Health

There is an illegal market for abortion pills on the Internet. The FDA is ill-equipped to stop this.

“Counterfeit criminals go where there’s demand — and there’s demand and there are access challenges,” said Libby Benney, senior counsel for the Alliance for Safe Online Pharmacies, an advocacy group on the abortion pill market. “This creates a criminal opportunity and a major patient safety risk.”

Google says it usually can’t determine when sites violate the law, but it will remove them from search results when the government asks.

Cytotec, the brand-name version of misoprostol, is an FDA-approved prescription drug for the treatment of stomach ulcers. It is also one of two pills used to end pregnancy. Cytotec is the target of counterfeiters, according to a statement from drugmaker Pfizer.

But in states where abortion is restricted, patients have had trouble getting prescriptions For issues related to abortion.

Experts said people go online to get drugs anytime there is a barrier to getting it legally. In the case of abortion, these barriers can be in the form of state regulations, but also pressure from family, friends, and community leaders to maintain the pregnancy. Other times, people turn to the Internet thinking they can get the drug at a lower price.

Although there are legitimate telemedicine operations and online pharmacies that help connect people online in states that restrict abortion, they Sometimes it’s hard to promote their services. At the same time, illegal pharmacies are adept at circumventing Google’s rules and climbing to the top of search results.

For example, there is a strong online black market for the erectile dysfunction drug Viagra because people are too embarrassed to ask their doctor for it. Men seeking HIV prevention sometimes go online if they don’t want to see a sexual health clinic. During the pandemic, people bought hydroxychloroquine, an anti-malaria drug touted by former President Donald Trump, and ivermectin, an antiparasitic, from shady websites despite FDA warnings against their use.

“Anytime you create a broken healthcare system or a broken supply chain, criminals will take advantage of that confusion,” said John B. Hertig, associate professor of pharmacy practice in Butler University’s College of Pharmacy and Health Sciences.

An emerging black market

State laws that restrict abortion already limit access to drugs that can terminate a pregnancy, even when the patient is taking them for other reasons.

Patients complain to pharmacies Will not fill prescriptions For methotrexate, which is used to treat the immune disorder lupus, as well as other diseases, but can cause miscarriage.

Although The Biden administration Having told pharmacies that it is an offense to fail to provide medicines to a patient, pharmacies may still be able to restrict access. Some allow individual pharmacists not to fill orders if they have a good faith objection. At least one state, Texas, actively restricts Providing abortions.

Price is also an issue. Scam sites are selling Cytotec for about $4 per tablet, slightly below the typical cost of Drugs.com, a New Zealand price-monitoring firm. More than half of abortions in the United States are already caused by medication, according to the Guttmacher Institute, a research group that supports abortion rights. This share is likely to increase after the Supreme Court decision, providing a huge market to tap.

Extralegal, though legitimate organizations abroad, have sprung up to help people access medical abortion in states where it is illegal. It is difficult for individuals to tell which sites are safe.

“Most American consumers think that if they see a medical service listed on the first page of Google, it has been verified or certified by some authority in the US,” Hertig said. “And that’s absolutely not the case.”

All of these issues create market opportunities for unauthorized online sellers.

Online search for medication abortion ascended into the sky After POLITICO published a draft of the Supreme Court’s opinion that preceded the overturn Roe v. Wade.

What they find is often labyrinthine. Of the approximately 35,000 online pharmacies worldwide, 95 percent operate illegally. National Association of Boards of Pharmacy.

“In our experience, these fraudulent pharmacies are master marketers, and they’ll take any drug that’s in the news and trending, use it as a marketing tool to try to drive business to their website,” said David Khalaf, a spokesman for LegitScript. and an Oregon firm that audits online health services and works with government agencies and companies to identify illegal operations.

enforcement problem

The pandemic offers the latest example of how an atmosphere of fear and confusion can enable criminals to operate. From January 2020 to March 2020, fraudsters created 190,000 domain names linked to Covid-19, said Dan Burke, senior operations manager for the FDA’s Office of Criminal Investigation, during a June webinar on fraudulent pharmacies.

While scientists were still trying to understand the new virus, these sites promised a cure. “We were drinking from the gun,” Burke said.

FDA criminal investigators are responsible for going after illegal pharmacies and counterfeit drug operations. It is a difficult task. Online, drug dealers can hide their tracks and disappear in an instant. Additionally, the Office lacks the necessary enforcement tools to remove sites, especially when dealing with uncooperative domain registrars.

“You can register a domain name anonymously from anywhere in the world and bid almost anything you want on it – and good luck trying to shut down this site because you don’t know who’s running it,” said Benny of the Alliance. Safe online pharmacies.

The European Union introduced the General Data Protection Regulation in 2018 to protect the privacy of web users. But the regulation also made it harder to track down fraudulent sites. Domain registrars that operate globally have stopped publishing the names of website owners to comply. Now, some domain registrars won’t give up information to U.S. regulators without a subpoena, and won’t take down illegal sites without a court order, Benny said.

The FDA has no subpoena power and must instead rely on the Justice Department, which faces its own legal hurdles.

“As a public health agency, we’re caught in a catch-22 situation,” Burke said during the webinar. “We can’t show the scope of the network without a subpoena, but we can’t get a grand jury subpoena if you don’t show the scope.”

Benny said that Domain reform for illegal drug dealers, a Senate bill introduced in December by Florida Republican Mark Rubio, seeks to hold domain registrars accountable. The bill would require a domain registrar to block and suspend a domain name associated with illegal activity after notifying the FDA or the Department of Justice.

Locking a domain name prevents its owner from transferring it to a new registrar and continuing operations.

The FDA also recently pressed the Internet Corporation for Assigned Names and Numbers, a nonprofit organization that oversees the larger domain name registry industry, to ensure that registrars comply with its terms of accreditation, which include responding to reports of illegal activity and abuse. .

Users can familiarize themselves with what a fraudulent pharmacy can look like. According to the FDAPeople should avoid any site that offers to sell over-the-counter drugs. LegitScript also has a domain checker on its website that can check if a site is legitimate. Plan C, a project of the National Women’s Health Network, offers a list of vetted abortion pill resources.

Bain wants search engines to take more responsibility. “The algorithm is controlled,” he said. “You can prioritize legitimate, licensed vendors and online pharmacies.”

A Google spokesperson said the company works to return high-quality sources to the top of search results and remove fraudulent pharmaceutical websites from results when the FDA determines they are violating the law and asks Google to do so.

Still, scam sites find their way in, and patients should proceed with caution, Hertig said. “When you’re a patient who’s struggling because right now they can’t find access to care, whether it’s abortion or whatever, naturally they’re going to Google, and that’s a really risky proposition.”



There is an illegal market for abortion pills on the Internet. The FDA is ill-equipped to stop this.

Source link There is an illegal market for abortion pills on the Internet. The FDA is ill-equipped to stop this.

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