Rogue pharmacy

Dangers lurk online for those purchasing unlicensed medication

Before purchasing medicine, consumers should consult a doctor or pharmacist. Photo courtesy of Thonburi Hospital

The internet these days is drowned in ads. Many of them involve convincing promotional messages urging consumers to buy medication imported from countries like Japan and South Korea.

"I was seriously constipated. I had to take three to four laxative pills, so I could go number two, but those pills caused me to cramp. After I found this Japanese laxative, I was happy. Only one pill before bedtime. No more cramp," wrote one internet user.

"Highly recommended! Lots of Koreans use this medicine to treat pimples which can reduce it very fast and leave no scars. I have tried it for a couple weeks and it is great. It can reduce the pimple's size as well as remove the scars. This medicine is very popular. Many Korean beauty vloggers reviewed it," reads another message.

Promotional messages for medication from Japan and South Korea are all over the web, with many people interested in an online purchase. With various kinds of medicine available including flatulence and laxative medicines, diet pills and eye drops, it is worth asking: are these medications trustworthy?

While these medicinal products are usually accompanied by user reviews that can somehow be useful for consumers, buying medicine from sources on the internet needs extra scrutiny given medicine-related errors can result in death. Under Section 19 of the Drug Act 1967, the law cites that medicine isn't general merchandise. To purchase medicine, buyers must receive advice from medical professionals. The medicine cannot be sold outside any premises without a license. The person who violates the law is subject to a fine of no more than 10,000 baht or five years imprisonment.

"According to Section 88 and 89 or the Drug Act 1967, medicine can't be advertised; except for household remedies, which requires permission to advertise from the Bureau of Drug Control under the Food and Drug Administration [FDA]. Medicine review is similar to advertisement, which is a wrongdoing," said the secretary-general of Foundation for Consumers (FFC) Saree Aongsomwang.

"Some diet pills that are dietary supplements can obtain permission to advertise. However, since they aren't medicine, their advertisements can't include therapeutic properties as in being capable of curing, treating or preventing diseases or symptoms like medicine. For instance, a dietary supplement can't claim that it cures diabetes or high blood pressure."

Some medicines sold online in Thailand are available over-the-counter in Japan or South Korea. However, when they are imported to the Kingdom for selling, every medication must be registered under the FDA for safety reasons. Imported medicine without a registration number is an illegal product. The only exception is for personal use in only 30 days.

"The medicine review also violates Section 14 of the Computer Crime Act 2007 because the review is considered as false online information," Saree added.

Employees stock shelves at a Walgreens Boots Alliance Inc. store in Elmwood Park, Illinois, U.S., on Tuesday, April 5, 2016. Walgreens Boots Alliance Inc.'s cost-cutting measures helped the drugstore chain beat analysts' earnings estimates for the fiscal second quarter. Photographer: Christopher Dilts/Bloomberg Christopher Dilts

Messages circulated online are powerful. Many people believe them when they see lots of likes or retweets on the posts or the messages are shared by people they trust. On Twitter, it is worse because many accounts use fake photos for their profiles and are unidentified, but followers aren't aware that they risk their lives trying medicines recommended by unknown persons.

"Consumers should believe in the precautionary principle because the worst result of believing in medicine reviews is death. Another negative result is to lose money. If you buy [unregistered] medicines from other countries, you can't be sure they are legal. Medicines can affect your health. As the precautionary principle, you shouldn't buy them," Saree warned.

Sophid Khumchat, pharmacist and manager of the Pharmacy Division at Phyathai 2 Hospital, echoed the same viewpoint.

"Despite a positive review, if consumers don't know details of its substances and haven't received advice from medical professionals, I don't recommend anyone to take those medicines at all. When a patient came to the hospital after having a serious allergy [from an online medicine], it was difficult to verify ingredients because the medicine wasn't registered in the country. If the medicine is sold from a quality drugstore or a hospital here, we can track and find out the ingredients easily. Some medicines from abroad are safe to use, but not everyone can use them. Each patient is different," she said.

Merchandise from developed countries are trusted by most Thai people because they are thought to be better quality than local products. With this in mind, some Thais believe medicine from Japan and South Korea meets higher standards.

"It is a myth. Not all merchandise produced by these countries is better than ours. Many Korean companies hire Thai companies to manufacture their cosmetics. To meet standards, we must look through materials, cleanliness and quality of factories," Saree said.

"Every country has a central organisation to ensure the effectiveness and safety of products before registration numbers are issued. However, if we order medicine online, there is no guarantee that the medicine is registered. When it comes to medicine, let doctors decide whether we need to use it or not," the pharmacist advised.

Not everyone listens to warnings from medical professionals though. After taking an unregistered medicine from overseas and having an allergy, what can a person do?

"You must go see a doctor and bring the product with you, so we can analyse what's inside the pills," Sophid recommended.

Saree added that if we buy any unregistered medicine from sellers in Asean countries, we can fill out complaints at the Office of the Consumer Protection Board (OCPB) and they will co-ordinate with the OCPB in Asean. Beyond Asean, however, it is difficult to proceed.

"Thai law is different from France's Consumer Protection Law. French people can sue companies overseas if they don't receive safety services," Saree explained, citing an example of the French court, which recently fined the former CEO of One Two Go Airlines to compensate a French passenger over the aeroplane crash in Phuket.

However, if we know foreign languages, it is possible to receive compensation. We have to fill out the complaint ourselves and send it to a consumer protection organisation abroad.

"You must see a doctor to get a medical certificate reporting your problems from using the medicine. Go to a police station to get a police blotter including details of how and where you purchased the product. Get the name of the entrepreneur. And keep all records about purchasing."

So what kind of medicine is safe and legal to purchase from an overseas company?

"It is fine to purchase dietary supplements, but I don't recommend purchasing medicine from overseas. If you want to buy any medicine, please bring a sample of that medicine to consult with a doctor or a pharmacist before taking it. We have had patients who had diabetes or heart disease who wanted to take medicine recommended by their friends. They consulted with us to see if there were any interactions with their regular medicine or if it would trouble their congenital diseases. As long as the medicine was safe, they could take it," Sophid said.

Saree agreed that medicines shouldn't be a gift from overseas.

"Consumers should bear in mind to use medicine only when necessary. Every medicine has side effects, more or less," Saree said.