Online Medical Quackery and Public Health

It never ceases to amaze me how quickly and efficiently purveyors of unregulated nonscientific and potentially dangerous “alternative medical” products can mobilize their Web-based marketing strategies after a serious new public health concern becomes well-publicized. Take, for example, the swine flu epidemic. It has been reported that the FDA “identified 140 different dubious products sold online and sent letters to 75 manufacturers” related to claims that these products could prevent or treat swine flu.¹ It seems these individuals or groups do not care that many people may suffer serious or even fatal consequences from using such products or delay others from receiving appropriate and necessary medical interventions.

Some of the online sites that received letters from the FDA were found to be selling fake Tamiflu, which is one of the few drugs known to favorably impact the course of a serious case of swine flu. Just consider how many worried parents may have failed to understand that the worsening of their child’s H1N1 infection was not due to the severity of the virus, but rather the worthless powdered talc they bought online because they thought it was a cheaper version of the FDA-approved product. Sadly, given the current economic climate, individuals selling such fake products are finding plenty of buyers, and even some respected organizations and entities have been reprimanded for preying on people’s fears and selling questionable products. According to one report, Dr Andrew Weil, a well-known advocate of certain alternative medicine practices, was cautioned by the FDA regarding “claims that the dietary supplements he was promoting could help prevent swine flu.”¹ Of course, none of this is new, as numerous reports have noted the dangers associated with purchasing pharmaceuticals designed to treat both life-threatening and less serious medical conditions from unregulated online companies and organizations.^2-4

According to a recent report from Manhattan Research, more than 150 million consumers use the Internet to obtain health-related information.⁵ As a result, it should come as no surprise that this mass-marketing vehicle will be increasingly utilized by those selling modern versions of snake oil. In fact, in this same survey, it was noted that more than 100 million patients used the Internet specifically to look for information related to prescription medications. So, what can physicians do to help their patients avoid the enticing trap to purchase products with a price or promise of benefit that is simply too-good-to-be-true?

While there is no simple or definitive answer to this critically important question, a reasonable initial response is that physicians (and their staffs) should encourage patients and their families to be open to discussing the medications they intend to buy, or have actually already bought through online merchants. The physician can then offer a second opinion regarding the patient’s plans to purchase these medications, letting him or her know that while there may be absolutely nothing wrong with the specific medication available online, a detailed review of the medications’ origin (manufacturer and authenticity/ credentials of the online pharmacy) and the data supporting the utility of the product are crucial in preventing him or her from making a serious, or even tragic error in judgment. Of course, the physician’s advice can be accepted or ultimately rejected by the patient, but at least the individual will hear a perspective beyond potentially unregulated hype and misinformation.

Maurie Markman, MD, is editor-in-chief of Oncology Net Guide and vice president of clinical research for University of Texas MD Anderson Cancer Center in Houston, Texas.

References

1. Wayne L. F.D.A. fi ghting false online claims about swine flu treatments. New York Times. November 6, 2009. www.nytimes.

com/2009/11/06/business/06cure.html. Accessed February 20, 2010.

2. Veronin MA, Nguyen NT. Comparison of simvastatin tablets from the US and international markets obtained via the Internet. Ann

Pharmacother. 2008;42(5):613-620. www.ncbi.nlm.nih.gov/sites/entrez/18413690. Accessed February 20, 2010.

3. Eysenbach G. Online prescribing of sildenafi l on the World Wide Web. J Med Internet Res. 1999;1(2):e10. www.jmir.org/1999/2/e10. Accessed February 20, 2010.

4. Vernonin MA, Clauson KA. Internet pharmacy drugs delay treatment for congestive heart failure. J Am Pharm Assoc(2003).

2007;47(4):436-442.

5. Monegain B. Millions of people use the Internet to research drugs. Healthcare IT News. www.healthcareitnews.com/news/millions-people-use-internet-research-drugs. Accessed February 20, 2010.