Special domain for legitimate pharmacies could go long way toward ensuring safety of supply chain

Efforts to create a generic top-level domain for legitimate pharmacy websites gained traction last week when the Internet Corporation for Assigned Names and Numbers, or ICANN — the body that controls what goes into Internet URLs — gave the National Association of Boards of Pharmacy a passing grade for an initial evaluation of its plans for the domain ".pharmacy."

If successful, the .pharmacy domain will create a powerful new weapon to combat the rise of illegal online pharmacies, which according to many studies, constitute all but 3% of the websites selling drugs on the Internet. These are the "Canadian" pharmacies selling cheap drugs that one often sees links to on search engines and other websites; despite their supposed provenance, they're usually based in countries where regulations are lax or unenforced.

Tackling the problem of illegal Internet pharmacies would go a long way toward securing the country's pharmaceutical supply chain and keeping adulterated, counterfeit and contaminated drugs out of the United States and, more importantly, out of the hands of unsuspecting patients who may be searching for bargains, but don't realize they're tempting fate. This could be far more effective - and much simpler - than requiring pharmacies, especially independents with limited resources, to implement track-and-trace technology. Brick-and-mortar pharmacies typically buy their drugs only from trusted sources in order to limit the risk of counterfeits, stolen drugs or diversion.

In April, the Food and Drug Administration took a step toward this goal by creating BeSafeRx, a page on its website that helps users distinguish between legitimate pharmacies and fake ones, warning users, "If you cannot confirm that an online pharmacy is licensed in the United States, you should not use that online pharmacy."

Drugs can be expensive, and the copays for them - to say nothing of shouldering the entire cost - can put patients deeply in debt. On Saturday, for example, The New York Times profiled several aging HIV patients, one of whom had racked up $40,000 in credit card debt from drugs and didn't know if his cards would continue to go through. The high cost of some drugs is a major reason why many patients turn to illegal pharmacies, but the cost they may incur as a result could be far higher, including prices not measurable in dollars. For that reason, it's important that the industry ensures they are getting their medicines from sources they can trust.