A swing in online pharmacy use may open up patients and caregivers to misinformation or fraudulent product representation online, as stressed in a recent Alliance for Safe Online Pharmacies (ASOP Global) study. In July 2020, ASOP Global conducted a 1,500-respondent national survey aimed at identifying consumer behavior and perception related to online pharmacy use and impacts of the coronavirus disease 2019 (COVID-19) pandemic on the use of the internet to procure health care-related information and services. This effort follows a May 2017 survey of 500 Indiana residents (representative of national demographics), also conducted by ASOP Global, that set a baseline comparator for the 2020 research. Four hundred of the 2020 survey respondents were from Indiana to allow a comparison between the data sets.
ASOP Global’s 2020 findings found consumers are increasingly going online for health care services. Up from 33% in 2017, more than 35% of respondents in 2020 had used an online pharmacy to purchase prescription medications for themselves or someone under their care. More than one-third of respondents cited the pandemic as a core driver in their increased utilization of the internet for both health care information and related services. There is a growing awareness of online pharmacies with six in 10 respondents demonstrating familiarity with the websites.
Dangerously, a significant majority (71%) still remain unaware of the risks associated with substandard, falsified, or otherwise counterfeit products that have been found to be sold via illegal online pharmacy websites. When asked about risks, it was a near even split regarding whether online pharmacies were worth the risk, with 51% indicating yes.
While an increasing number of patients and caregivers are going to health care professionals for help navigating these issues, consumers are getting mixed messaging: 66% of physicians, 71% of pharmacists, and 73% of nurses had not discussed online pharmacies with respondents. When providers and patients did discuss online pharmacies, the discussions were split between those who emphasized the risks associated with illegal online pharmacies (16%, 14%, and 11%, respectively across provider categories) versus those who encouraged their use (18%, 15%, and 16%, respectively).
The survey also reaffirms that cost and convenience are the two primary forces surrounding online pharmacy use. Comparing Indiana data from 2017 to 2020, seven in 10 cited cost as a significant driver of online pharmacy use, with 56% pointing toward the apparent convenience online. These figures have risen 28% and 36%, respectively, between 2017 and present. The survey also indicated a significant rise in prior purchasing or willingness to purchase a variety of pharmaceutical products via the internet, including specialty medications and those for chronic conditions.
The COVID-19 pandemic has unequivocally changed the way in which patients and caregivers engage with the health care system, particularly through the surge in telehealth utilization. ASOP Global found that of all online pharmacy users, almost half (47%) initiated use this year with 16% of these first-time users reportedly driven online primarily due to the pandemic circumstances.
It is estimated that within the first weeks following the declaration of COVID-19 as a public health emergency, hundreds of thousands of websites were registered using terms such as “COVID,” “virus,” and “corona.” NABP’s own research found that more than 90% of coronavirus-related domain names were registered using privacy/proxy services, rendering such registration anonymous.
While many internet intermediaries have taken appropriate actions to address the immediate public health and patient safety risks associated with COVID-19 fraud and misinformation, there remains a consistent need to ensure patients, caregivers, and health care providers have access to legitimate, evidence-based information to guide decision-making online and off. Ongoing initiatives are available that prioritize users and put an end to bad actors that seek solely to profit during and after a global pandemic.