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Verified Internet Pharmacy Practice
Sites™ (VIPPS®)
Most Frequently Asked Questions
VIPPS® PROGRAM
What is the VIPPS Program?
The Verified Internet Pharmacy Practice
Sites™(VIPPS® ) program and its accompanying VIPPS seal of
approval identifies to the public those online pharmacy practice sites
that are appropriately licensed, are legitimately operating via the Internet,
and that have successfully completed a rigorous criteria review and inspection.
How does NABP verify the sites?
Internet-based pharmacy practice sites wishing
to become VIPPS-certified submit a detailed application to NABP, which
includes the pharmacys policies and procedures addressing the
VIPPS criteria. Licensure information is verified with applicable
state boards of pharmacy. The VIPPS team reviews the application,
policies, and applicants Web site, and performs an on-site inspection
of the pharmacys facilities. Once the policies and procedures
as well as the operations of the pharmacy appear to meet the intent
of the VIPPS criteria, permission to display the VIPPS Seal is granted
and the verified information about the pharmacy is posted on the VIPPS
Web site. Clicking on the VIPPS Seal links the user to the VIPPS Web
site that then verifies that the Seal is indeed posted on a VIPPS-certified
site. If so, the user is then shown pharmacy-specific information,
including licensure information.
Does NABP regulate online pharmacies?
NABP does not regulate online pharmacies. Regulation
of pharmacy practice, whether online or not, is primarily the jurisdiction
of the state boards of pharmacy with some federal oversight. The VIPPS
program is a voluntary certification program for which Internet pharmacy
practice sites may apply. The value of the program to the patient and
the Internet pharmacy is that it provides members of the public with
a means to assure themselves that the Internet pharmacy they choose
is a bona fide, fully licensed facility exercising competent Internet/interstate
pharmacy practices.
When was the VIPPS program developed?
In 1999, NABP became aware of the need for
this program when consumers contacted several state pharmacy boards
to complain about illegal Internet prescribing and dispensing sites
posing as legitimate pharmacies. The Association developed the VIPPS
program in response to public and regulatory agency concerns regarding
safety of Internet pharmacy practices in order to provide a means for
the public to distinguish between legitimate and illegitimate online
pharmacy practice sites.
Isnt the number of Internet
sites far too large to monitor and control?
No. NABP and the regulatory framework of state boards of pharmacy, federal
agencies, and the medical community have been working together for several
years now to achieve this goal.
Online Pharmacy Questions
How many online pharmacies are out there?
It is difficult, if not impossible, to answer
this question accurately, but it is probably fewer than you would think.
Illegitimate pharmacies (usually those that offer online prescribing)
open and close on a daily basis. One company posing as a legitimate
pharmacy may have many URLs or Web addresses, creating the impression
that there is a greater number of Internet pharmacies than actually
exists. In addition, pharmacies may only register with select search
engines. If these search engines are not utilized when performing a
search then all pharmacies may not be counted.
How many prescribing sites are out there?
The number of prescribing sites, using patient
questionnaires and fee-based cyberspace consultations, as well as sites
that sell prescription medications and controlled substances without
requiring a consult, is difficult to estimate. NABPs
research indicates that the number of such rogue operators is less
than the number of legitimate online dispensing pharmacies.
Whats wrong with using a prescribing
site to get Viagra® and Xenical®?
I dont have to see a doctor and
can obtain the medicine with increased privacy and confidentiality;
and its cheaper.
First, the Food and Drug Administration (FDA) restricts the distribution of
certain drugs to a prescription-only basis because in certain medical situations
they can be dangerous if not taken with ongoing medical consultation. Most
regulatory authorities and professional organizations regard online prescribing
to be unprofessional, and in some states it is illegal, unless it is done pursuant
to a valid, ongoing patient-prescriber relationship that has included an in-person
physical examination. Completing only an online questionnaire does not establish
a valid patient-prescriber relationship. Moreover, without a physical examination
you could receive inappropriate medication and worsen an underlying, undiagnosed,
serious medical condition.
As for increased privacy and confidentiality, evidence appears to indicate
that illegitimate prescribing sites frequently sell their customer lists to
other illegitimate online pharmacy operators and owners of Internet scam and
pornography sites. By buying drugs from an illegitimate site you may be designating
yourself as someone who is a good target for rip-off schemes.
Frequently, deceived consumers notify us of non-receipt of medications they
ordered, and/or credit card charges that illegitimately operating pharmacies
refuse to remove. Many also complain that they are unable to contact the pharmacies:
phone lines are disconnected or no one answers.
Can I get really cheap prices from pharmacies
outside the US?
First, the FDA generally prohibits
the importation of foreign-made versions of prescription medications
that are commercially available in the US. The safety and efficacy
of these medications cannot be guaranteed. Many countries drug
research and control programs are not as safety oriented as those in
the U.S. Though some of the drugs advertised by foreign sites may be
manufactured by the same name brand international drug manufacturer
as you are used to, they usually are not manufactured in FDA inspected
facilities that have met FDA standards. Further, sometimes the medications
have been subjected to storage conditions that compromised their potency
or safety.
Can I get cheap prices from legitimate
online pharmacies?
Yes, and more. One of the great benefits to
shopping online to fill your prescriptions is the ease with which you
can comparison shop. Many pharmacies offer price comparisons between
their charge and that of other legitimate pharmacies. This is one way
to stretch your health care dollar. Many online pharmacies accept prescription
benefit insurance coverage as well. In addition, legitimate online
pharmacies often offer valuable health care information in a searchable
format. VIPPS-certified pharmacies are required to offer their customers
free phone consultation with a pharmacist, and many offer free ask-a-pharmacist
e-mail service as well.
What are the main advantages of ordering
medications online?
Convenience is a major advantage that online
pharmacies provide over some of their pharmacy competitors. Consumers ability
to order and receive medications without leaving their home is a tremendous
time-saver. Often, drug information and price information may be accessed
via the pharmacys Web site, or this information may be requested
via e-mail so the consumer does not have to wait on the phone for an
answer or travel to the pharmacy to ask for this information in person.
In addition, online pharmacies may provide more privacy than traditional brick-and-mortar
pharmacies. Consumers who are too embarrassed to purchase certain medications
or health care products from the local pharmacy may find greater anonymity
by ordering these products from an e-pharmacy where staff may not be able to
put a face to a name.
Laws/Regulations
Who regulates online pharmacies?
The state boards of pharmacy have primary responsibility
for regulation of online pharmacies. Regulatory authority is mainly
exercised by the state board of pharmacy of the state in which the
pharmacy is physically located. In addition, most states protect their
citizens by licensing out-of-state pharmacies that ship
medications to patients in their jurisdictions. The same regulations
that apply to traditional brick-and-mortar and mail-order pharmacies
typically apply to online pharmacies. Federal agencies, such as the
FDA and Drug Enforcement Administration (DEA), are also partners with
the state boards of pharmacy in this regulatory process. The FDA, however,
mainly regulates foreign-based sites and practitioners.
How do I set-up an online pharmacy?
When pharmacists are thinking about setting
up an online pharmacy, we encourage them to do their homework and work
in conjunction with the state boards of pharmacy. The VIPPS criteria
may serve as a solid guideline when an organization plans to expand
into interstate/Internet pharmacy practice and seeks to address issues
of quality, verifiable relationships, regulatory compliance, and good
pharmacy practices.
How does NABP work with government
agencies that regulate online pharmacies?
NABP has strong working relationships with the state boards of pharmacy and
the federal agencies. Inspector training programs and the VIPPS Report
a Suspicious Site programs are examples of ways in which NABP helps
regulatory agencies monitor and investigate illegitimate pharmacy Web sites.
How are international online sites regulated?
As mentioned earlier, online sites located
outside the United States pose the greatest challenges for state and
federal regulators. Cooperation with other nations and their regulatory
agencies has been and continues to be the key to regulating online
international pharmacy sites. NABP is working with a number of international
regulatory agencies to establish VIPPS programs for their online pharmacies.
What organization can I contact
regarding regulations and online pharmacies?
Your first contact should be the local state
board of pharmacy . You may also subscribe to NABPLAW®, NABPs
state pharmacy law and rules database, which allows users to research subjects
one state at a time or across all 50 states. Annual subscriptions include two
updates to assure users access to the most accurate information possible.
For more information contact NABPs Publications Desk, or e-mail NABP
at custserv@nabp.net.
What if I believe an online pharmacy
has dispensed the wrong medication or labeled the medication incorrectly?
Please report these incidents to your local
state board of pharmacy as well as the board of pharmacy in the
state where the pharmacy is located. You should also contact the pharmacy
that mistakenly dispensed the medication. VIPPS pharmacies are required
to document, track, and analyze these types of incidents to determine
what went wrong and to prevent recurrences.
What are the signs of a suspiciously operating
pharmacy?
First, e-pharmacies are suspect if
they dispense prescription medications without requiring the consumer
to mail in a prescription, and if they dispense prescription medications
and do not contact the patients prescriber to obtain a valid
verbal prescription. Further, online pharmacies are suspect if they
dispense prescription medications solely based upon the consumer completing
an online questionnaire without the consumer having a pre-existing
relationship with a prescriber and the benefit of an in-person physical
examination. State boards of pharmacy, boards of medicine, the FDA,
as well as the AMA, condemn this practice and consider it to be unprofessional.
Second, online pharmacies should have a toll-free phone number as well as a
street address posted on their site. If the pharmacy merely has an e-mail feature,
so that the sole means of communication between the consumer and the pharmacy
is via e-mail, this is a suspect site.
Third, legitimate sites allow consumers to contact pharmacists if they have
questions about their medications. If a site does not advertise the availability
of pharmacists for medication consultation, it should be avoided.
Many suspiciously operating e-pharmacies have limited numbers of medications
that they sell, particularly lifestyle medications that treat such
conditions and diseases as impotence, obesity, herpes, pain, and acne. Although
pharmacies may not sell every medication available in the US, those online
pharmacies solely selling lifestyle medications may not be operating legitimately.
What if I believe that an online pharmacy
may be operating suspiciously?
Please report suspiciously operating pharmacies
to NABP by using the Report-a-Site feature
in the VIPPS section of our Web site. You may do so anonymously. We
also encourage you to report such sites to your local state board of
pharmacy, especially if you or a loved one has been harmed. NABP forwards
information regarding suspiciously operating sites to the most appropriate
regulatory authorities.
What organization covers the security
of patient information for online pharmacies?
Security, confidentiality, and privacy are among the chief concerns of patients
and health care professionals regarding online pharmacy services. State and
federal laws such as the Health Insurance Portability and Accountability Act
(HIPAA) protect patient identifiable information. VIPPS and other voluntary
certification programs require participating organizations to adhere to and
post their privacy policies. In addition, NABP has published guidelines regarding
the confidentiality of patient health care information. Please contact NABP,
847/698-6227, for information about obtaining a copy of these guidelines.
Prescriptions/Prescribers
Can a prescription be faxed to the online
pharmacy, or does the pharmacy need the original prescription? Does
the online pharmacy verify the prescription with the prescriber?
Generally state laws require faxed prescriptions
to be received directly from the prescriber (not the patient) to be
valid. Online sites that do not protect the integrity of the original
prescription, or that do not verify the authenticity of suspect prescriptions
may be in violation of the law. In addition, VIPPS-certified pharmacies
must have policies and procedures in place that address these issues.
Before you entrust your health to anyone online, look for the VIPPS
Seal, and click to verify.
Disclaimer
Last modified: 12-31-01 |