This is the world we're living in right now.
Marilyn G. Hill, PharmDAn ad for Ozempic flashes across your computer screen. It says you can save hundreds of dollars and don’t need a prescription. What do you do?
The promise is probably too good to be true. Experts say there are between 30,000 and 40,000 active, illegal online pharmacies—and most belong to organized and international criminal networks.
Slick ads for high-cost, popular drugs dominate the internet, often giving the impression of legitimacy. These networks are persistent and endlessly adaptive, says Marilyn G. Hill, PharmD, ambulatory pharmacy manager at Dartmouth Health.
“As soon as the Food and Drug Administration shuts one of these websites down, another one pops up,” Hill says. “It’s really hard to control. Unfortunately, this is the world we're living in right now.”
That's why being vigilant about online pharmacy scams is crucial for your health, bank account and personal data.
“We’re in uncharted territory”
Before you order medicine online, beware of websites that offer deep discounts or advertise that you don’t need a prescription. Also, steer clear of ordering from websites or companies that send you unsolicited mail or emails offering cheap medicines.
Elizabeth A. Wade, PharmD, Dartmouth Health’s system director for Medication Safety, Quality and Compliance, says online pharmacy scams often target expensive prescriptions that are in high demand. The scams frequently advertise drugs that insurance plans don't cover.
Most illegal online pharmacies don’t require a prescription, either.
GLP-1 medications like Ozempic, Wegovy and Mounjaro are among the most common targets.
“When ordering from an illegal pharmacy, you could lose your money, give away personal information for identity theft or even receive something completely unsafe,” Wade says.
As an example, Wade says one patient ordered an injectable medication online that arrived in an unmarked plastic vial shipped from a residential address. After injecting the unknown substance, the patient suffered severe vomiting and needed emergency medical care.
Hill recalls another patient purchasing a nonexistent, fake “GLP-1 patch” advertised as a cheaper alternative to injectable Ozempic.
“We're in uncharted territory these days,” Hill says.
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Targeting drugs in high demand
Drug counterfeiting and online distribution are the largest forms of organized crime, representing $75 billion annually, according to the National Association of Boards of Pharmacy (NABP).
Wade points out that nearly a quarter of Americans who have used an online pharmacy have been exposed to counterfeit or low-quality drugs.
Being the victim of an online pharmacy scam isn’t a problem limited to older adults or people unfamiliar with technology. Anyone struggling to afford a high-cost medication—or simply searching for a better price—can be vulnerable.
And the trend extends beyond GLP-1 medications. Scam sites frequently target any drug with high demand, high price or high potential for misuse.
That includes medications for HIV, fertility treatments, injectable hormones, erectile dysfunction drugs, opioids, pain management and medicines for substance-use treatment.
“People are in this coverage gap. They’re taking something like a weight loss drug, getting good outcomes, and want to continue, but they can’t afford it,” Hill says. “And unfortunately, they are looking at every possible option to keep taking the medication.”
How to stay safe
Our experts agree that the best defense against fake pharmacies is awareness and asking questions.
Check accreditation and website
Organizations like the NABP or URAC will accredit any legitimate online pharmacy. If a pharmacy lacks URAC or NABP accreditation, avoid it altogether.
You can also visit Safe.Pharmacy, part of NABP’s Buy Safely tool, to learn whether a pharmacy website is “safe” or “not recommended.”
Consult your clinician or pharmacist
Before buying any medication from an unfamiliar source, ask a trusted healthcare provider first. They can tell you whether the product is legitimate, safe or even medically-appropriate.
If affordability is an issue, talk to your healthcare provider.
You need a prescription
A real pharmacy will require a prescription for medication.
Experts also say to stick with well-known, reputable brick-and-mortar pharmacies. These pharmacies work closely with your healthcare team, maintain records and follow strict safety standards.
Report suspicious activity
Wade urges consumers not to use any medication that arrives from an unverified source.
If you receive medication from an unknown source, file a report with the NABP or U.S. Drug Enforcement Administration (DEA).
Not worth the risk
Hill recommends that you consider your own well-being before ordering medication. Sourcing questionable medication is never worth the risk, she says.
“How much of your healthcare are you willing to farm out to an unknown resource?” she says. “You don’t want to sacrifice quality, especially when it comes to your health.”
Resources + Related Stories
National Association of Boards of Pharmacy
