Few problems found at Canadian Internet pharmacies, GAO report says

WASHINGTON (AP) - Narcotics are easily purchased over the Internet from U.S. pharmacies with no prescription, congressional investigators maintained Thursday at a Senate hearing on the dangers of buying medications online.

Investigators said they purchased the painkiller hydrocodone from eight Web sites. "It seems that the key thing here is having your credit card," Robert Cramer, a senior investigator with the General Accounting Office, said.

In no instances were GAO employees who posed as patients asked to see a doctor or provide a prescription, Cramer said.

Despite safety concerns voiced by opponents of prescription drug imports, investigators said, however, they encountered few problems with medicines purchased from Canadian Web sites.

In some instances, Canadian online pharmacies had stricter standards than those in the United States, the GAO said in new report.

Canadian pharmacies appeared to be more reputable than Internet pharmacies in other countries, it said.

Investigators who filled prescriptions on the Web in the United States, Canada, Mexico, Spain, Thailand and seven other countries were testifying Thursday to a Senate Governmental Affairs subcommittee. Prominent opponents of imported drugs also were to testify.

In contrast to orders filled in Canada, some of the drugs received from other foreign pharmacies were counterfeit and many came with no instructions or warnings, said the report by the GAO, the investigative arm of Congress. Others arrived in damaged or unconventional packaging.

A shipment of the narcotic OxyContin arrived in a plastic compact disc case, investigators said. A bottle of pills of the AIDS drug Crixivan came inside a sealed aluminum can that was itself enclosed in a box labeled "Gold Dye and Stain Remover Wax."

All 18 Canadian sites required consumers to supply a physician-written prescription before filling orders. That was the case for five of 29 U.S. pharmacies; no other foreign pharmacies did.

Prescriptions filled in Canada and the United States came with labels from the dispensing pharmacy and generally included patient instructions and warnings, the report said.

The biggest problem investigators noted was that drugs shipped from Canada did not have FDA approval for use in the United States for reasons such as production in unapproved plants or carrying different labels.

But the medicines had a comparable chemical composition to approved pharmaceuticals, the report said.

"The samples from U.S. and Canadian pharmacies exhibited few problems otherwise," the report said.

Food and Drug Administration officials long have complained that it is misleading to say drug products are equivalent without subjecting them to extensive tests.

"Whether a foreign product contains the same active ingredient is no guarantee that it is identical to the FDA-approved product," the agency's acting commissioner, Lester Crawford, wrote in comments included with the report.

Tom Steward, a spokesman for Sen. Norm Coleman, the subcommittee chairman, said Canadian pharmacies came off well in the report.

"It gets down to strengthening Customs and FDA agents' ability to license and hold accountable these Internet Web sites wherever they are," Steward said.

Coleman, R-Minn., is among the lawmakers who recently abandoned opposition to importing drugs.

Lawmakers who advocate drug imports from Canada and elsewhere are trying to force a Senate vote to legalize the practice. The FDA has said it cannot guarantee the safety of the foreign products.

Older Americans have flocked to Canada for prescription medications as drug prices in the United States have soared and fixed incomes have not kept up, advocates say.

Several bills would strengthen federal regulation of Internet pharmacies and inspections of pharmaceutical manufacturing plants abroad.