All prescription drugs have 2 names - 1) the general, or generic name; and 2) the brand name. Any drug can be called by either of these 2 different names, but it is still the exact same substance, regardless of which name it is called by.
Generic drugs should be exactly the same as the more expensive branded version of a drug. They are cheaper because they are not made by the company that invented the drug. Because the inventing company owns the patent on their drug, they can charge higher prices for that drug while the patent is valid.
For example, Valium is the brand name for a drug originally discovered by the drug company Roche. For 12 years after Valium was discovered Roche owned a patent on Valium. This meant that only they could legally manufacture and sell Valium. However, when the patent expired back in the late 1970s, any company could start selling Valium, but they had to call it by the generic name (diazepam).
When any drug is invented it is given 2 names 1) the generic name and 2) a brand name. When Valium was invented Roche gave it the generic name "diazepam" and the brand name "Valium". However because it was marketed under the name Valium for 12 years, most people nowadays still call the drug Valium, instead of the generic name diazepam.
Generics' chemical equivalence to brand-name drugs means that they contain the same active ingredient, at the same strength (dose). Generics and brand will therefore have the exact same effect on your medical condition, as well as the same risk of side effects.
Generic medications are produced by multinational companies and in well-maintained facilities. In fact, the same pharmaceutical companies that manufacture brand-name drugs often manufacture generic versions of other companies' brand drugs, or even of their own, at the same time. Some of the companies that make generic drugs are huge long-established multinationals. For example Dr Reddy's Laboratories Ltd. is an Indian company that mainly makes generics, but it is listed on the New York Stock Exchange (see Dr Reddy's stock price). Generics are not just made in India, highly developed countries like Israel host generic drug manufacturers, including TEVA, the world's largest manufacturer of generics. There are even increasing numbers of generics manufacturers in the USA, for example Able Laboratories in New Jersey, InvaGen Pharmaceuticals in New York and Valeant Pharmaceuticals International, with factories in California and Ohio. So when you buy generics you should not assume you are getting something made at a lower quality than the brand name drug.
Some countries, like Brazil, do not always recognise patents for prescription drugs. This may result in drugs like Cialis, which are still under patent in the USA, being made in a country like Brazil as a generic drug.
If you are a regular user of Propecia, Prozac, Augmentin or many other popular prescription medications, you already know how expensive brand-name medications can be. These are three examples of popular drugs which can be made and sold legally as generics in the USA (because their patents have expired). Generic medications are the cheaper substitutes which contain the exact same drug and have the exact same therapeutic effect -- but they are much cheaper. Through online pharmacies you can get generic medications at even lower prices while at the same time saving yourself the hassle and possible embarrassment of a trip to the pharmacist. How can you be sure you are receiving the product you ordered rather than a fake? And how can you be sure you have found the pharmacy offering it at the best price? This is where Pharmacy Reviewer comes in - just use the reviews or the price comparison feature on the front page to search for the medicine you need, using either the generic or the brand name!
Scams against online pharmacy customers generally fall into two types:
- Asking customers to pay by Western Union then failing to deliver the goods (this is not to say that all companies that only take Western Union are scammers). This is a particularly common scam used against people who buy controlled medicines by clicking on links in spam e-mails they have received; often the online pharmacy disappears shortly after the transaction, if they have a website at all. Buying from an individual with only an e-mail address, not a website, who will inevitably request payment by Western Union, is even more likely to lead to money being sent and nothing being received in return.
- Playing on people's fear that by ordering from online pharmacies they are doing something illegal. Again, this is more commonly used against people who have bought controlled medicines. One increasingly common version of this type of scam has been practised a lot recently by “Golden Meds” – a definite scam operation long listed on our “blacklist” section of pharmacies to avoid (even before they started this particular scam we are proud to say.) In this scam, which I shall call the customs scare scam, the customer of the criminal online pharmacy receives a phone call instead of their order. The phone call is from someone who claims to be from that country's Customs Office (this has been used mainly against US residents so far). The fake Customs Officer then tells the online pharmacy customer that their medicines have been confiscated and they must pay a fine immediately by credit card over the phone. Another variant is that the customs officer will claim to be from the country from which the medicines were shipped (this serves to help explain the inevitably poor English of the customs officer and makes the request for money more plausible, particularly if the country he or she claims to be from is known to be a corrupt hellhole). The foreign customs officer demands money, claiming that they have confiscated the goods after searching packages destined for the United States (or whatever country the hapless online pharmacy customer lives in), and that he or she was going to contact United States Customs Service and inform them of the customer’s attempted import of controlled medicines unless the customer pays them a large amount of money immediately. In both cases the customs officers will inevitably be conmen working for the online pharmacy from where the customer ordered. Customs officers, nor anyone working for the government will ever ask for money on the spot. Furthermore, as explained in my post entitled, “Is it legal to buy controlled substances over the internet for delivery to the US?” online pharmacy customers currently have little reason to fear prosecution for importing medicines that they have a prescription for. Prosecutions of individuals for importing controlled medicines have long been extremely rare in the United States and other developed countries. However these scams play on people's fears that they have broken the law, and so unfortunately are likely to continue to be used.
Help spread the word against these fraudsters! Recommend pharmacyreviewer.com to anyone you know who intends to buy medicines over the internet! And if you hear of anyone who has unfortunately already suffered from one of these scams, please ask them to come on this site and write a review about the criminal online pharmacy, to stop others suffering the same fate.
The best test you can do at home is to heat a small glassful of water to bath temperature (100F/37C) and see if one of the pills dissolves completely in the water. This works because bath temperature is roughly human body temperature and all pills should dissolve in water at human body temperature, however counterfeiters sometimes use talc, dolomite, anhydrite, or gypsum to bind the pill together, and these substances do not dissolve well.
Another test you can do at home is to drop part of the pill in vinegar. If the pills fizzes then that increases the likelihood that it is a fake. This is because the fizzing suggests it contains calcium carbonate as a 'filler'. Although it is used in genuine medicines as well sometimes as a harmless material to bulk out the pill, calcium carbonate is more often used in fakes because it is cheaper than starch (which is the filler ingredient more often used in genuine medicines).
If you have access to a highly sensitive set of scales you could try comparing the weights of different pills in the batch that you have received. If the pills all weigh the same (to within 1%) then that is a good sign; the weight of pills in batches of fake medicines often varies, by as much as 10%.
Use the free pill identifier tool on the drugs.com website: Pill Identification Wizard from Drugs.com Type in the shape and color or the imprint code found on the capsules or pills. This is quite an imperfect way to check if the pills are real, because obviously it is easy for forgers to put the correct imprint code on fake medicines, but it will at least help to identify the crudest fakes.
How much of a problem is this when buying medicines online?
“The best 'guesstimate' is that 1% of drugs in the developed world are counterfeit. In developing nations, between 10 and 50% of drugs are thought to be fake.” (Source: Chemical and Engineering News, January 4, 2010 Volume 88, Number 1, pages 27-29)
A lot of medicines bought online are manufactured in developing countries. Also some online pharmacies use "drop shippers" (wholesale companies that also take care of posting the medicines to customers on behalf of the pharmacies) so they don't have much control over the quality of the medicines that they send out, and cannot check easily if the drop shipping company they employ has been buying poor quality medicines from China, for example. For these reasons it pays to be careful in selecting an online pharmacy to order from, and using pharmacyreviewer.com to communicate with others to check which pharmacies are consistently reliable.
A point worth keeping in mind is this: just because the medicine is fake it does not mean that it does not contain the active ingredients which it should. It just means it was not manufactured by the company it says on the box. There is a lot of hype put about by the marketing departments of the big pharmaceutical companies instilling fear in people that if they buy medicines online they will end up with rat poison, but instances of counterfeit medicines actually containing harmful substances are pretty rare (why would anyone in the business of manufacturing counterfeit medicines put poison in them?) Much much more common is that they will contain either too much or too little of the active ingredient, and the rest of the pill will be made up of filler substances such as calcite or aspirin. From the limited statistics available it appears that buying medicines online, even when the medicines are manufactured in developing countries, is generally pretty safe.
Moreover, most of the highest rated online pharmacies on pharmacyreviewer.com sell medicines either made by the big pharmaceutical companies, or by large, long-established “generics”manufacturers, such as Dr Reddy's in India, which have quality control procedures in place comparable to the big pharmaceutical companies (indeed, Dr Reddy's for example has a manufacturing agreement with Glaxo Smithkline Inc, in which some Glaxo Smithkline medicines are manufactured in Dr Reddy's factories.)
It depends on the answers to these 2 questions:
- Are the medicines you want to buy controlled by the Drug Enforcement Agency (DEA)? (See the complete list at the DEA's website)
- Do you have a prescription (given to you by a physician following a face-to-face medical evaluation)?
Ordering with a prescription in-hand:
If you have a valid prescription and want to buy non-controlled substances online then that is perfectly legal, from US-based or international online pharmacies.
If you have a valid prescription and want to buy controlled substances online within the US then from our best (non-legaly qualified) guesstimation that appears to be legal, but a bit academic as there are no legitimate online pharmacies which sell medicines controlled under federal law inside the US anymore. Ordering controlled medicines from outside the USA, even with a valid prescription, is illegal under the original Controlled Substances Act of 1970. (see 21 USC, Section 952)
Ordering without a prescription:
If you don't have a valid prescription and want to buy non-controlled substances online then if you buy from US-based online pharmacies you won't be breaking any laws, as far as we can tell. If you buy from a Canadian pharmacy the law makes generous provisions, but even if the pharmacy is located outside North America federal law is quite relaxed. Importing any prescription drugs (even non-controlled medicines) falls under the Federal Food, Drug, and Cosmetic Act, but the law specifically states that enforcement should be focused on cases in which the importation by an individual poses a threat to public health. Furthermore it says that discretion should be exercised to permit individuals to make such importations in circumstances in which the prescription drug or device imported does not appear to present an unreasonable risk to themselves. (See section J here)
The FDA's own guidance states: “FDA personnel may use their discretion to allow entry of shipments of violative FDA regulated products when the quantity and purpose are clearly for personal use, and the product does not present an unreasonable risk to the user. Even though all products that appear to be in violation of statutes administered by FDA are subject to refusal, FDA personnel may use their discretion to examine the background, risk, and purpose of the product before making a final decision. Although FDA may use discretion to allow admission of certain violative items, this should not be interpreted as a license to individuals to bring in such shipments.” (Source: FDA Regulatory Procedures Manual March 2010, Chapter 9 Import Operations And Actions, page 13.)
Note also that the restricted definition of what is a valid prescription has only been changed by the law in relation to controlled substances. Therefore it could be argued that if an international online pharmacy issues you with a 'prescription' as part of the ordering process for a non-controlled substance then you would not be breaking any laws (see this quite complex legal article).
If you don't have a valid prescription and want to buy controlled substances online then you should be aware that according to the 'Ryan Haight Online Pharmacy Consumer Protection Act of 2008' that would be illegal. The new law is quite specific about what is, and what is not, considered a “valid prescription” in connection with controlled substances. In this case a valid prescription is one that you get from a physician following a face-to-face medical evaluation; any prescription obtained over the internet or telephone is not valid under this law. The law is mainly aimed at pharmacists, not their customers, and prosecutions of customers by the Department of Justice's DEA to-date have to our knowledge been few and far between, but you should be aware that you could be breaking the law if you order controlled substances over the web without a valid prescription.
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