How to spot a fake online pharmacy

The scale of the problem

The World Health Organization reports that an estimated 1 in 10 medical products circulating in low- and middle-income countries is substandard or falsified, and that falsified products have been found in every therapeutic category — from cancer drugs and antibiotics to vaccines and contraceptives. NABP's reviews of internet pharmacy sites have consistently found that the overwhelming majority operate out of compliance with pharmacy laws and practice standards.

A falsified medicine is one that deliberately misrepresents its identity, composition or source. In seized samples, laboratories have found the wrong active ingredient, the right ingredient at the wrong dose, no active ingredient at all, and industrial contaminants. "Cheap version of the same thing" is not what is being sold.

Twelve warning signs

• Prescription-only medicine sold with no prescription, or with an on-site questionnaire presented as a substitute for one.
• No named, licensed pharmacist reachable for questions.
• No verifiable physical address, or an address that returns nothing in a map or company-register search.
• No entry in any national pharmacy register — or a register entry naming a different website.
• A verification seal that is a flat image with no working link to a regulator.
• Prices far below every licensed source, especially for expensive originator brands.
• Payment only by cryptocurrency, wire transfer, gift card or a 'contact us for payment details' arrangement.
• Unsolicited email, SMS or social-media adverts as the way you found the site.
• Medicine shipped in plain packaging, without a patient information leaflet, or with a leaflet in a language unrelated to the stated origin.
• Claims to be Canadian, Swiss or EU-based while the domain registration, phone number and shipping origin point elsewhere.
• Marketing language typical of scams: 'no prescription needed', 'guaranteed cure', 'FDA approved' as a slogan rather than a verifiable approval number.
• Domain registered very recently, or a site that repeatedly changes domain name while keeping identical design and stock.

Checking the physical package

In the EU, most prescription medicine packs carry a unique 2D barcode and an anti-tampering device under the Falsified Medicines Directive; the pharmacy scans and decommissions the code at dispensing. Elsewhere, comparable serialisation schemes are in place or arriving.

• Broken, resealed or missing tamper-evident seal.
• Batch number or expiry date that differs between the outer carton and the blister inside.
• Spelling errors, colour shifts or blurred printing on the carton.
• Tablets differing in colour, size, smell or markings from a previous supply of the same product.
• Missing or photocopied patient information leaflet.

If you have already ordered

1. Stop taking the product and keep the packaging.
2. Contact your doctor or pharmacist, especially if you have taken any of it or feel unwell.
3. Report it to your national regulator — in the U.S. via MedWatch, in the UK via the Yellow Card scheme, elsewhere via your national agency.
4. Treat your card details as compromised: contact your bank, dispute the charge and watch for repeat billing.
5. Assume the email address you used will be sold on, and expect follow-up phishing.