August/September 2014, Vol 2, No 4 - The First Word
Donald J. Dietz, RPh, MS

Pharmacists have consistently been ranked near the top of the list of most trusted healthcare professionals. According to a 2013 Gallup poll,1 pharmacists are rated as the second most trusted professionals in terms of honesty and ethics, with 70% of people saying that they would give pharmacists a “high” or “very high” rating.

A concern exists that online pharmacy scams and illegal websites may be leading to a decline in these numbers, because some patients may be confused about the legitimacy of a product. Although most consumers have become savvy to these fraudulent practices, others still fall for the scams. Currently, the gold standard for online pharmacy accreditation is the Verified Internet Pharmacy Practice Sites (VIPPS) accreditation from the National Association of Boards of Pharmacy (NABP).

The .Pharmacy Domain
VIPPS has accredited 34 online pharmacy websites, which, with chains, encompasses over 12,000 dispensing pharmacies.2 Using 19 criteria for certification, pharmacies with accreditation can be considered safe for consumers.3 However, the costs of becoming VIPPS-certified can be quite onerous and prohibitive for a small independent pharmacy. This may be why free Internet pharmacy verification services, such as LegitScript.com, have emerged. LegitScript is approved by NABP and provides free certification to online pharmacies once they pass an 11-point standards test.4 So far, 216 online pharmacies are listed on LegitScript as being safe for patients.5 For smaller pharmacies that want to obtain some sort of certification for their websites, LegitScript can be a worthwhile, free alternative.

To further strengthen the legitimacy of online pharmacies, NABP has supported the creation of a .pharmacy domain registration through the Internet Corporation for Assigned Names and Numbers (ICANN). It was only in 2005 that ICANN began considering the introduction of new domains, also known as generic top-level domains (gTLDs), besides the usual .com, .net, .org, and others. There are currently 22 gTLDs, but ICANN expects dozens or even hundreds more in the next few years,6 due to the new gTLD Applicant Guidebook. NABP has been working for over a year to secure the .pharmacy domain and negotiate the terms, and in June 2014, a registry agreement was executed.7

The new domain is scheduled to launch this fall, and should give a sense of confidence to users who visit these pharmacy sites that the visit is secure and trustworthy, and that medications are both safe and authentic. Similar to the VIPPS accreditation, NABP will screen anyone applying for a .pharmacy domain. Eligible registrants must meet a number of criteria, including demonstrating com­pliance with their laws of jurisdiction and ensuring that they have the proper pharmacy licensure, drug authenticity, and valid prescription requirements.8 The website names chosen must correspond to a trademark, service mark, or business name of the registrant, followed by the .pharmacy domain.9 This will help to reduce confusion related to website authenticity by refusing site names such as “painpills.pharmacy.”

Building Patient Confidence
So far, the .pharmacy domain has been met with much excitement in the pharmacy community. Eli Lilly, Merck, and Pfizer have all contributed $100,000 or more to support the initiative to have NABP establish the domain.10 A successful adoption of legitimate .pharmacy websites will help to stop the rampant illegal distribution of unauthorized products claiming to be from manufacturers. Other supporters in this global approach include the European Alliance for Access to Safe Medicines, International Pharmaceutical Federation, and state boards of pharmacy.

Unlike the current VIPPS accreditation, the .pharmacy domain will be available for parties other than pharmacies. Pharmacy benefit managers, wholesalers, manufacturers, drug-related patient advocacy groups, and many others may be eligible to apply for a .pharmacy website. For now, interested parties can go to www.dotpharmacy.net for information about the application process.

The .pharmacy domain will provide a low-cost option for properly identifying legitimate pharmacy websites. This is another step in the right direction for pharmacies, as it enables patients to have confidence in the pharmacy websites they visit and ultimately helps ensure that pharmacists remain one of America’s most trusted professionals.

References

    1. Gallup poll. Honesty/Ethics in Professions. 2013. www.gallup.com/poll/1654/honesty-ethics-professions.aspx. Accessed August 21, 2014.
    2. National Association of Boards of Pharmacy. Recommended Sites. 2014. www.nabp.net/programs/consumer-protection/buying-medicine-online/recommended-sites. Accessed August 21, 2014.
    3. National Association of Boards of Pharmacy. VIPPS Criteria. 2014.www.nabp.net/programs/accreditation/vipps/vipps-criteria. Accessed August 21, 2014.
    4. National Association of Boards of Pharmacy. Standards. 2014. www.nabp.net/programs/accreditation/e-advertiser-approval-program/standards. Accessed August 21, 2014.
    5. LegitScript. Pharmacies. www.legitscript.com/pharmacies. Accessed August 21, 2014.
    6. The Internet Corporation for Assigned Names and Numbers. About the Program. 2014. http://newgtlds.icann.org/en/about/program. Accessed August 21, 2014.
    7. The Internet Corporation for Assigned Names and Numbers. gTLD Applicant Guidebook. 2012.
    8. National Association of Boards of Pharmacy. NABP Executes Registry Agreement with ICANN for .Pharmacy Domain. 2014. www.nabp.net/news/nabp-executes-registry-agreement-with-icann-for-pharmacy-domain. Accessed August 21, 2014.
    9. LegitScript. Standards. www.legitscript.com/pharmacies/standards. Accessed August 21, 2014.
    10. National Association of Boards of Pharmacy. NABP .PHARMACY Governance Document. www.nabp.net/system/rich/rich_files/rich_files/000/000/290/original/pharmacy-gtld-governance.pdf. Accessed August 21, 2014.
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