Geographical Location

Declaration of geographical location is an important feature with regard to transparency. Apart from the studies that focused only on websites based in a specific area, the sampled websites declared a geographical location ranging from 11% to 100% [47,61]; according to the results of Armstrong et al [57], Bessel et al [60], Bloom and Iannacone [62], Gallagher and Chapman [71], and Tsai et al [93], more than half of the samples mentioned where the company was based; the others found that less than half did [10,61,65,84,90]. Orizio et al [84] found that online pharmacies asking for a prescription were significantly more likely to declare their geographical location than were online pharmacies that did not, which were more often just virtual interfaces. Online pharmacies were most frequently based in the United States in virtually all the studies that investigated samples that were not restricted geographically [10,57,60,61,62,66,73,84]. Other studies focused on online pharmacies based in specific countries, such as the United States [87,88,95], the United States and Europe [27], the United States and Canada [89], Canada [94], or Brazil [92]. Some researchers looked for where the websites were registered, and they found the United States to be the most frequent location of domain registration [10,67,68,84,93]. Orizio et al [84], who compared the declared physical location with the registration domain, found that in only 55% of online pharmacies declaring their physical location did it correspond to the area of domain registration. Armstrong et al [57] found that US-based websites were more likely to ask for medical information and provide information about risk of treatment or its efficacy, and the GAO [73] found a better quality in websites based in the United States.

Delivery: Where From and Where To

The National Center on Addiction and Substance Abuse (CASA) [63] found that 24% of shipments were declared to be from the United States, and 36% of the sample gave no indications. In Orizio et al [84] 42% of the websites declared where they deliver from, the most frequent place being Asia (47%); agreement between declared physical location and delivery location was found in 31% of online pharmacies providing both details. The attempt by Bate and Hess [59] to purchase drugs showed several cases of shipments from a different location from what was indicated on the website.

Both Arruanda [58] and Bessel et al [60] found that two-thirds of the online pharmacy samples sold internationally, whereas all the websites sampled by Schifano et al [91] did. Raine et al [90] selected only online pharmacies delivering to the United Kingdom. Makinen et al [27] related the fact of shipping abroad to the prescription requirements: online pharmacies that asked for a prescription were more likely than those that did not to sell only in the country they were based in, and delivered anywhere in the world. Mainous et al [82] found that almost all the websites sold to the United States, followed by the United Kingdom (84%) and Canada (80%). None of the small sample of 4 US-based online pharmacies analyzed by Wagner et al [95] delivered internationally.

Date: 2016-03-03; view: 833