Pharmacist-affiliated going after online pharmacies

[Image: A CC-licensed photo by Steve Snodgrass, via Flickr]

If you followed the health care reform debate, you know many Americans pay out of pocket for prescription drugs. Online prescription companies have made it possible for many of us to get drugs we could not otherwise afford from "offshore" sources. Now, one of the most prominent offshore suppliers is telling customers "After recent action taken by we have had to stop supplying customers within the USA." Alex Blaze at Bilerico reports:

LegitScript also wears their partnership with the National Association of Boards of Pharmacy, which opposes drug reimportation from Canada, a cheaper alternative to American medications that was discussed during health care reform but was rejected mainly because it would save the average American $800 a year, which would come directly from the pharmaceutical industry (crazily enough, the NABP decries Canadian drugs as "unsafe," even though they help license pharmacies in nine provinces).
If this were about protecting people from shady online companies providing unsafe or counterfeit drugs, that would be one thing. But the blocked site,, has been providing great products and service for years. I know it's widely used by transgender people, who are far more likely to be priced out of insurance and privatized healthcare options. The alternative is dangerous black market hormones that used to be far too prevalent among low-income trans people. LegitScript feels like they're pulling a page from other protectionist trade organizations in the news, in order to maintain revenue streams for deep-pocket industries. stops shipping to the US (via Bilerico)

Since the LegitScript site is down (!) some extra info on the latest push, which includes action by Google against "rogue pharmacies": (News: Link 1, Link 2, Link 3).


What Can LegitScript Do For You?

LegitScript offers the following services.

Internet pharmacy verification.

LegitScript is the leading source of information for patients, Internet users, physicians, businesses and other third parties who need to know if an Internet pharmacy is acting in accordance with the law and accepted standards of ethics and safety. LegitScript is identified by the National Association of Boards of Pharmacy as the only Internet pharmacy verification service that adheres to its standards. Currently, verification is offered as a free service to Internet pharmacies.

Prescription drug website monitoring

LegitScript monitors thousands of websites that facilitate the sale of prescription drugs via the Internet. We provide assistance to organizations that have a need for continuing oversight of large numbers of health-related websites to ensure compliance with relevant laws and policies.

Internet enforcement

LegitScript is the only Internet enforcement service focusing exclusively on the online pharmacy market, and we have provided investigative assistance to some of the worlds leading government agencies and corporations. We investigate and monitor online pharmacies using our unique network approach, which breaks down a seemingly infinite number of illicit online pharmacies into a manageable number of related groups (or networks). While other companies just look at one website at a time, LegitScript finds the links between thousands of related websites, allowing us to target hundreds of rogue websites simultaneously.

LegitScript™ is a registered trademark of LegitScript LLC.


  1. It’s true what they say about Canadian drugs – side effects include: mellowing out, respect for legalized gay marriage, and the realization that the most delicious food in the world is bacon dipped in maple syrup

    1. Yes, Inhouse does sell meds without a prescription.
      Most trans people can’t afford / don’t have access to doctors who would write a script for hormones (thanks to the bigotry prevalent in many parts of the USA).

      Inhouse also sells HIV retrovirals, allergy inhalers, anti depression meds and a wide variety of meds that are essential to the people taking them. Now these people will be forced to pay 3 times more, if they can even afford it.

      It’s going to result in deaths. God Bless America.

      swadeshine, yes, it is. The usa is going to start yanking domain names because it thinks they own DNS.

  2. When they talk of “rogue” pharmacies, what they mean to say is that many online sites that appear in so much spam sell drugs made in India or other places that are not made properly (too strong or weak), if they are not outright fakes. Additionally criminals that rob drug warehouses or steal large truck rigs or cargo containers that contain whole shipments of drugs launder these drugs through networks which are purely organized crime. Stealing drugs from warehouses and truck shipments can make BIG money for thieves.

    1. “Any way that the ruling class can extract money from the working class, it will be done.”
      No – Americans always seem to act as if there is no stopping the copmbined bastardry of the ruling 1% and their pets in politics.
      But every other developed nation claws back enough power and profit from that class to ensure a decent basic level of healthcare for all.
      As with many things, what Americans treat as universal and inevitable is a situation that is both local and mutable. Please stop exporting your pessimism about the power of the public; try importing some optimism.

  3. Reason To Move To Canada #652.

    If I have to expat in 2012 after Sarah Palin gets elected, Canada is looking pretty appealing. Alternatives include Iceland and India. We Shall See.

    1. Church, it’s not about production costs. Frankly, chemistry isn’t THAT much more expensive to run in the US than elsewhere, since electricity is more reliable and chemical purity major from american suppliers tends to be very high. The issue is patent rights. It’s not about where stuff is made, it’s about where the end product is sold, since that’s what affects the end-cost to the consumer. And in many cases, it’s not that manufacturers are going offshore for their suppliers, it’s that there are offshore manufacturers not bound by US patents, and thus they just make and sell the pills cheaply, just like any generics company does once the patent expires.

      1. Patents are not it. Canada honours drug patents. Canada legislates price caps for some drugs, and restricts drug advertising. That’s why drugs are cheaper here.

  4. Hmm. On the one hand, what people often forget (or conveniently ignore) is that most new medication is developed in the US. And while some (a lot…) of it is just slight modifications, and not even always improvements, over previous treatments, much of it is also incredibly important to maintaining the modern way of life.

    Now, it’s REALLY expensive to develop a drug. Do drug companies make absurdly large profits? Yes, they do. Could they sell drugs cheaper? Maybe, it’s always hit and miss, some drugs never pay back the research investment. Could drug companies sell drugs at Canadian, or Indian, prices, and still stay open and doing research? No, absolutely not. At least, not until the government starts funding clinical trials.

    Now, unlike almost any other invention, a drug company ‘wastes’ upwards of 25-50% of its patent time in the clinical trial phase, where it can’t sell compounds to the public. So any given compound is only under patent for about 2/3 the time that any OTHER invention would get sole sales rights. And since any useful drug WILL get picked up by a generics firm the instant it comes off patent, the companies have to make back the research investment (a bit over 8 billion, on average) in a reduced number of years. Hence: pills are expensive.

    This really is different than, say, the IP debate, where an artist records something once on a piece of equipment bought a decade ago, then prints 10 cent CDs and sells them for 20 bucks, and gets offended when people dare to lend the CDs to one another. Drug discovery is immensely expensive, and if we want drugs to keep getting made, and for progress to be made fighting cancer, alsheimers, etc., we kinda need to pony up the funds. It’s very unfortunate for those priced out of the market. But they actually are putting future advances at risk by keeping these internet companies afloat.

    Of course, on the other hand, if the choice is buying a pill online, or not buying it at all, it’s not like the company is actually losing money when somebody gets it from a different source. Sort of like how downloading an MP3 when you had no intention of ever, ever purchasing a CD doesn’t ACTUALLY cost the record industry a dime. But anyways. It’s in pharma’s best interest to shut down internet sites because of people who CAN afford local rates. Unfortunately, a lot of folks who aren’t in that category get caught up in the process.

    1. “Could drug companies sell drugs at Canadian, or Indian, prices, and still stay open and doing research? No, absolutely not.”

      Sure. Cut their advertising budgets a tiny bit. Wouldn’t be a problem. Or are you one of those people who believes the drug industry spends all of it’s money on research?

      And to add to vacant’s post. Here’s a bit about the patent protection and shenanigans associated with modafinil. Nice to see the government is working for the protection of Americans!

      A U.S. Patent 4,927,855 was granted to Lafon for modafinil in 1990. The FDA granted modafinil orphan drug status in 1993. The formulation patent expired on 30 March 2006. The particle size patent was filed by Cephalon U.S. Patent 5,618,845, covering pharmaceutical compositions of modafinil, in 1994. That patent, granted in 1997, was reissued in 2002 as RE 37,516, which provides Cephalon with patent protection for certain preparations of the drug in the United States until 2014, which is now apparently extended to April 6, 2015 after Cephalon received a six-month patent extension from the FDA.[97][98]

      Some competing generic pharmaceutical manufacturers applied to the FDA to market a generic form of modafinil in 2006 (the year of patent expiry of the active ingredient). At least one withdrew its application after early opposition by Cephalon based on its new patent on particle sizes (set to expire in 2015). There is some question as to whether a particle size patent is sufficient protection against the manufacture of generics. Pertinent questions include whether modafinil may be modified or manufactured to avoid the granularities specified in the new Cephalon patent, and whether patenting particle size is invalid because particles of appropriate sizes are likely to be obvious to practitioners skilled in the art. However, under United States patent law, a patent is entitled to a legal presumption of validity, meaning that in order to invalidate the patent, much more than “pertinent questions” are required. To date, no generic manufacturer has been able to invalidate Cephalon’s particle size patent, and, indeed, those that attempted to do so were not successful such that the patent remains in force.

      Cephalon made an agreement with four major generics manufacturers Teva, Barr Pharmaceuticals, Ranbaxy Laboratories, and Watson Pharmaceuticals between 2005-2006 to delay sales of generic modafinil in the US until April 2012 by these companies in exchange for upfront and royalty payments.[99] Litigation arising from these agreements is still pending including an FTC suit filed in April 2008.[100] Apotex received regulatory approval in Canada despite a suit from Cephalon’s marketing partner in Canada, Shire Pharmaceuticals.[101] [102] Cephalon has sued Apotex in the US to prevent it from releasing a genericized Nuvigil.[103]

  5. From my view this is all about protecting people from online companies providing unsafe medication or medication that has not been prescribed by doctors (and therefore might not be good for them). From the blog post that was linked to in the artice and from legitscript’s pages (see link in #3) it seems that has supplied medication without prescription and medication that is illegal in the US. Self-medication and taking prescription medication without a prescription is illegal for health reasons.

    In my view this blog post totally misses the point. It points at the correct symptom that prices of medication are too high and that transgender people self-medicate because of high prices, but shutting down InHousePharmacy has nothing to do with the price of medication or protectionist trade organizations that want to maintain revenue streams for deep-pocket industries, and everything to do with protecting people from shady online companies providing unsafe drugs.

    1. “and everything to do with protecting people from shady online companies providing unsafe drugs.”

      I’m afraid that this kind of protection is putting people in danger. The problem is most widespread and most obvious among trans people, many of whom have trouble accessing and affording good medical care. Since the unemployment rate among trans womyn is at least twice a high and may be several times as high as the unemployment rate for the rest of the population, and since most insurance companies, most doctors, and many pharmacists won’t do trans-related care, it can be difficult to get the medicine without places like Inhouse.

      Hormone replacement therapy is often a matter of life or death. Depriving people of access to hormones can cause, among other things, severe osteoporosis. Since the regular medical system often deprives people of access, other sources are necessary.

      It also means that the community vets which pharmacies to trust and which ones to avoid. Shutting down the safe pharmacies, and shutting down any pharmacy before it can get return customers, will just open the door to fly-by-night operations.

  6. US price 12.37 times higher on MS drug:

    100 tablets of 200mg Modafinil (Provigil) here in the US, $ 1,855.39
    100 tablets of 200mg Modafinil everywhere else in the world, $149.98.
    The cost is higher here because we have to repay Cephalon for the $200 miilion paid to their comptitors to not produce a generic drug.

    I assume the FTC will someday, after patent expirations, collect a fine from Cephalon so another branch of our gov’t will have enough funds to give it back to Cephalon in R&D credits.

  7. I have purchased my medicine from this company for many years. In Australia progynova is legal and cheap and I just go to my regular doctor for a prescription. In the US however, I can get the prescription, but guess what… the drug does not make enough money for a company in the US to push it through the FDA. SO I have to order it from overseas anyway.

    Either way, now they will not ship to the US, and I need to find a new source before my current supply runs out.

  8. I was going to tirade about drug companies and how they alone have shaped the federal and private climate that provides them their enormous margins.. as well as direct to consumer advertising and doctor detailing.. but instead i just want to point out that mail order pharmacy is not a model in your best interest. Soon, if corps like CVS Caremark, other PBMs and the Feds have their way you will all be receiving your prescriptions through mailorder only. Think medication errors are bad now? Wait until your insurance company forces you to mail order only. Want to ask the pharmacist a question about your meds? Pick up the phone and hope they route you to a good one.. or wait for that email/chat session. Do yourselves and loved ones a favor, support local INDEPENDENT pharmacies. As far as price goes, i have nothing for you there. Mailorder will be cheaper, it’s true. It’s a more efficient business model.. i’ve been looking into Canada’s immigration guidelines myself. As far as transgender people.. they knew that before and after the pricey operations there would be pricey drugs… their sexuality may not have been their choice, but the decision to have surgery etc. was..

  9. Several people are missing the point here.

    inhousepharmacy do NOT manufacture drugs so they are not ripping off intellectual property rights. They buy their drugs, in many cases, from the same companies that US pharmacies do (e.g. Glaxo Smith Cline, Cipla, Merck) for in-patent and generic drugs or reliable generic manufacturers for out of patent drugs. They are based in Vanuatu which is not exactly a hot house of high tech industry.

  10. Devil’s advocacy:

    If Americans wanted drug prices kept in line, they’d legislate price caps like the countries being re-imported from.

  11. Yeah… when a country mandates specific prices, that’s sort of a way of bypassing patent rights. I mean, the whole point of a patent is that the owner gets to control the market. If you patent a hammer, you can sell it for $200… people might not BUY it, but you can do what you want till it expires.

    As for mandating prices in the US, again… if prices get too low, research costs never get made back. And if that happens, drugs stop getting researched. It’s foolish to request the first part happen without thinking about the consequences of the second. Right now, pharma counts on the US to make back most of its money. Which is, frankly, decidedly unfair. But with Canada, and India, and most places, restricting prices, or bypassing patent altogether and letting other companies make the stuff, where else is the capital going to come from?

  12. My asthma medication costs $375./ the local drug store, $275. copay with my insurance. I can’t afford that, and I’ve gotten kind of accustomed to breathing, so I need it.
    I order it through a company in Australia, which gets it from a licensed pharmacy in a number of different places ( came from Vanuatu last time)they do require a prescription. The medication is manufactured in India and costs me $186.00 for a three month supply. My doctor approves.
    Needless to say I would be —-ed if I could not import from overseas. I would not order from a company that advertises via spam and distributes without a prescription. There is a site called that rates and gives reviews of overseas pharmacies.

    1. NIH funds academic research, but not very much industrial stuff. And it doesn’t do much of anything for clinical trials, which is where the costs really get inflated, anyways. Public funding of clinical trials is a way out of that, but that means huge expense for gov’t, and more people running clinical trials because they have less money on the line.

  13. Drug companies spend a HUGE amount of money on advertising. Watch US TV for a month and you want to talk to your doctor and ask them why you don’t need any prescription drugs. Is there something wrong with me? is that why I feel fine? The US health Care system allows them to inflate the prices to such a level, where the same companies simply aren’t allowed to do it in Canada and other places. A profit is still made, it’s just not enough to buy a new yacht every year.

  14. And this is me moving somewhere else. Apparently my country is more corporate property than it is mine.

  15. I import the medicine that I use to control my mental illness. I have grown accustomed to being sane and rational.

    Being uninsured, I’d have to pay for monthly doctor visits, and 30-day prescriptions, and the meds, all out-of-pocket.

    One month supply of my meds, generic, here in the U.S.: $390
    One year supply of my meds, brand name, imported: $380

    I guess I will hurry up and buy another year’s supply, or perhaps to lat until 2014.

  16. Tell you what, I’m not really into Fakebook or IM stuff, but if you need some meds just hook up with someone you trust in Australia and they will go the doctor, get a script and buy your meds for $5.40(AU) and send them over.

  17. I am one of the trans people this effects. I have been unemployed for over 5 years, have no medical insurance, and as a result cannot simply afford to get a prescription. This decision will likely cost me my life. I have no expectation that those who aren’t trans to understand the impact this has, both emotionally and physically. There are no equal rights, or equal protections for our class in the US. We are on our own to what we can afford to do ourselves. Much will be lost, time will only tell if anybody cares in the end.

    1. I wrote this originally in an anonymous account, but I feel that its probably better to have a name to it, and for the comment to get here faster. There are many, many, many domains currently that are the same place. I have no idea why they’re only shutting down one domain at a time, but is still shipping to the US, and I think fourcorners is also owned by them. And if those ever go down, there is still hope, its just harder to find.

      I’m able to get the hormones through insurance when I actually get on HRT, so I can’t tell you I’ve been in the position for it. But quite a few people I know have, and I do feel for you. But being unable to get things online is not a reason to give up, the alternatives are just a bit harder to find.

  18. I’m another (TS person) that this is going to screw over and quite seriously, too, as I was just about to place another order on androgen blockers that I am running low on. Adequate employment is already very difficult to find for Trans folk, let alone one with excellent insurance too.

    I have been ordering from Inhouse for years with NO problems. These are the same meds I was getting when I had insurance (and a prescription) at FAR LESS COST. Inhouse doesn’t supply addictive narcotics, counterfeits, or any crap that these shills for Big Pharma scream about. All my meds came from big pharmaceuticals in Germany or New Zealand nullifying the claims of meds coming from sketchy 3rd world countries. Also, that protecting US research costs and all that? BS, all of my meds have been around for many years and long since out of patent.

    I love the double talk from corporations and conservatives of “the free market” and their offshoring-that is the corporations can, but the people can’t.

    Between this, our total sell out on the health care debacle, and the probably right wing wins in the next elections courtesy of a backlash against Obama et al., I’m done…outta here, tired of being shit on by the puppet masters. Off to a country that actually protects and cares about THE PEOPLE and not corporate profits and the rich. Off to a country where the people aren’t total drones that just keep taking the punishment the power elite bestows upon them.

    Also, I just posted separately on how I have computer skills and would go back into the Army (because of my aforementioned lack of health insurance) if it weren’t for DADT. Yet another reason I just don’t feel very welcomed by the USA anymore.

  19. I am also an InHouse customer of long standing. They supply me with Motilium, a drug that has no hope of FDA approval, but that is the only effective treatment for my gastroparesis. Before my (US-based) doctor prescribed me this drug, I could not eat without pain and other, less pleasant side effects. I have relied on it ever since.

    I only wish there was some way of obtaining this legally in the United States. I would be thrilled to be able to buy it from my local pharmacy, but I can’t and now I’m not entirely sure what to do without it short of moving to a liquid or soft foods diet on a semi-permanent basis.

    What LegitScript can do for me is sod off and stop interfering with the medication I absolutely rely on to live and eat normally.

  20. So Chinese baby formula with plastic & lead dust that kills people is just a cost of business we have to live with but drugs made in the US and shipped to Canada and then back all without ever being opened are too dangerous?

    I’d be happy to outsource my entire government to Canada and sell our Congress to forced labor camps in China.

    1. I’d be happy to outsource my entire government to Canada and sell our Congress to forced labor camps in China.

      As what, feed? It takes a dozen people to get one of them dressed and presentable in the morning. They wouldn’t make very good workers.

  21. Yes, people will die. But LegitScript and the US drug companies will protect their ability to get the highest prices in the world, and to hell with the uninsured.

    There is also another issue here.

    If one man or one company can determine who will be blackballed from the Internet, there is a fundamental question of free speech.

    From the outset, most of the world suspected that ICANN was under the thumb of the US government. It turns out that is close to the truth.

    In the interest of full disclosure, I point out that John Horton of has told me he will sue me for defamation.

    My article and his reply can be found at:

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