Diego Cevallos* – Tierramérica
MEXICO CITY, Jul 20 2008 (IPS) – Mexico is drafting measures to regulate the sales of pharmaceuticals over the Internet: reforms have been announced for laws dating back to the 1980s, when the world wide web did not yet exist, and new monitoring systems are in the works to track the who, how and what of online sales.
For medications sold online, caveat emptor. Credit: Public domain
Enlarge your penis. Want to lose weight? Say good-bye to impotence. Who hasn t received messages like this by e-mail?
The sale of medications over the Internet involves thousands of vendors and continues to grow, fuelled by low prices, lack of need for a medical prescription and a supposed guarantee of anonymity. But the medicine that is purchased this way may be adulterated, it may have been stolen, it may be contraband, or may simply have passed its expiration date, and in the worst case may contain dangerous or even deadly compounds.
The World Health Organisation (WHO) estimates that 10 percent of the medications sold worldwide are fake, although in some developing countries that proportion can reach 25 percent. And half of the medicines sold over the Internet on web sites that hide their real address are believed to be fakes.
A study published last month by the European Alliance for Access to Safe Medicines says that 62 percent of the pharmaceuticals sold online are false and do not meet the minimum standards for health, including those intended to treat serious cardiovascular, respiratory, neurological and psychiatric conditions.
Ninety-five percent of the online pharmacies studied operate illegally, and 94 percent of their web sites do not have an identifiable pharmaceutical chemical in their product. More than 90 percent provide people with prescription-only medications without requiring a prescription.
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In Mexico, which has the largest pharmaceutical market in Latin America and ninth in the world, annual sales of medications represent about 9 billion dollars. But because of sales of fake medications the drug companies lose 700 to 900 billion dollars annually.
Furthermore, every so often pharmaceutical shipments are reported stolen, and 40 percent of the medications that expire end up in the garbage, in illegal markets or sold on the Internet.
The government and non-governmental organisations warn of the dangers surrounding online sales of drugs, but general measures to fight the trade have yet to be defined, although there are some isolated efforts.
Mexico will confront the phenomenon, although authorities, pharmaceutical executives and activists consulted by Tierramérica admit that it will be very difficult to shut down Internet sales.
Before the end of the year, Mexican health authorities will present new Internet monitoring and tracking systems. There will be a new focus on this reality, Luis Hernández, an advisor of Cofepris, the federal health protection commission, told Tierramérica.
This agency, entrusted with monitoring the safety of medications, is in an intense process of readaptation that aims to determine which medical products are being sold online, said Hernández.
In addition, Cofepris will propose a new general law on health to replace the law currently on the books, drafted in 1984 and since then undergoing regular reforms. Globalisation brought with it a new focus on commercial practices, which is why there has to be legislation with a current viewpoint, he said.
Cofepris warns the public that medicines are not merchandise, that it s not the same as buying a pair of shoes. They are inputs for health, which implies a risk, so that this new form of sales over the Internet needs to be dealt with and regulated, Hernández said.
Thousands of web sites, some operating inside Mexico, offer mostly pharmaceuticals to enhance sexual performance, fight depression, lose weight or lower cholesterol.
Mexico right now has no regulation for sales of medicines over the Internet, but the best way is to raise consumer awareness with broad campaigns and set up pages on the Internet itself to inform people about the risks of buying their medications online, said Héctor Bolaños, president of the Association of Free Access Medications Manufacturers (medicines that do not require prescriptions).
We have seen adulterated medicines or which do not contain the ingredients of the original formula, and others with lower quantities (of the active ingredient) or toxic substances, he told Tierramérica.
For Alejandro Calvillo, president of the consumer protection group El Poder del Consumidor, many pharmaceutical companies that operate in Mexico sponsor the Internet sales sites, although they complain that some send fake or adulterated products, in the end for them it is part of the business, it is a way of positioning their brands.
The WHO discourages pharmaceutical advertising, but in Mexico medications are openly advertised and, further, through ad campaigns they even create diseases in order to sell more and more, Calvillo said in a Tierramérica interview.
In this country of 104 million people, with 70 percent of the population self-prescribing its meds, there are 224 pharmaceutical laboratories belonging to 200 companies, 46 of them corporations that are majority foreign-owned. Their drugs are sold in supermarkets and in about 23,000 pharmacies.
Mexico is a good market for the sector, because of its demographic characteristics. In 1970, the population over age 65 represented four percent of the total. By 2025 it will be 15 percent, and life expectancy will reach 81.6 years for women and 76.8 years for men.
The drug companies know that the higher the age the greater demand for health services and for medications.
I know that because of embarrassment many adults buy Viagra (a drug for erectile dysfunction) over the Internet. It s difficult to fight that, but they have to be warned that they could be in danger from the pills they buy online, said Bolaños.
In 2004, The U.S. Drug Enforcement Administration found in a worldwide investigation that in Mexico there were about 200 pharmacies that sold their products online, and most were located along the U.S.-Mexican border. From those sites they sold adulterated versions of Viagra and some illegal narcotics.
According to the U.S.-based Centre for Medicine in the Public Interest, in 2010 the global value of sales of falsified medications will reach 75 billion dollars, representing a jump of more than 90 percent from 2005 levels.
The Internet, where sites appear one day and disappear the next, is an excellent place to sell adulterated medicines. The consumers must be informed about this because their health is at stake, and the authorities should monitor it to the maximum extent, said Bolaños.
(*Diego Cevallos is an IPS correspondent. Originally published by Latin American newspapers that are part of the Tierramérica network. Tierramérica is a specialised news service produced by IPS with the backing of the United Nations Development Programme, United Nations Environment Programme and the World Bank.)