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Frequently Asked Questions
LegitScript Classiﬁcations of Internet Pharmacies
What are the different classiﬁcations of online pharmacies used by LegitScript.com?
Within our system, we separate online pharmacies into three groups:
- Legitimate: These are online pharmacies that meet LegitScript standards.
- Unveriﬁed: These are online pharmacies that we are aware of, and may be legitimate, but have not had an opportunity to fully review.
- Unapproved: These are online pharmacies that LegitScript has reviewed, and determined do not meet our standards. Rogue is a sub-category of unapproved, and indicates that the online pharmacy blatantly violates or is not in compliance with laws or regulatory standards. This includes "offshore" online pharmacies that insist they don't have to follow any safety standards whatsoever.
I disagree with the classiﬁcation of an online pharmacy. What should I do?
We do our best to correctly determine whether an online pharmacy meets our standards. We welcome additional information about a website, and are willing to reconsider any determination that a pharmacy website does or does not meet our standards. Please contact us through our contact page.
Why are some online pharmacies listed as "unveriﬁed"?
An unveriﬁed listing is a neutral descriptor; it means that we are still reviewing the pharmacy website, and haven't reached a conclusion yet as to the website's legitimacy. It doesn't mean that the pharmacy website is a legitimate one, but it deﬁnitely doesn't mean that it isn't legitimate. We just haven't ﬁnished our review.
Rogue Internet Pharmacies
What is a "rogue" Internet pharmacy? Are all of your unapproved pharmacies "rogue"?
We deﬁne a "rogue" Internet pharmacy as one that intentionally or knowingly:
- violates, appears to violate, encourages violation of, or is not in compliance with applicable national or regional laws or regulations;
- does not adhere to accepted standards of medicine and/or pharmacy practice, including standards of safety; and/or
- engages in fraudulent or deceptive business practices.
"Rogue" also means "operating outside of normal regulatory controls." Internet pharmacies that ship drugs into a particular country and then claim that they do not have to comply with that country's drug safety standards because they are "offshore" or in a foreign jurisdiction meet this deﬁnition and are typically classiﬁed as "rogue."
If an online pharmacy is unapproved but not listed as a "rogue" pharmacy, that means that LegitScript has veriﬁed that the pharmacy website doesn't meet our standards and we cannot recommend it.
What are some signs that a pharmacy website is a "rogue" Internet pharmacy?
- "No prescription required.” Prescription drugs, by law, require a prescription. If you see the words "no prescription required," that's a warning sign.
- "Online consultation" or "online questionnaire.” An online questionnaire can be helpful if the pharmacy requires it in addition to a prescription written by a physician who has examined you at least once in person. However, websites that employ doctors to write prescriptions based only on an online form, without a physical examination, do not meet LegitScript standards.
- The website isn't transparent. Can you ﬁnd the contact information for the dispensing pharmacy? If not, we urge caution.
- Location. The pharmacy claims to be located in Canada or elsewhere outside of the United States, and offers to ship prescription drugs into the United States. Or, the pharmacy claims to be located in the United States and ships drugs into Japan. In these cases, the transaction is typically unregulated for safety and product authenticity.
Shouldn't people be able to tell when a site is rogue just by looking at it?
"Rogue" Internet pharmacies go to great lengths to appear legitimate. They announce themselves as "legitimate," "approved," "veriﬁed," when in fact they may only be engaging in false advertising. LegitScript's online pharmacy veriﬁcation standards are recognized by the National Association of Boards of Pharmacy. We use these to determine which, among thousands of prescription drug websites, are legitimate and which are not.
If the rogue Internet pharmacies are so bad/dangerous why isn't anyone (the government, search engines, pharmaceutical companies) doing anything about it?
Actually, governments, both US and abroad, are trying to do something about the rogue Internet pharmacy problem. One of the major roadblocks — and what rogue online pharmacies count on — is that jurisdiction is often difﬁcult to establish and it is not often that the operations of a rogue pharmacy fall entirely under one country's law. The search engines, and other Internet companies, have made major strides since 2010 to get these rogue pharmacies off their platforms. But with over 40,000 active rogue pharmacies all trying to make their way onto popular online platforms, it can be difﬁcult to stay on top of. We are proud to say that LegitScript helps some of the most popular Internet companies today keep their platforms clean.
That's one reason LegitScript was created — to help businesses and individuals identify and avoid rogue online pharmacies.
Who controls what kind of pharmacies can advertise? Why don't they just block these guys?
Google, Yahoo, and Bing now require VIPPS-accreditation for participation in their online advertising programs (the ads at the top and right side of the page when you do a search). LegitScript is responsible for monitoring all three search engines on the back end and notifying the search engines when a bad ad appears. We're glad for the opportunity to help keep the search engines' sponsored search results clean!
Note: This only applies to paid search results, also called "online advertisements." It doesn't apply to everyday, unpaid search results (sometimes called "organic search results").
Who can “shut down" a rogue online pharmacy?
There are a few types of Internet service companies that can shut down a website. A shutdown involves hiding the rogue content on a website from internet users. Registrars and internet service providers (ISPs) are two examples of the types of companies that have the power to shut down a website.
Domain name registrars, in particular, typically have user agreements that contain a contractual clause requiring websites to act lawfully. LegitScript urges domain name registrars to "take down" rogue Internet pharmacy websites in accordance with those agreements.
Where's your list of unapproved Internet pharmacies?
We don't publicly list these websites. That's because we don't want a teenager, for example, to use our list to ﬁnd a website for getting prescription drugs without a prescription.
However, if you want to conﬁrm the legitimacy of an Internet pharmacy, you can enter it into the check online pharmacies box on the homepage.
Ordering from Internet Pharmacies
Why shouldn't I order from a Canadian (or other foreign) Internet pharmacy?
The Food and Drug Administration (FDA) has determined that in nearly all cases, imports of prescription drugs from pharmacies located outside of the United States will violate federal law.
Additionally, pharmacies located in other countries are subject to different safety and legal requirements than pharmacies located in the United States.
In most cases that we have investigated, the drugs shipped from so-called "Canadian" online pharmacies never go through Canada at all. Instead, the business often isn't even a pharmacy, and sources drugs from places like India, China, Turkey, etc. and repackages them to appear as though they came from someplace like Canada or the UK.
For a more detailed discussion, please see Consumer Safety.
If a pharmacy is legal where it's located, why isn't it OK to order from it just because it's not located in my country?
In order for an online pharmacy to be legitimate, it has to be licensed and operating lawfully both in the place where it is located and in any place it ships into. So, a pharmacy that's licensed and legal in Germany is perfectly ﬁne to dispense drugs to German residents. However, it would not lawfully be allowed to ship into the United States (or most other countries) because the laws of those countries do not have safeguards in place to make sure that drugs coming from outside their borders are safe and meet regulatory standards.
I only order from pharmacies I know and trust, what does your site have to do with me?
If you are already using an online pharmacy on our legitimate pharmacies list, that's great! However, you may want to compare your current pharmacy with others on our list to see if there is one that is even more convenient.
And, if your pharmacy is not on our approved list, please contact us to ask why.
Aren't there some drugs that you don't really need a physical examination to get? My doctor has prescribed over the phone to me before.
It's perfectly OK for your doctor to prescribe to you over the phone if you have a pre-existing relationship with that doctor, and he or she has physically examined you before. In the United States, a prescription is only "valid" if it is based on a legitimate doctor-patient relationship, and in virtually all cases, that requires that the doctor know you from at least one in-person visit.
We do have a name for drugs that don't require that a physical examination have occurred: "over the counter drugs." If it's a prescription drug, that means a valid prescription is required, and that means you shouldn't trust a doctor who has never laid eyes on you.
The Internet pharmacy I went to said that an "online consultation" with the doctor is a "recent innovation in health care" and is just as safe!
"Online consultations" are almost always a substandard, and potentially dangerous, practice designed to make money for Internet pharmacies. Here's how it works:
- The online pharmacy presents you with a questionnaire, telling you that a doctor will review it.
- In many cases, there is no doctor on the other end — it is a sham.
- If there is a doctor on the other end, most websites pay the doctor a certain amount of money for each questionnaire they review — and they may review several online forms a minute!
- The cost of the "online consultation" is passed on to you, the consumer.
Here's why this is unsafe:
- By deﬁnition, prescription drugs are designated as such because a physical examination is usually required. This goes for so-called “lifestyle drugs” as well.
- Example: Viagra shouldn't be prescribed for somebody with certain heart conditions, and erectile dysfunction could be a result of prostate cancer. It is not possible to test for these conditions without an in-person examination, which could save a person's life.
- Example: Propecia should not be taken by a man if he and his female partner are trying to conceive. An online consultation with a non-existent doctor will not cover this possibility.
(Caveat: Online consultations are legal in one state (Utah) in extremely limited circumstances; however, the National Association of Boards of Pharmacy and Federation of State Medical Boards have both indicated that even this exception does not involve the safe and legitimate practice of medicine or pharmacy. Additionally, there are other extremely limited circumstances, called “telemedicine," that involve, for example, doctors viewing a patient over a remote video camera, but no unapproved pharmacy websites fall into this category.)
Don't most people just go to their local pharmacies anyway? How many people are really using online pharmacies for the right reasons to begin with?
Some government data — the Medical Expenditure Panel Survey, to be precise — indicates that about 1% of the 3.9 billion prescriptions ﬁlled each year are ﬁlled online. However, those are probably all legitimate online pharmacies, and that number likely does not include rogue Internet pharmacies — a multibillion-dollar business.
We think it's great if people go to their local, brick-and-mortar pharmacies! It's very important to be able to consult with a pharmacist in person, and online pharmacies are not for everybody.
However, online pharmacies, if they are safe and legitimate, can offer an added convenience, especially if you are just seeking to reﬁll an existing prescription online.
How does LegitScript interpret the Ryan Haight Act (RHA)?
In the US, any pharmacy whose website facilitates the distribution of controlled substances requires a modified DEA registration and compliance with the Ryan Haight Act, unless qualification for an exemption can be demonstrated.
Online pharmacies, as defined by the RHA, must hold a modified DEA registration and complete additional record-keeping for their controlled substance sales.
Statutory exemptions that remove a group from the RHA definition of “online pharmacy” and relieve the associated registration and reporting requirements do exist. Most legitimate pharmacies take affirmative steps to avoid being considered an online pharmacy under the RHA; perhaps the most well known exemptions are those for only filling new and refilled prescriptions for Schedule III-V substances.
There is also an RHA exemption for “filling new prescriptions for controlled substances in schedule III, IV, or V”, which includes only prescriptions that arise as a result of a pharmacy contacting a prescriber to request a new prescription for a controlled substance the patient has previously received from that pharmacy and that prescriber. In this context, the meaning of the phrase “new prescription” within the RHA does not match with the commonly accepted meaning by most pharmacies (i.e., the patient must have previously received that drug from that pharmacy without the involvement of the Internet). Functionally, it’s more similar to what a pharmacy would consider “continuation of therapy,” not a new prescription.
Because of the specific definitions used in the legislation, LegitScript interprets the RHA to apply to all pharmacies operating websites that process controlled substances, unless documentation is supplied describing how they qualify for an exemption. Because the exemptions relating to new or refilled prescriptions require a patient to have obtained the same medication previously from that pharmacy and prescriber without the use of the Internet, LegitScript does not consider pharmacies that operate solely or primarily online to be eligible for this exemption. Pharmacies that qualify as “online pharmacies” under the RHA will not be eligible for certification without applying for a modified DEA registration, and otherwise complying with the Ryan Haight Act.
Comparable requirements may exist in other countries, and LegitScript applies those jurisdictions’ rules as may be appropriate.
How does LegitScript evaluate compounded medicine (including hormone replacement therapy, or HRT) advertising?
LegitScript requires advertisements for compounded medicines to clearly distinguish the medicine from commercially available products and to avoid making misleading claims.
The varieties of compounded medicines are endless, and methods to market these medicines are just as varied. The FDA has found certain kinds of advertising for compounded medications to constitute the offense of “misbranding,” stating that such advertisements make safety and efficacy claims unsupported by evidence. Some examples of problematic claims are:
- Stating or implying a compounded medication is safer or more effective than an FDA-approved therapy due to effects not related to customizing a drug for an individual patient.
- Advertising of HRT using the terms “bio-identical,” “BHRT,” or any marketing of compounded hormones intended to imply the drugs are natural or identical to human hormones, and therefore better than commercially available products.
- Stating or implying a disease can be treated or prevented by a compounded medication when the FDA has stated there is evidence contradicting, or no supporting evidence for, such a claim.
Pharmacies should review their online material advertising compounded medications, and ensure it complies with advertising standards. Pharmacies advertising in a manner contrary to FDA or FTC guidelines will not be certified.
Does LegitScript have any additional requirements for facilities compounding without prescriptions for identified individual patients?
In the US, LegitScript requires facilities compounding without obtaining prescriptions for identified individual patients to be registered with the FDA as a 503B facility. These facilities may also be required to undergo inspection via the National Association of Boards of Pharmacy’s Verified Pharmacy Practice (VPP) prior to LegitScript certification.
Compounded medications without prescriptions for identified individual patients, such as compounds supplied to clinics for use in the physician’s office, are subject to increased government regulation. Such a practice also justifies an on-site evaluation. US facilities compounding these medications must be 503B registered with the FDA. Additionally, they must receive on-site inspections through NABP’s Verified Pharmacy Practice program. In most circumstances, a VPP inspection will be considered valid for 12 months.
May a pharmacy ship medicines outside of its home country and still be LegitScript-certified?
LegitScript requires applicants to submit proof of licensure and/or a basis for legal compliance with non-resident jurisdictions prior to approval of a pharmacy.
The practice of pharmacy and supply of medicines to the public is highly regulated in most jurisdictions. These regulations are often local (e.g., provincial, state or prefectural) laws and regulations as well as national. While a pharmacy may participate in international sales, any such pharmacy must conduct its own due diligence to verify its own compliance with laws and regulations in all jurisdictions to which it offers to ship medicines. Accordingly, pharmacies shipping medicines internationally are required to provide their documentation of compliance with the laws and regulations of foreign jurisdictions, as well as licensure where required.
This requirement also applies to pharmacies in the European Union that serve other countries within the European Union. EU Directive 2011/24 on Cross-Border Healthcare explicitly permits EU nations to set their own laws and criteria for Internet-based prescription drug sales. It is the pharmacy’s responsibility to follow the regulations of foreign countries when shipping medications internationally.
What is “WHOIS,” and why is it important for LegitScript certification?
WHOIS information is a record of the individual or organization that controls a domain name. Providing an accurate WHOIS record is an important way to verify that any website used to sell drugs is in fact operated by the licensed pharmacy in question or their designee. LegitScript requires an applicant’s WHOIS information to be public and accurate to become certified.
Some domain name registrars sell “privacy protection” services that hide an owner’s information from the public. While anonymized domain name registration has valid uses, LegitScript requires that the WHOIS for any pharmacy website be non-anonymous and accurate.