If you think your patients aren’t looking at online pharmacies for cheaper medications, you’re kidding yourself. Medicine is expensive—everything is expensive. And when people are desperate, they look for alternatives. The problem? 96% of online pharmacies are illegal. They’re selling unregulated, potentially dangerous medications, and most patients have no idea. The ease of ordering meds online makes it seem safe, but the truth is terrifying.
A recent report from the U.S. Trade Representative revealed that 35,000 online pharmacies are selling to Americans, and almost all of them are breaking the law. These aren’t amateur operations. These websites look professional. They have customer service, slick designs, and prices that seem almost too good to be true—which they are. They lure in desperate patients looking for affordability, only to sell them fake or unsafe medications. Some contain the wrong active ingredient. Some have no active ingredient at all. Some are straight-up toxic. Yet, a 2023 survey found that 54% of Americans mistakenly believe all online pharmacies are FDA-approved. That means over 150 million people could be trusting their health—and their lives—to counterfeit drugs.
These illegal pharmacies are part of a massive global network, operating mostly outside the U.S. Many are based in India, China, and Russia, making them nearly impossible to regulate. Meanwhile, pharmacy closures are accelerating. CVS just announced another wave of shutdowns, and independents are closing their doors at alarming rates. Rural areas are turning into pharmacy deserts, forcing people to drive 30, 40, even 50 miles just to pick up essential medications. And what happens when people are faced with high prices, bad insurance, and no nearby pharmacy? They turn to the internet. It’s no different from what’s happening at the U.S.-Mexico border, where people cross over for cheaper dental work and prescription drugs.
There are red flags that should make anyone think twice before ordering from an online pharmacy. No prescription required? Huge warning sign. Prices that seem too good to be true? They probably are. A legit pharmacy will have verification from the National Association of Boards of Pharmacy (NABP) and be listed in their VIPPS (Verified Internet Pharmacy Practice Sites) program. If the site you’re looking at isn’t on that list, it’s not worth the risk. Another step? Call them. A real pharmacy has real pharmacists you can talk to. If they can’t answer basic questions or prove their credentials, run.
Counterfeit meds are no joke. Imagine taking warfarin that’s contaminated with arsenic. Or insulin that’s just water. The risks are massive, but people keep taking the bait because it feels like a safe alternative. Governments are cracking down, but shutting down illegal pharmacies is like playing Whack-A-Mole—one goes offline, three more pop up.
Online pharmacies can be a good option, but only if they’re legitimate. There are ways to save money on prescriptions without gambling on your health. Talk to your pharmacist. Look into generic alternatives, patient assistance programs, and discount cards. There are safe ways to cut costs without putting yourself at risk. Because at the end of the day, no discount is worth dying over.
Alex is the Founder of The Happy PharmD. He loves anime, his family, and video games, but not in that order.