A new study finds that a majority of online pharmacies selling the chronic myeloid leukemia therapy imatinib are not certified and may be operating unsafely.
PLYMOUTH MEETING, Pa., July 28, 2022 /PRNewswire/ — Patients seeking to purchase chemotherapy drugs online are faced with a confusing array of websites, more than half of which may be operating unsafely or illegally. a new study in the July 2022 problem of JNCCN—Journal of the National Comprehensive Cancer Network. A survey of online pharmacies claiming to sell the oral chemotherapy drug imatinib found that only three of the 44 identified English-language sites operating within the United States were certified through the LegitScript online pharmacy monitoring service. A full 52% were classified as “rogue” pharmacies that may be operating without a license, selling counterfeit or expired products, stealing payment information from users, or disregarding important security measures such as requiring a prescription for potentially dangerous drugs.
Tyrosine kinase inhibitors such as imatinib have made chronic myeloid leukemia (CML) a manageable condition rather than a fatal one. But to work optimally, the drug must be taken for the rest of a patient’s life and with high adherence. Although a generic version of imatinib became available in 2016, the high prices (more than $700per month at brick-and-mortar pharmacies) have remained a barrier for many patients, who then turn to online pharmacies in the hope of finding discounts. The authors advise physicians to be aware of the market their patients can turn to, and advise patients to use LegitScript, www.legitscript.comto check URLs and identify certified online pharmacies.
“We noticed how easy it is to buy an oral chemotherapy drug online, since imatinib is not a benign drug,” said study co-author. Sachiko OzawaPhD, MHS, associate professor, University of North Carolina Eshelman School of Pharmacy. “By simply searching Google, Bing, Yahoo and DuckDuckGo, we found 44 websites selling and shipping imatinib in the US; 13 of these websites sold imatinib without a prescription, and more than three-quarters offered patients no way to speak to a pharmacist. This is a major patient safety concern.”
The use of imatinib requires monitoring and frequent dose adjustments. Even if an online pharmacy delivers the medication as ordered, “patients who evade interactions with the provider are likely to be at much greater risks of drug adherence, discontinuation, treatment failure, and side effects,” said Dr. ozawa.
In addition, rogue or unclassified pharmacies may not provide patients with the real medication at all, and may even steal medical or payment information from patients. These sites are difficult to regulate, as they often originate from abroad. The authors note that the online marketplace for drugs such as imatinib is likely larger than represented in the study, as they only analyzed the first 10 pages of search engine results. “We also found it deceptive how well some illegitimate websites mimic legitimate sites,” said Dr. ozawa.
But how can we address the reason why patients would use these underregulated online pharmacies in the first place? Patients should be encouraged to talk to their pharmacist, financial adviser or other members of their healthcare team if they cannot afford their medications, said Benyam MulunehPharmD, BCOP, CPP, Assistant Professor, University of North Carolina Eshelman School of Pharmacy, who was also a co-author of the study. “Cancer drugs are very expensive, but there are some resources, such as third-party grants that can potentially help. If a drug is not affordable through mainstream channels, patients can also discuss alternative drug options with their suppliers instead of seeking out for discounts on the Internet.”
“The exorbitant price of oncology drugs is a major barrier to optimal therapy of many malignancies, including CML,” the commentary said. Bernard MariniPharmD, BCOP, Clinical Pharmacist Specialist, Michigan Medicine, treating patients with leukemias and other hematologic malignancies. dr. Marini was not involved in the investigation. “As this eye-opening study has shown, the problem has become so bad that there is a large illegitimate online marketplace for generic oral oncology drugs. Healthcare providers should be aware that many of these rogue and unapproved pharmacies don’t even have a prescription or access to pharmacy consultations, which puts patients at high risk for drug side effects.While patient-centered NCCN guidelines for CML can be a great tool to strengthen patient education, this study reminds us of the need to fully understand the dangers of illicit online pharmacies recognize and ensure that our patients receive appropriate financial support when prescribing expensive drugs.”
To read the entire study, visit JNCCN.org. Free access to “Online pharmacies accessibility of imatinib, an oral chemotherapy drug” is available until October 10, 2022.
About JNCCN—Journal of the National Comprehensive Cancer Network
More than 25,000 oncologists and other cancer care professionals across the United States read JNCCN—Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information on innovation in translational medicine and scientific studies related to oncology health services research, including quality assurance and value, bioethics, comparative and cost-effectiveness, public policy, and interventional research into supportive care and survival. . JNCCN contains updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN guidelines)®), review articles addressing guidelines recommendations, healthcare research, and case reports highlighting molecular insights into patient care. JNCCN is published by Harborside. Visit JNCCN.org. To find out if you are eligible for a FREE subscription to JNCCN, visit NCCN.org/jnccn/subscribe. Follow JNCCN on Twitter @JNCCN.
About the National Comprehensive Cancer Network
The National Comprehensive Cancer Network® (NCCN®) is a non-profit alliance of leading cancer centers dedicated to patient care, research and education. NCCN is committed to improving and facilitating high-quality, effective, equitable and accessible cancer care so that all patients can lead a better life. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention and support services; they are the recognized standard of clinical direction and cancer management policy and the most thorough and frequently updated clinical practice guidelines available in any field of medicine. The NCCN guidelines for patients® providing expert information on cancer treatment to inform and empower patients and caregivers, by supporting the NCCN . Foundation®. NCCN is also moving forward permanent education, global initiatives, policyand research collaboration and publication in oncology. Visit NCCN.org for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg and Twitter @NCCN.
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