Patients looking to buy chemotherapy drugs online are faced with a confusing array of websites, more than half of which may be operating unsafely or illegally, finds a new study in the July 2022 issue 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 shipped 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, high prices (averaging over $700/month at brick-and-mortar pharmacies) remained a barrier for many patients, who could then turn to online pharmacies in hopes of finding discounts. The authors advise physicians to be aware of the market their patients can turn to, and advise patients to use LegitScript to 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 Ozawa, Ph.D., 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 advisor or other members of their healthcare team if they cannot afford their medications, said Benyam Muluneh, PharmD, BCOP, CPP, assistant professor, Eshelman School of Pharmacy at the University of North Carolina, 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 treatment of many malignancies, including CML,” said Bernard Marini, PharmD, BCOP, clinical pharmacist-specialist, Michigan Medicine, who treats 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.”
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Yujiao Sun et al, Online Pharmacy Accessibility of Imatinib, An Oral Chemotherapy Medication, Journal of the National Comprehensive Cancer Network (2022). DOI: 10.6004/jnccn.2022.7007
Provided by National Comprehensive Cancer Network
Quote: Chemotherapy drugs from ‘rogue’ online pharmacies may endanger leukemia patients (2022, July 28) retrieved July 28, 2022 from https://medicalxpress.com/news/2022-07-chemotherapy-drugs-rogue-online-pharmacies. html
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