Members of a U.S. House of Representatives committee seemed to agree Thursday that illegal online pharmacies should be shut down, but there was less consensus on how to define illegal online practices and what new laws are needed to deal with companies that sell medications on the Web.
Lawmakers made several suggestions for ways to police online pharmacies at the House Government Reform Committee hearing. However, much of the hearing veered off the topic of online pharmacies when some committee members ripped into the pharmaceutical industry for the high prices of prescription drugs. Lawmakers also promoted the practice of some U.S. citizens who cross the border into Canada to purchase less expensive drugs.
"While many online pharmacies operate in the same manner as traditional brick-and-mortar drug stores, and comply with the standards of state licensing authorities, not all pharmacies practicing over the Internet are legitimate sites," said committee chairman Tom Davis, a Virginia Republican. "The Internet creates an easy environment for illegitimate sites to bypass traditional regulations and established safeguards for the sale of prescription drugs."
But Representative Dan Burton, an Indiana Republican, said high medication prices are driving U.S. consumers to look for cheaper prescriptions, and online pharmacies often offer discounted prices. About three-quarters of U.S. residents between ages 50 and 64 are on at least one prescription drug, he noted.
"The price of prescription drugs in the United States is the highest of any country on earth," Burton said. "In these troubled economic times, the pharmaceutical industry is thriving."
Neither the pharmaceutical industry nor online pharmacies were represented on the committee's witness list.
Burton said he was opposed to more national laws regulating online pharmacies because most medical regulation falls to individual states.
Witnesses from the U.S. Food and Drug Administration (FDA) told the committee the agency actively pursues illegal online pharmacy activity, such as dispensing drugs without a doctor's supervision, but the lack of a national definition for a valid prescription is hampering national efforts. Some online pharmacies only require the consumer fill out a short questionnaire or answer no questions at all before dispensing drugs, said John Taylor, associate commissioner for regulatory affairs at the FDA. However, some state regulations don't prohibit online-only questionnaires, he said.
The FDA has conducted 372 Internet drug-related criminal investigations since 2000, with 90 involving U.S. Internet pharmacies and others involving the sale of unapproved medications, said William Hubbard, the FDA's associate commissioner for policy, planning and legislation. Since then, the FDA has participated in 150 Internet-related drug arrests, 60 involving online pharmacies, and 92 of the 150 arrests resulted in convictions. The agency has about 100 open Internet drug-related investigations, Hubbard said.
A handful of lawmakers criticized the FDA for not being tough enough. "It would seem that you would not have to wonder whether or not federal law was being violated ... if you can determine or ascertain that a U.S. state-licensed doctor was not participating in the transaction," said Michael Turner, an Ohio Republican.
Representative Dutch Ruppersberger, a Maryland Democrat, suggested that the FDA require all online pharmacies doing business in the U.S. to receive a seal of approval from the Verified Internet Pharmacy Practice Sites program, a certification administered by the National Association of Boards of Pharmacy. The FDA's Taylor said that might trample on the rights of states to regulate the medical industry, but Richard Blumenthal, attorney general of the state of Connecticut, said some kind of national direction is needed.
However, Blumenthal said he wouldn't support a national definition of a valid prescription because it would take the attention away from more pressing issues in Congress, such as requiring online pharmacies to provide information on the physical location of the pharmacy and names of staff members, and requiring online pharmacies to abide by the standards of the state where each customer lives.
But Representative William Janklow, a South Dakota, questioned whether the FDA was paying enough attention to current laws, and Diane Watson, a California Democrat, suggested Congress start with requiring foreign Web pharmacies to have U.S.-licensed doctors on staff.
And a handful of lawmakers urged Congress not to shut down online pharmacies that fill prescriptions written by doctors who actually see the patients. "You can't blame these people for trying to get cheaper drug prescriptions about anyway they can," said Representative John Duncan Jr., a Republican from Tennessee.