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Rogue Internet Pharmacy Shipping Analysis: How Do Illegal Drugs Get Into U.S. Commerce and Delivered to Customers?

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When you’re running an online pharmacy, there are a few things you have to take into account. First, you need a website, which means a server and domain name. You need a strong advertising or social media presence. You have to give your customer a way to pay you. And, you want repeat business, so you have to ship the medicines to your customers somehow.

That’s true for legal and illegal online pharmacies alike. Which leads to a logical question: what services do illegal online pharmacies use to get drugs to their customers? Our research indicates that the answer is: international posts, with the United States Postal Service making final delivery.

But first, some context.

There’s sometimes a misimpression that illegal online pharmacies are by definition “fake” online pharmacies — websites that take your money, don’t send you anything and just rip you off. Those exist too, but they are a tiny fraction of what we see out there. Why? Our assessment is that it’s because illegal online pharmacies have something important in common with legitimate online pharmacies: an interest in repeat customers, meaning a focus on refills. If a patient fills one order with your pharmacy, that’s great, but it’s far better and more profitable to have a stable and repeat clientele.

That means that successful online pharmacies, including the illegal ones, must have a shipping solution that is reliable and fast. But some carriers have come under scrutiny for allegedly shipping drugs domestically for illegally operating online pharmacies, namely UPS (which settled with the government and wasn’t charged) and FedEx (which is under indictment). Whatever may have happened since that scrutiny, how are things looking today?

In June of 2015, UPS asked LegitScript to analyze our most recent data to study the question, and we were happy to take a look, in part to help UPS understand how bad actors get illegal drugs into the country (or, from a domestically located illegal supplier to the end customer). LegitScript conducted 29 test buys between November 2014 and May 2015 from a variety of illegal online pharmacies targeting US customers. By our estimate, here are roughly 27,500 to 40,000 illegal online pharmacies active at any one time. The 29 Internet pharmacies represent, by our estimate, roughly 7% - 9% of the Internet pharmacy market when measured by website, or about 1% of the Internet pharmacy when measured by shipper, in that each one was part of a “network” of hundreds of online pharmacies presumably shipping from the same source.

Here’s what we found. (Our full findings are available in our report.)

  • None of the 29 illegal online pharmacies used private carriers such as UPS at any point in the shipping process. Without exception, all of the online pharmacies used government-sponsored shipping services, such as Canada Post, Deutsche Post or India Post.
  • Unfortunately, in no case did US Customs stop or intercept the package.
  • In all cases, the US Postal Service provided the shipping once the drugs reached US soil (or, in the two instances where the drugs originated from a US pharmacy, the full shipping was provided by the USPS).

This data should be of interest to the US Postal Service, which seems to be the carrier of choice for illegal online pharmacies. It leads to the question: How could the USPS improve its detection of illegal, unregulated medicines?

One answer is to simply be aware of patterns and shippers that over the past few years LegitScript has seen again and again. In our research, we observed that some of the same suppliers were distributing drugs on behalf of different Internet pharmacy networks. Accordingly, the US Postal Service and its foreign counterparts may wish to consider a more intelligence-driven approach that would identify shippers known to be engaging in illegal activities, and possibly share this information with their foreign counterparts. To the extent that foreign postal services are unable or unwilling to refuse shipments from these senders, the information may be useful to US Customs in developing a more targeted approach. Another possible solution — one that has already been adopted by private-sector carriers — is the use of advance electronic manifesting and Air Cargo Advance Screening, or ACAS, data, which allows US Customs and Border Protection, the Transportation Security Administration and dozens of other law enforcement agencies to target high-risk shipments.

In any case, as drug safety regulators seek to better understand and curtail the activities of illegal online pharmacies, it’s important to not just follow the money and online advertising — it’s also important to understand these illicit businesses’ reliance on carrier services.

At present, LegitScript’s data indicates that our own government-run postal service is the carrier of choice for most illegal online pharmacies.