CONTROLLING INTERNET Rx

December 28, 1999
		After this background report, Susan Dentzer discusses buying prescription drugs over the Internet and the proposed White House regulations with Gwen Ifill. The Health Unit is a partnership with the Henry J. Kaiser Family Foundation.

Focus: Internet Rx Dec. 28, 1999: Update: Internet Rx Regulations Dec. 27, 1999: Taxing E-Commerce Nov. 17, 1999: Background on the InternetRx issue Small Pharmacies: In on the Act. Nov. 17, 1999: RealAudio extended excerpts with: Ron Klink, Carla Stovall and Eric Thom. Browse the NewsHour's coverage of health.   White House Federal Drug Administration FDA testimony on e-pharmacies National Association of Boards of Pharmacy	PHARMACIST: Just a half a teaspoon, twice daily. SUSAN DENTZER: Getting a prescription filled at your local pharmacy usually looks a lot like this ... PHARMACIST: And who's the doctor? SUSAN DENTZER: ... but increasingly, it's apt to look more like this.   SUSAN DENTZER: First there was e-mail, then budding e-commerce -- and now, there's e-pharmacy. Just this year alone, dozens of major pharmacy sites have sprung up on the Internet, with names like Drugstore.com, Soma.com and PlanetRx. They're trying to prove to consumers that getting a prescription filled online is more convenient than waiting in line at the local drugstore.
	A new type of pharmacy
	TOM PIGGOTT: I saw it as an exciting opportunity to create essentially a new type of pharmacy. SUSAN DENTZER: Just under a year ago, 31-year-old Tom Piggott founded a Seattle-based Internet pharmacy site. Now owned by drugstore giant CVS, it's called CVS.com. The site affords consumers Internet access to the same products they can get in CVs pharmacies across the U.S. Consumers simply call up the site, answer questions about their medical history, then enter their prescription and physician's name and phone number. TOM PIGGOTT: After it is submitted, the pharmacists at CVS.com will verify the information that you have entered, contact your physician if it is a new prescription. CVS.COM OPERATOR: Let me follow up with the doctor and I need to find out who called this prescription in today. SUSAN DENTZER: At the customer's behest, the prescription order is then routed to one of two places -- either the customer's local CVs retail pharmacy, or to CVS.com's own state-of-the-art dispensing facility in Ohio. The order then can be packed and shipped from the warehouse directly to the customer. E-pharmacy is still just a fraction of overall pharmacy sales. But it's expected to grab an increasing share of the drugstore business. That's in part because the convenience of ordering medications over the Net can be a real plus for consumers. Dr. Jane Henney is commissioner of the federal Food and Drug Administration. DR. JANE HENNEY: Ordering over the Internet for your refill or your prescription drug that you need I think is very beneficial, particularly for people who have difficulty getting to the drugstore, people who are disabled, who are home-bound, who are elderly, who live in rural communities.
	Filling false prescriptions
	SUSAN DENTZER: But for all the benefits, Henney and other experts say there's also a serious, and even dangerous, downside. Buying already prescribed drugs over the Internet doesn't appear to pose any safety problems. But health officials are concerned that drugs are also being prescribed over the Internet. Sometimes, legitimate physicians affiliated with the sites are doing the prescribing -- but sometimes not. A recent report published in the New England Journal of Medicine highlighted the problem. Researchers at the University of Pennsylvania Medical School examined 4,000 Internet sites. They found 86 that were selling the well-known impotence drug Viagra without requiring a visit to a physician or, in many instances, even a perfunctory online medical evaluation. Congressman Ron Klink, a Pennsylvania Democrat, is alarmed. REP. RON KLINK: We've talked to people where family pets, or people who had died 20 years ago were given prescriptions for various drugs. And they didn't lie about the information. When it said, 'What's your status?', well, family pet. Sex, neutered. And yet they were able to get Viagra. SUSAN DENTZER: Phony prescriptions for pets are one thing, says Klink, but the risks to humans are obviously far greater -- and growing. One reason is a rising number of foreign drug-selling sites, many of which operate out of places like Southeast Asia or Mexico. The sites are selling drugs illegally into the U.S., violating a number of federal and state laws in the process. State officials are also concerned. In Kansas, the attorney general, Carla Stovall, is cracking down on sites that are selling prescription drugs unlawfully to Kansas citizens -- almost always from outside the state's borders. So far, her office has sued six sites for violating state consumer-protection laws and licensing requirements. One of those sites, called Confimed.com, had sold Viagra without a prescription to the 16-year-old son of an employee in Stovall's office. CARLA STOVALL: What he said was that he wasn't able to have sex and that was sufficient apparently because, even though his age was 16, they sent him the drug and he received it. There is no reason to think that someone younger couldn't have been able to get these drugs too. I think it is a tremendous concern. SUSAN DENTZER: Last June, Stovall sued Confimed, including its founder, a physician, Dr. Howard Levine. Levine would not appear on camera, so we interviewed Confimed's senior vice president, Eric Thom, at the Web site's small office in Seattle; he told us Confimed had seriously erred in selling Viagra to the 16-year-old. ERIC THOM: It was a mistake. We acknowledge that mistake and we respect Kansas's jurisdiction. SUSAN DENTZER: So what was it, the doctor just didn't notice that he was 16? ERIC THOM: He didn't see it. He literally didn't see it. He made a mistake.
	Ensuring your health
	SUSAN DENTZER: Thom says Confimed has since taken steps to make sure such errors don't recur. And in reality, he says, about one in five patients who try to get Viagra from Confimed are turned down. Stovall was still concerned. CARLA STOVALL: We don't let people today write their own prescription and walk into a pharmacy on Main Street and get that prescription filled. You have to go through your physician. And because we have Internet and it makes things more accessible doesn't mean that those rules should change, and that I should be able to write my own prescription, basically, for a drug that I want to have that my own physician won't give to me. SUSAN DENTZER: FDA Commissioner Henney agrees. DR. JANE HENNEY: You're putting your own health, which is really fragile, at risk and that's the issue here. SUSAN DENTZER: Earlier this year, federal agencies formed a working group to look further into illegal activity by Internet sites and to try to enforce all applicable state and federal laws. Now, the Clinton administration is proposing to ratchet up federal regulation over the sites. It proposes to increase the FDA's investigative powers and drastically raise the financial penalties for making online drug sales without valid prescriptions.