During the 2009 United Nations Internet Governance Forum held November 15-18 in Sharm El Sheikh, Egypt; the Council of Europe hosted a Workshop entitled

Medicines on the Web - Risks and Benefit

Dr. Paul Zickler, past President of CIPA was invited to speak at the workshop as part of a 5 member panel of international experts.  "Patients who cannot afford their medicine at home are patients at risk", he declared.  According to information from the U.S. based Kaiser Family Foundation, the current economic crisis has one in three Americans skimping by reducing prescribed dosage on medications that fight chronic conditions like high cholesterol, high blood pressure, depression and diabetes. "Having medicines available on the web provides access to medications that are either not available or not affordable within a patient's home jurisdiction, at competitive prices and extremely conveniently."

Also on the panel, Kin Ping Tsang, International Alliance of Patients Organizations based in Hong Kong; promoted health literacy, maintaining that patients can benefit if patient-centred-medical information on the web is established. Similarly, Mr Griffith Molewa of the Department of Health in South Africa delivered the message that public health authorities should take a leadership role in educating the public and forging partnerships with Internet Service Providers and professional associations to develop safe practices for the public when using the web for pharmaceutical purchases.

"In order to enjoy safely the richness and freedom of the Internet in the area of healthcare, a strong and effective regulation should provide for a situation of checks and balances. Adequate safety standards are necessary to protect consumers and patients."  This statement came from Dr. Nico Kijstra of the Dutch HealthCare Inspectorate, Ministry of Health, Welfare and Sport in the Netherlands.

Moderator and panellist for this workshop was Mr Hugo Bonar, Enforcement Manager, Irish Medicines Board.  He acknowledged that policies and best practices support and protect patients against bad medicines, but criminals do not adhere to such controls. Usually, there is no intention by counterfeiters to harm the consuming patient but profit is usually the only consideration.

While Dr. Zickler acknowledged the existence of fraudulent and unscrupulous operators on the web, "Purchasing drugs through internet and mail order can be controlled so that the benefits are greatly favoured. Legitimate sites reduce any risk by using credible credit merchants, using search engines that verify users, conducting independent testing on medications and being involved in setting standards of best practice for the sites."

Dr. Zickler concluded his presentation by outlining four important points to be followed. 

1. Patients must be able to contact their pharmacist, and to confirm that the source of their medicine is a legitimate operation and brick-and-mortar facility.
2. Prescription-only medication must not be dispensed without the patient having had a face to face interface with a licensed physician who provides an original prescription for the medication(s). This includes verifying the patient's identity and the doctor's credentials.
3. Controlled substances must not be shipped over borders and no prescription medication should be shipped without a prescription. The pharmacist/pharmacy should comply with the professional standards in their jurisdiction.
4. The pharmacy must have in-depth knowledge of the medication(s) pedigree and works with licensed professional suppliers with which it has an established relationship. The idea is to build a process that is as direct as possible from the manufacturer to the patient."

"It is vital to assist consumers to identify legitimate distance-based pharmacy operators from rogue sites on the internet.  As with all kinds of pharmacy care, safety protocols must be first and foremost" stressed Dr. Zickler, reflecting the position of The Canadian International Pharmacy Association. This industry association ensures that its member pharmacies deliver affordable medications both safely and efficiently from Canada to patients in the U.S.A and worldwide. Since its founding in 2002, tens of millions of prescriptions have been filled by CIPA member pharmacies for maintenance drugs following our strict safety procedures, with not a single incident of patient harm.