Insider Tips to Consider Before Using an Online Pharmacy


Searching for a pharmacy has become increasingly difficult with many new ways to obtain your medication, weeding through the scam and legitimate pharmacies have become an increasingly prevalent matter. I’ve compiled a list of online pharmacies that I have verified are legitimate and trustworthy. If you want to find out the requirements necessary to make the list then keep reading.

What is an online Pharmacy?

Today people are searching for the cheapest opportunity, and prescription medication is no exception. Along with everything else becoming more accessible to purchase online, companies selling and distributing medicine has also taken the internet by storm.

Online pharmacies are companies that supply medication through internet-based services. These companies can be legitimate, like Healthwarehouse.com, or non-legitimate sites. With companies able to open and lure new customers from the flashing appeal of extremely cheap prices, being able to find trusted companies is of utmost importance.

These sites are appealing to cash-paying patients or people who require cheaper medication. Most likely your insurance is not going to cover utilizing these online pharmacies unless it is the mail order pharmacy owned and operated by your prescription insurance processor.

Some of the legitimate online pharmacy sites allow for specialized patient-specific needs like women’s health or men’s health. Which can be huge for someone who is in an area where they usually would not have access to such resources.

The NABP working with the FDA have helped to screen and regulate companies and offer comprehensive lists of who to use and trust, as well as clues to look for when deciding where to spend your hard-earned cash.

Tools to use to identify a legitimate online pharmacy

Detecting a legitimate pharmacy is a daunting task, compiled throughout this article are the tools to pick out the good from the bad. Some key takeaways include utilizing the National Association of Boards of Pharmacy (NABP) and the Food and Drug Administration (FDA) websites to find regulated vs. unregulated online pharmacies, and to assess what makes illegal sites stand out. The recommendations include using websites with the .pharmacy domain, and the VIPPS Seal or BeSafeRx for tips.

Beware of super low prices

Cheap online prices can lure you in, but beware that non-legitimate sites have the potential to lead to many issues. Many times they can provide medication that is unregulated, so the certainty of knowing what exactly is in the pill you received becomes a mystery.

Quick summary guide to identifying the legitimacy of an online pharmacy

With the impending need to figure out which pharmacies online are real regulated pharmacies, the NABP and FDA have cracked down on what to look for. Listed below are the quick and short rundown of information needed to pick out real entrusted online pharmacies.

NABP recommends

  • Sites that have a .pharmacy domain
  • Look for the Verified Internet Pharmacy Practice Sites Seal (VIPPS Seal)
  • Avoid websites that:
    • Do not require a prescription for prescription medication
    • Dispense foreign or unapproved medication
    • Fail to meet state, federal law or NABP standards

FDA recommends

  • Website provides a street address based in the U.S.
  • Licensed by your state board of pharmacy or equivalent agency
  • Ability to speak with a state licensed pharmacist
  • Use BeSafeRx tips
  • Avoid websites that:
    • Do not require a prescription for prescription medication
    • Unable to talk with or have questions answered by a state-licensed pharmacist
    • Low prices that are too good to be true
    • Ship worldwide or are based outside the U.S.
    • Cheap medicine offered through an unsolicited email or spam mail

Using an online pharmacy

  • An alternative to using insurance (if a pharmacy is associated with your insurance this is another route that may be used)
    • Many sites have easy online account setups
    • Some can also be set up over the phone
    • Need a valid prescription or refills remaining
    • Pharmacist from online site
      • Needs to transfer from current pharmacy
      • Physician must send or call in new prescription 
    • A lot of websites offer different specialty benefits
      • Can cater what site to use based on your specific needs
    • Most legitimate sites deliver right to your mailbox

Find out if my #1 Recommended Online Pharmacy Healthwarehouse.com can save you considerable money on your medications and find out just how easy it is.

As of December 2017, the NABP has analyzed 11,749 internet pharmacies to find that 95.7% of their online websites they have reviewed were “rogue” websites. These websites were not meeting necessary laws, patient safety, and practice standards. The guidelines the NABP puts forward are required to make sure the site you are using is one you can trust.

NABP study screening online pharmacies:

To understand NABP and their role in screening online pharmacies the next section goes in-depth into the tools they use and each of their importance. Using this information can help to solidify that you are on a site that meets necessary standards to keep you and your data safe.

What exactly is the NABP and what is its role in medication regulation?

The NABP is an independent entity which is trusted by the FDA. They help to ensure proper licensure of pharmacists and pharmacies and help to protect the public through their regulatory programs and member board that includes 8 districts of all 50 states.

The NABP has a hand in many accreditations, including medical equipment, and wholesale distribution facilities. Their VAWD(Verified-Accredited Wholesale Distribution) program is a program they use to regulated pharmacy distribution centers. They utilize this program to make sure facilities are within good standing, so the medication you receive is ensured to be in the best possible form.

They also cover the two programs discussed earlier, the .pharmacy, and VIPPS Seal of a secure site. Each of these options helps to ensure that the online pharmacy you are using is a legitimate choice.

The .pharmacy domain:

The .pharmacy domain is a critical distinguishing feature that can clue you into whether this is an excellent website to use. The NABP ensures the pharmacy is able to use the .pharmacy domain name, are legitimate websites with proper licensures, and that follow all applicable laws.

The .pharmacy is the pharmacy equivalent of .com or .net.. This gives a clue that it is a website NABP deems to have quality and that certain standards are upheld. Only pharmacies that are approved by NABP can use this specific domain.

Once the website has received approval through NABP, they add the pharmacy to their lists of verified .pharmacy sites. These include pharmacy websites in the U.S., Canada and United Kingdom.

The website also lists veterinary pharmacy’s sites that meet their criteria. Also, they provide a list of Boards of Pharmacy, associations, and consumer advocacy groups that they have deemed establishing acceptable practice and legitimacy. 

To obtain this .pharmacy credibility, they must meet a specific set of policy’s, standards and fees. So they must keep up with many of the laws your local pharmacy has to follow. These websites must renew every year ensuring that they’re keeping their credentials up to date. Which is super essential for you the consumer!

The company must pay a $975 per website application fee to NABP, with additional charges varying. Each year they must reapply and pay this fee to ensure they are compliant with all requirements.

Keep in mind the .pharmacy is not always visible in the URL but there should be a symbol visible on the site that links to the verified sites on NABP. Also to find legitimate sites googling .pharmacy can lead to some, but remember to cross-check them!

.Pharmacy Program Standards include all of the following:


Just like your local pharmacy these websites must apply through the NABP and follow ALL the above credentials to use the .pharmacy domain. So if you are thinking about using a pharmacy that is not one of the .pharmacy approved sites, they could be meeting none of these requirements. This leaves a lot up in the air as far as what you are receiving and what happens to your personal information.

Websites that meet these requirements mean that you are able to utilize their services with ease of mind that they must follow the necessary guidelines. This can make sure that the medication you are receiving is accurate and held to high standards.

VIPPS Seal:

This is the next step for verifying the legitimacy after the .pharmacy domain. Online pharmacies must first receive the .pharmacy domain before pursuing this credential.

Additional qualifications to obtain VIPPSaccreditation:


The VIPPS seal allows you to be sure that the website you are using to obtain life-sustaining medication is a trusted site. So even further this is an extra check in determining the legitimacy of an online pharmacy. Keep in mind like everything companies can claim false credentials so it is essential to double check the website through the NABP trusted sites list.

NABP lists the websites that have the VIPPS Seal to ensure that they are a legitimate online pharmacy. To verify the NABP website list or when you are on a site the link should take you to the NABP list where you can make sure the website matches precisely to what they have listed.

The pie graph highlights how slim the options are for regulated online pharmacies. There are even smaller options for websites that obtain the VIPPS Seal.

What exactly is the FDA’s Role in regulating these online sites?

The FDA spells out similar warnings to the NABP website regarding these online sites. They indeed reiterate key points like being wary if they offer to send you medication without a prescription, sell too good to be true prices on medication, and/or are located outside of the US.

The FDA also warns against using sites from another country as they do not have jurisdiction over these medications. Thus leaving the ability to receive medication that varies from the US’s medication which can ultimately lead to different therapeutic outcomes.

The FDA sponsors the campaign BeSafeRxwhich works to bring to light the dangers of using fake online pharmacies. The campaign is an outreach to people who are looking to use online pharmacies, either from lack of health insurance, ease of use or an attempt at a cheaper deal. The point is to ensure the medication received is regulated and controlled.

With the FDA’s role in medication quality, it is essential to use the tools they offer to ensure that the medication you are taking is accurate in achieving your individual health goals. The FDA reiterates that it is essential to be taking medication that is up to the standards they expect and ensure what they regulate is consistent and precise.

The FDA also has links to each state’s licensing page to verify that the pharmacy or pharmacists you are trying to use are a valid option. They ultimately want to steer away from sites that are unregulated and therefore unable to be proven that they provide quality medication.

They have a list accessible on their website of illegitimate online websites that they have sent warning letters to. The warning letter to each site can be viewed to see what they were in violation of. They also allow the option to report illegal sites or any contact you have had with them.

How to verify that an online pharmacy is a legitimate online pharmacy vs. a fake online pharmacy

Look for these key images! But be sure to cross-check they are real through the NABP website list:

Dangers of choosing a scam online pharmacy

What if someone came up to you on the street and offered you medication? Would you take it? Most people would say probably not. What if the bottle they offered was labeled? Would you be any more inclined to accept it?

Well, that’s what you’re signing up for when you go to these cheap unregulated medication websites. There is no way to really know what the medication is. So why then are we so trusting when we’re behind our computer or phone screens?

The allure of finding the medication that you needed cheaper is one way the websites draw patients in. But I think deeper within we have become so accustomed to purchasing items online. So why should medication be any different?

Fortunately, medication is regulated in the US for a reason. Medicine is so complex, its effects on the body, side effects, how long they take to work, where they work, when to take them, are just some things to consider. These are necessary things that you may not account for, but your physician or pharmacist does.

When going to these scam online pharmacies, you are not only losing out on money, but you are also putting your health at risk. Being unaware of the ingredients, ordering medication without a prescription, and putting your patient information on the line are all huge decisions that should not be taken lightly.

Pharmacist and patient interaction are important. When these sites lack this, they are creating a huge deficit. Taking medication safely and correctly is essential to ensure your medicine is therapeutic or doing its job. 

All aspects of the healthcare field deal with HIPPA and privacy laws. They work to make sure that your information is protected and secure. When using these rogue websites, it is hard to know where your data is going or what it is being used for. With a lack of guidelines in place for these sites, there is no way to know.

With a lack of quality control, even with the slight chance that what you are receiving is legitimate, you have no idea what conditions the medication has been subject to. Medicine is fussy, and can breakdown when it is subjected to unstable elements. Ultimately leading to an unstable or ineffective medicine.

What it comes down to is that purchasing medication from random websites can lead to you receiving medication that can be harmful. Not knowing what is in what you are taking, whether it’s too little of the drug, too much of the drug or even nothing to do with the intended drug, is a cause for concern.

Using mail order as an alternative

If you are looking for convenience and the ability to use your insurance when trying to obtain your medication, mail order might be a great option. This, as opposed to the other online pharmacy sites, allows you to use your insurance to purchase your medication and ensures you will receive your medication safety. If you have access to mail-order services through insurance, either contact your insurance or look online at their website to see how to set it up.

Similarly, the legitimate online pharmacy sites require a prescription sent from your prescriber or available refills that they can transfer to their facility. Once your prescription is obtained by the mail-order pharmacy, it is input by technicians, check against other medications and undergoes thorough analysis before it is reviewed by the pharmacist and the order ultimately is sent to the distribution center.

The mail-order services sometimes have extra steps that they include when looking at prescriptions. For example, they have employees dedicated to checking allergies; if a patient is gluten-free, they have an entire notebook of every component of each medication that contains gluten. The companies are thorough to ensure their percentage of mistakes are not surpassing a certain threshold.

For these mail order companies to function and be able to dispense prescriptions they must meet necessary requirements. The companies must comply with their state location laws, as well as, any state’s location they are providing services to.

Many qualities mail-order pharmacies have to offer are a factor of their mass amount of resources working together. They supply a lot of manpower to check, double check, then check some more that everything is in order.

Canadian online pharmacies and importation

Canadian online websites can be verified through CIPA (Certified Canadian International Pharmacy), an association that licenses retail pharmacies.  CIPA certified companies are ensured to sell quality Canadian medication. CIPA also works internationally with companies and distribution centers to supply drugs to patients directly to their home.

CIPA certified companies require:

The CIPA association has accepted and attached their seal to 68 pharmacies. The legitimate online pharmacies must meet CIPA required standards to receive this seal. Their website features the ability to type in a domain to verify its legitimacy or the ability to see the full list of their accredited pharmacies.  

The NABP analyzed over 100 online pharmacies, and the outcome was that nearly 2/3 of the pharmacies were illegitimate. 76% of the 108 pharmacies were outsourcing medication from outside of Canada. Below is a table that shows the percentage of the Canadian pharmacies falling into each category.

With these occurrences, it goes to show that patients could be receiving medication that is dissimilar to the regulated medicines from their local Canadian pharmacies. Ordering from one of these companies can lead to sub-therapeutic outcomes or even dangerous side effects.

The CIPA registered companies can list medication prices depending on what medication you are looking for. Below is a chart of a common medication comparing each price they offer and for how many tablets.

Price comparison chart of Atorvastatin 20 mg:

CountryPharmacyQuantity
of
Tablets

PricePrice
per
Tablet
CANBlue Sky Drugs84$34$0.40
CANMaple Leaf Meds84$54$0.64
USAHealthwarehouse90$18$0.20
USAWalmart90$24$0.27

This is an example of one medication’s pricing options. Ultimately each medication can differ so it is important to find out what the best options are for you. It is best to shop around and analyze the cheapest options. Keep in mind there is not a hug difference between all four of the prices, and one of the local grocery chains has the better option.

Utilizing the services at your local pharmacy is something to look into as they may have cheaper medication options or ideas to help you receive your medications.  

The FDA still warns against using Canadian pharmacies as they are out of their jurisdiction of regulation. They prefer that should you decided to use online pharmacy services to stick to the NABP and FDA approved sites.

If a Drug is approved for use in another country, and it is not something that has been approved or can be resold in the US, it is illegal for you to import it. However, the FDA does allow for some exceptions for importing medications. They include:

  • Drugs that are an effective treatment for a serious condition
  • If the drug does not pose an unreasonable risk
  • Person cannot promote or sell the drug to other U.S. residents (personal use only)
  • Not more than a 3-month supply
  • Written verification that the medication is for their own use
    • Includes physician information prescribing the product
    • The product is used to continue medication treatment that had previously begun in a foreign country

Using online pharmacies legally vs. illegally

So how do you know what line not to cross in the legality of an online pharmacy? Legally you must have a valid prescription to receive prescription medication. Makes sense. The medication you are ordering must not be something that is illegal or unavailable in the US. As the FDA cannot approve the use of a drug it has not assessed.

So for best legal use stick to sites that are credentialed by the NABP and FDA to ensure what you a receiving is correct and accurate. Receive medication from a verified pharmacy whether it’s local or online.

If you want to utilize a mail service double check through your insurance to see if that is a possibility. If you wish to lower your cash price costs the best way to find the best deal is to shop around. Check local pharmacies or online discount websites such as Blink Health which allow you to receive a significant discounted cash price on many medications.

It is important to take medication that is legal in the US, drugs are widely assessed and regulated, and that should not be taken lightly.

Controlled substances and online pharmacies

With the ongoing opioid epidemic, online websites offer discounted and easy to obtain controlled and narcotic medications. From these sites most of the time these medications are not what they seem and can be something far more deadly.

The NABP evaluated 100 websites during 2017 and the results show 100% of the pharmacy websites they assessed were operating illegally. Each category breakdown shows how many pharmacies were meeting these illegal categories.

If anything, this goes to show that these sites are not worth the risk. They offer fake medications that could potentially be counterfeit, sub-therapeutic or even possibly laced with something far worse.

During the study, NABP also analyzed usually faked controlled substances that were being sold through the websites. With most of them offering some type of combination of the medications.

Medications Percentage
Xanax 45%
Percocet 3%
Oxycodone, Xanax 10%
Oxycodone, Percocet, Xanax 23%
Oxycodone, Percocet 3%
Oxycodone 8%
Norco, Oxycodone, Percocet, Xanax 5%
Fentanyl, Oxycodone, Percocet, Xanax 3%
Fentanyl, Norco, Oxycodone, Percocet, Xanax 3%

With the ever-growing numbers of overdoses due to opioids, giving people easy access to obtain these medications is fatal. They are things that need to be monitored and adjusted by a qualified physician. When purchasing these medications online just like any medication from an illegal site, there can be dire consequences when taking something you are not 100% sure is what it claims to be.

Stay safe when choosing an online pharmacy.

With the ever-growing opportunity for new rogue online pharmacies with the ability to pop up at a moments notice. It is essential to look for crucial distinguishing features to keep your health and privacy safe. The NABP and FDA work hand in hand to ensure the medication you receive is something that meets a certain required standard. If your ultimate goal is to save some cash, be sure to contact your local pharmacy or use legitimate online pharmacies to do your business.

Check out my list of online pharmacies that I trust and have verified are legitimate.

TheFrugalPharmacist

As a practicing community pharmacist in his home state of Michigan, Joe (AKA TheFrugalPharmacist) is always on the lookout for new information and ways to ensure you can afford your medications and don't get ripped off in America's complicated world of healthcare.

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