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Assessing Website Pharmacy Drug Quality Safer Than You Think 英文参考文献
AssessingWebsitePharmacyDrugQuality:SaferThan
YouThink?
RogerBate1,2*,KimberlyHess2
1AmericanEnterpriseInstitute,Washington,DistrictofColumbia,UnitedStatesofAmerica,2AfricaFightingMalaria,Washington,DistrictofColumbia,UnitedStatesof
America
Abstract
Background:Internet-sourceddrugsareoftenconsideredsuspect.TheWorldHealthOrganizationreportsthatdrugsfrom
websites that conceal their physical address are counterfeit in over 50 percent of cases; the U.S. Food and Drug
Administration (FDA) works with the National Association of Boards of Pharmacy (NABP) to regularly update a list of
websiteslikelytoselldrugsthatareillegalorofquestionablequality.
Methods and Findings: This study examines drug purchasing over the Internet, by comparing the sales of five popular
drugs from a selection of websites stratified by NABP or other ratings. The drugs were assessed for price, conditions of
purchase,andbasicquality.Pricesandconditionsofpurchasevariedwidely.Somewebsitesadvertisedsinglepillswhile
othersonlypermittedthepurchaseoflargequantities.Notallwebsitesdeliveredtheexactdrugsordered,somedelivered
nodrugsatall;manywebsitesshippedfrommultipleinternationallocations,andfromlocationsthatweredifferentfrom
those advertised on the websites. All drug samples were tested against approved U.S. brand formulations using Raman
spectrometry. Many (17) websites substituted drugs, often in different formulations from the brands requested. These
drugs, some of which were probably generics or perhaps non-bioequivalent copy versions, could not be assessed
accurately.Ofthosedrugsthatcouldbeassessed,nonefailedfrom‘‘approved’’,‘‘legallycompliant’’or‘‘notrecommended’’
websites(0outof86),whereas8.6%(3outof35)failedfrom‘‘highlynotrecommended’’andunidentifiablewebsites.
Conclusions:Ofthosedrugsthatcouldbeassessed,allexceptViagraHpassedspectrometrytesting.Ofthosethatfailed,few
couldbeidentifiedeitherbyacountryofmanufacturelistedonthepackaging,orbythephysicallocationofthewebsite
pharmacy.Ifconfirmedbyfuturest
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