled to your opinion about WOT, there are times that opinions are best left unsaid . . . I think this was one of them.

EDIT: The other issues you brought up would have been sufficient for some members to deduce your opinion of WOT without having to see the statement outright.

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Wed Jun 29, 2011 5:09 am

Tip: too much text.

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Wed Jun 29, 2011 7:15 am

@ PharmacyChecker,

Here's an exercise that I probably should do more myself since some of my posts tend to be long winded also:

Assume that people glaze over after about 20 to 30 seconds of reading . . . which is a pretty safe assumption.

Time the reading of your post, using a normal reading pace so that the concepts can be digested.

Now, at the 20 to 30 second mark . . . THAT is when people are going to start to dial out and everything you say after that will be missed/ignored.

So, put yourself in their place, and force yourself to distill your "novel" down to the most important points in the first 20 to 30 seconds.

Or better yet, consider what it would look like in an abstract and write that.

You can always offer to expand on a concept and likely do that IN SMALL bursts in response to questions anyway. Much easier to digest.

Guest

RE: Online Pharmacy Ratings Undermine WOT Credibility and Uninsu

Post by Guest » Wed Jun 29, 2011 9:10 am

<quote user="bobjam">
@ PharmacyChecker,

Here's an exercise that I probably should do more myself since some of my posts tend to be long winded also:

Assume that people glaze over after about 20 to 30 seconds of reading . . . which is a pretty safe assumption.

Time the reading of your post, using a normal reading pace so that the concepts can be digested.

Now, at the 20 to 30 second mark . . . THAT is when people are going to start to dial out and everything you say after that will be missed/ignored.

So, put yourself in their place, and force yourself to distill your "novel" down to the most important points in the first 20 to 30 seconds.

Or better yet, consider what it would look like in an abstract and write that.

You can always offer to expand on a concept and likely do that IN SMALL bursts in response to questions anyway. Much easier to digest.
[/quote]

No offense, but echo that! ~smiles~

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