Heartache in online cures

By FRANCIS TILL

"Buy medicines from Mexico!" the banner reads. "Save 70%!!"

Don't laugh. When it comes to shopping for medicines online, for much of the world New Zealand is "Mexico".

The weak dollar and a different set of (generally more open) prescribing standards means that New Zealand can offer great deals to the rest of the world exporting drugs through online pharmacies.

In fact, a New Zealand pharmacist can sell a drug to a New York City client with even fewer restrictions than to a Kiwi, due to a loophole that requires proof of a prescription only for over-the-counter sales of many drugs such as Viagra.

There are other legal issues, as well. Some drugs that are sold openly here - such as codeine-laced Nurofen Plus - are controlled substances in other countries and some drugs, such as Melatonin, that are freely available elsewhere require a prescription in New Zealand.

More experimental drugs sold in some countries may be impossible to obtain in others because they have not been approved by health agencies - and those drugs can be impounded at Customs if they violate New Zealand law.

The upshot is that the internet can give the appearance of being an open, uncontrolled marketplace in which almost anything goes when it comes to medicines - but that's less and less the case as regulators, customs officials and the police catch up with what's been going on.

What's legal here?

Your right to buy something is defined by the jurisdiction in which it is sold.

Your right to actually receive and/or use the substance, on the other hand, is a matter of New Zealand law. Some of this is common sense, but it can get a bit weird: it's illegal, for example, to import a medicine that contains powdered tiger bone as an ingredient because tigers are a protected species.

It's made more complicated because neither Customs nor the Ministry of Health publish a detailed list of prohibited imports when it comes to medicines and other therapeutic agents. For a general overview, see the Customs website and if in doubt ask. Contact a local Customs office with your specific inquiry.

Customs may also hold up some foreign internet purchases, typically those worth more than $50, until you pay GST.

While some purchases may be confiscated by customs once they arrive here, you can reasonably expect to be able to buy what's sold online by a Kiwi pharmacy - subject to normal restrictions.

Pricing the process

Online pharmacies don't always provide deals that would be particularly attractive to someone within driving distance of a shopping mall, but prices can vary sharply.

Online Pharmacy offers a 24-tablet issue of Nurofen Plus for $40, including delivery, for example, while Health Chemist, an Australia-based Yahoo! Store operating locally, offers the same product for $10.25 plus $4.50 shipping.

So shop around, especially if you're buying local - and begin your price comparison by visiting the extensive list at the pharmacies section of the New Zealand Sites index and the online Yellow Pages searching for pharmacy and chemist.

Alternative medicine and miracle cures

The unproven, untested, unorthodox and unconventional are rife on the internet and nowhere is this more the case than when it comes to alternative and complementary medicines - which are all those things by definition.

A simple Google search for "alternative medicine" returns 1.5 MILLION hits and dozens of "sponsored" (paid) listings.

To sort through the chaff remember first that "natural" does not mean the same thing as "safe" - and that "experimental" is a warning, not a promise.

A good place to start culling is the National Center for Alternative and Complementary Medicine which is a US Government website that, among other things, maintains a current list of consumer advisories.

Then try the Alternative Medicine Homepage from the University of Pittsburgh.

The homespun look of this resource shouldn't put you off - it's a widely recognised jump station into the realm and the host, Charles B. Wessel, is a medical librarian.

Safety first

Check your proposed medications with one of the many online services that provide in-depth information about using medicines.

The American Society of Health-System Pharmacists' Med Master has a good searchable database as well as insightful guidelines about using alternative medicines.

The National Patient Safety Foundation has an excellent list of authoritative resources on patient safety.

And above all, always tell your doctor what you're up to.

Tips for online shoppers

Buying medicine online is a lot like responding to a telemarketing or mail order promotion, and many of the same rules apply - with a few extra concerns.

The US Government has a series of publications to help with online purchases.

1. Make sure the company is real, and reputable. Check that it has a physical address and a contact phone number. If it's foreign, check with local business authorities.

2. Don't give personal details, such as your medical history, without being certain the company will respect your privacy. Don't give away any information that's not required and make sure you understand why required information is being collected.

3. Make certain your purchase happens over a secure connection if you buy by credit card online. You'll see the web address in your browser bar change from HTTP to HTTPS, and in most recent browsers your computer will verify by pop-up that you are entering a secure connection.

4. Read the refund policy. If there isn't one, don't buy.

5. Read the privacy policy. If there isn't one, don't buy.

6. Keep a copy of your order form. If you can't print it out, use your computer's "Print Screen" key to take a screenshot of the transaction and save it as an image file.

7. If the claim sounds too good to be true, it is. Do a web search for background on any experimental drug you're thinking about using. Be especially cautious with "natural" remedies that have not been tested or approved by Government agencies.

8. Check with Customs to make certain you'll be able to collect your purchase if ordering from overseas and ask what extra charges will accrue (such as GST).

9. Go behind the brand name and get a list of all the ingredients in any new pharmaceutical. Make certain you understand what each ingredient does and what side-effects you may experience.

10. Check with your doctor.

US Government guide to buying medicine online

Links

Online Pharmacy

Health Chemist

New Zealand Sites: Pharmacies

Yellow Pages

Center for Alternative and Complementary Medicine

Alternative Medicine Homepage

American Society of Health-System Pharmacists

Pharmaceutical/Medication Safety Resources