Consumers Purchasing From Online Pharmacies

The most difficult task in connection with online pharmacies is attempting to establish the number of people buying and the volume of money traded. Except for cases when this practice is a legal requirement, there are no official data on the issue and it was not possible to obtain details from the Internet as in the sections above.

The scientific evidence about consumers comprises 2 types of data: population surveys and case studies on the adverse effects of drugs purchased via the Internet.

Population Surveys

Table 3 shows the 15 articles [12,64,75,105-116] dealing with consumer characteristics and based on surveys. Most studies were US based, except for 4, which were conducted in Europe [75,105,106] and South America [107]. The findings were published between 2003 [108] and 2010 [105-107,109-112]. Seven studies investigated the general population [12,75,106,108,109,113,114], while the remainder were about specific groups, described in Table 3 [64,105,107,109,111,112,115,116].

Table 3

Articles about consumers buying from online pharmacies, listed in alphabetical order according to the first author

In studies about the general population, the percentage of people buying drugs online was between 4% and 6% in the United States in the studies by Fox [12], Baker et al [108], and Cohen and Stussman [109] (who analyzed the health information technology questions of the National Health Interview Survey). Atkinson et al [113] (who analyzed the data of the US national representative sample of the Health Information National Trends Survey [HINTS] by the National Cancer Institute) found a higher percentage (13%), probably because the purchase of vitamins was included in the estimate. The UK-based survey considered both having bought and the intention to buy, so a third of the sample gave a positive response [75].

As in the general population studies, Mazer et al [112] found that 5.4% patients at an emergency department had bought drugs online.

Both surveys on prescription drug abusers [64,115] reported that 6% of the interviewees had used the Internet to purchase prescription medications for their addiction. The 2 papers by Inciardi et al [111,116] were based on several sources of information investigating different populations, including Internet-savvy high school and college students, chronic drug users, and members of the general population. Inciardi et al [116] tried to reveal the “black box” of drug diversion (the transfer of a prescription drug from a lawful to an unlawful channel of distribution or use) using several sources of information: the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS) System, the National Survey of Drug Use and Health (NSDUH), the Delaware School Survey, several Miami street studies, and 2 qualitative studies. The authors concluded that, although the Internet is indeed a source for prescription drugs, the overwhelming volume of purchases is probably at the wholesale level, since few end users report accessing the Internet for drugs. In the various population groups analyzed in this study, the percentage of people accessing prescription drugs via the Internet ranges from 1% to 6%. The results of the 2010 work by Inciardi et al [111] seem to confirm the findings of the previous paper: based on the RADARS System, the NSDUH, and the Monitoring The Future (MTF) survey, they still found that the Internet is a source of prescription opioid acquisition for 0.5%–3% of the investigated populations.

A US survey on the recreational use of erectile dysfunction medications in undergraduate men showed that 12% of users had bought them on the Internet [110]. Bechara et al [107] in Argentina investigated the recreational use of PDE5Is by healthy young men and found that 2.9% of the interviewees had bought the drug through the Internet. A cross-sectional Europe-based observational study examining the purchasing patterns for the same substances found that 11% of the 11,889 subjects reported current use of PDE5Is; 32% of these reported obtaining their PDE5Is from sources outside the health care system without prior health care personnel interaction (eg, Internet, friends) [105].

Some reports suggest widespread use of online pharmacies in people over 35 years of age [75,113] and in women [109]. Mazer et al [112] found no difference in age between those who bought drugs online and those who did not, and no difference in student status, but patients on multiple medications and those with prescription plans used online pharmacies more frequently. Fox [12] found that the most frequently bought products were drugs for chronic conditions (75%), followed by weight loss and sexual performance substances (25%). The most frequent reasons quoted by interviewees for buying or intending to buy online were convenience and saving money [12,75], followed by information anonymity and choice [75]. Regarding location of online pharmacies, the majority of buyers chose or would have chosen sites based in their own countries or in economically developed countries [12,75]. Regarding risk perception, Gurau’s [75] interviewees reported being worried by a lack of a license on the part of the pharmacy (31%), privacy issues (27%), security of online payment (26%), additional charges, drug quality, and superficial prescription. It is interesting to note that health-related risks (drug quality and prescription requirement) rank last in consumers’ perception. In Fox’s [12] survey 68% agreed that online purchasing makes it too easy to obtain drugs illegally.

Rajamma and Pelton [114] explored the potential impact of consumers’ cognitive characteristics on their decision making as it relates to procuring pharmaceutical products via online retail channels. They sent 350 consumers a self-administered electronic questionnaire. Their analysis showed that male, higher-educated, and higher-income consumers had a greater propensity to procure medication online, whereas insurance status did not have any influence. Wiedmann et al [106] investigated the consumer-perceived values and risks related to online shopping attitude and behavior in an e-pharmacy context; they used their model to identify 4 clusters labeled as “enthusiastic experts” (29%), “risk-averse traditionalists” (24%), “convenience-oriented rationalists” (20%), and “inexperienced opponents” (28%).

Date: 2016-03-03; view: 656