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Although distance dispensing currently accounts for only a small part of the health care delivery system in either Canada or the United States, it is expanding at a fast rate and will likely become a major part of the system in the near future. Ethically objectionable practices – such as dispensing drugs to patients for whom no physician has written a prescription – were especially prevalent during the early phases of the industry, before a rigorous licensing and regulatory framework was securely in place to keep a check on those practices.
It is important, however, for us to understand that, in their passion to curb unethical Internet prescribing, governmental bodies may react in the direction of over-regulation. At times, we have seen internet pharmacies emanating from countries with barely any health controls or regulation and selling medicines even without a Doctor’s prescription and that controlled substances or acute care medicines were dispensed without a face to face prescription from a Doctor.
There are rogue websites by means of which drugs are prescribed for patients who have had no face-to-face encounter with a physician but who, instead, have merely filled out a basic online questionnaire or, in some cases, have simply requested the drug in question without even the pretence of a medical examination. There are also rogue websites which supply fake drugs or which deliver genuine drugs but in a poor condition, e.g., drugs which have passed their expiry date.
Some sites offer to sell controlled drugs to people whose intention in purchasing them is to re-sell them for profit to drug addicts. Prescription drugs cannot be dispensed from a Canadian pharmacy unless a doctor licensed to practice in Canada has written the prescription.
The risk-benefit ratio of the rogue Internet Pharmacy industry is highly unfavourable, for reasons discussed earlier. By contrast, the risk-benefit ratio of the reputable Internet Pharmacy industry appears to be highly favourable since drugs should be available to the population and these drugs should be safe and affordable.