Online pharmacies - Canadian, American or other?

With over 400 online pharmacies out there, finding one that is legal, professional patient-focused can seem like playing Russian roulette with a gun set on full-auto.

Strangely enough, the US government issued a report in 2004 on the state of internet pharmacy practice that gives you some "ammunition" to filter out the good internet drugstores from the bad.

The report by the U.S. General Accounting Office in June 2004 tested American, Canadian and other "foreign" online pharmacy operations by placing orders for 13 different medications including narcotics and other controlled substances. (The report divides the testing geographically into three groups: American, Canadian and Foreign. )

Here are some of the highlights:

Prescription required? Despite the fact that this is a legal necessity for any prescription medication, only 5 of the 29 American internet pharmacies required a prescription to process the order. On-line drug stores outside of North America neglected this basic cornerstone of pharmaceutical care with zero of the 21 pharmacies tested asking for a script. By contrast, all of the 18 Canadian online pharmacies followed good pharmacy practice and the law by requiring a prescription.

Counterfeit drugs? Almost 10% of drugs imported from foreign online operation were considered counterfeit or contained completely different active ingredients.

Complete scam? Six of the sixty-eight order placed with foreign pharmacies were paid for but never received. Once again, that's almost 10%.

Under investigation? Twenty-one percent of all the pharmacies studied by the GAO were under investigation by either the FDA or the DEA for violations of federal or international laws. Nine were American-based, one was Canadian and all the rest were foreign online pharmacies.

While no country was perfect, it seems clear that your best choice would clearly be Canadian first, then the U.S. I would choose foreign only if the pharmacy was based in Europe, New Zealand or Australia.*

To see the complete report click here.

*The GAO report only tested foreign pharmacies from places like Turkey and Pakistan which probably skewed the test results a little.