Maybe you're going bald and decide you need hair-loss medication. Perhaps you want to buy an antidote for impotence. Would you rather stand in line at your neighborhood drug store or make your purchase on the Internet?
The fact many people might choose the latter to save themselves embarrassment (or just an extra errand) could help explain the rise of online pharmacies. The American Pharmaceutical Association estimates about 400 electronic drug stores can be found online, promising the convenience of 24-hour shopping, a larger selection of products, and sometimes cheaper prices for medication.
CVS.com, for example, offers 15 percent savings on prescriptions bought online, compared to prescriptions purchased at a CVS pharmacy.
For all the advantages offered by Internet pharmacies, people seeking prescriptions from many of the online businesses have run into an obstacle: They might not be able to use their insurance to pay for their medication. Unlike the traditional community drug stores, many online pharmacies are affiliated with only a limited network of insurance plans, says Carmen Catizone, executive director of the National Association of Boards of Pharmacy. "That's been a big controversy."
Catizone says some virtual pharmacies have had difficulty attracting HMOs and other health insurance plans. The reason for the hurdle boils down to the reluctance of companies known as pharmacy benefits managers (PBMs) to sign contracts with online drug stores. The PBMs, who administer about 85 percent of the prescription medication used by the nation's insured, coordinate transactions among the drug company, the insurer and the pharmacies.
PBMs earn revenue by selling prescriptions by mail order, in effect competing against online pharmacies. That's why they have been reluctant to sign contracts with the Internet pharmacies.
Online pharmacies must ensure your prescription is authentic. You can fax or mail the original paper prescription to the site, or your doctor can fax, mail, or e-mail the prescription to them. Some sites will contact your doctor or another pharmacy for you in order to obtain your prescription.
Although procedures vary, online pharmacies generally ask you to enter your insurance information the first time you submit a prescription, just as any brick-and-mortar pharmacy would. After you open an account, the online pharmacy will contact your insurer and verify your prescription coverage. The sites generally contact you by e-mail if the pharmacy does not carry your plan.
| Some online pharmacies have had difficulty attracting HMOs and other health insurance plans. |
If your insurer is indeed part of the online pharmacy's network of plans, the pharmacy will store your information as a reference for filling future prescriptions. You won't need to enter your insurance information again, unless you change insurance plans.
Online pharmacies automatically determine, based on your insurance plan, your portion of the prescription cost, and charges that to your credit card.
Even if the online pharmacy does not have a contract with your insurance plan, you can still have your prescription filled, but you must pay the full cost. (You can seek reimbursement from your insurance company after you receive your prescription.) Most insurance companies have a standard form for requesting reimbursement — just attach your receipt and provide information from your prescription label.
You can order your medication by mail or pick it up if you buy from a pharmacy with ties to drug stores. The time it takes for the medication to arrive depends on how you choose have it shipped (standard or overnight).
If you need a prescription filled immediately, you're better off at your local pharmacy. Another disadvantage of ordering online: You lose face-to-face contact with a pharmacist. Online drug stores should have pharmacists ready to answer your questions by phone or e-mail. If they don't, you should avoid doing business with them, according to the American Pharmaceutical Association.
The American Pharmaceutical Association recommends using only one pharmacy, which decreases your chances of suffering a harmful drug interaction by obtaining medications from multiple sources.
If your prescription is covered by insurance, your pocketbook shouldn't be impacted by any price differences between online and offline shopping. (Your insurer will negotiate with the retailer.) If you buy prescriptions online without insurance, you generally will pay about 10 percent less than you would at a drug store, according to "Bob Carlson's Retirement Watch," a monthly financial newsletter for retirement planning.
"With some of them, you can get a much bigger discount from what you'd be paying in your local drug store," says editor Robert Carlson, a certified public accountant and lawyer. Not all Internet pharmacies offer good discounts, so Carlson advises shopping around for the best prices.
While many Internet pharmacies are as reliable as your average neighborhood drug store, there are some that should be avoided. Perhaps the biggest danger is the "rogue" online drug store. These questionable online pharmacies, for example, will charge you to complete a questionnaire that is reviewed by one of their "doctors," who then dispenses a prescription to cure baldness, treat impotence, or assist in weight loss. Legitimate pharmacists and doctors call this practice dangerous.
| You can get a much bigger discount from what you'd be paying in your local drug store." |
Pharmacists caution shoppers to be wary of stores that operate in violation of state or federal laws. They might be dispensing outdated, damaged or counterfeit prescriptions. They might also be illegally importing drugs from overseas.
In an effort to separate the reputable from the rogue sites, the National Association of Boards of Pharmacy (NABP) has created a program called Verified Internet Practice Pharmacy Sites. Online pharmacies can apply for the certification. If they meet the board's standards, they can display a seal.
To become certified, a pharmacy must comply with the licensing and inspection requirements of its state. In addition, pharmacies displaying the seal have demonstrated compliance with NABP criteria, including a patient's rights to privacy, authentication and security of prescription orders, adherence to a recognized quality assurance policy, and consultation between patients and pharmacists.
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