State Seeks to Fine Online Pharmacy

In what probably would be the largest fine ever for illegal prescription drug sales over the Internet, California state regulators said Tuesday that they have proposed an $88.7-million fine against a Los Angeles pharmacy for selling medications directly to consumers without requiring a doctor’s examination.

The state Board of Pharmacy’s sanction against Los Angeles-based Total Remedy & Prescription Center II, pharmacist-in- charge and co-owner Barry Irvin and pharmacist William Packer must be approved by the 11-member state medical board. The fine amounts to the maximum $25,000 for each of about 3,500 prescriptions allegedly filled illegally.

The case represents the first use of a law passed in 2000 that requires a “good faith prior medical examination” by a doctor licensed in California before a prescription can be filled.

Irvin said the charges were “crazy, to say the least,” and came as a complete surprise.

“I’m just trying to maintain my normal routine,” he said in a telephone interview, adding that the prescriptions were legitimate.

He has 30 days to appeal the sanctions.

The pharmacy is operated at its Los Angeles location like any other drugstore, said Patricia Harris, executive officer of the California Board of Pharmacy.

Harris said the pharmacy’s operators also ran a Web site called CyberHealthServices.com that specialized in so-called lifestyle drugs such as Viagra for impotence, Propecia for hair loss and Xenical for weight loss. It is accused of filling prescriptions from out-of-state doctors who did not examine the patients.

State officials said the Web site was advertised mostly through unsolicited blanket e-mails. Harris added that the Web site also showed up on Web searches for Viagra and other drugs.

California officials were made aware of the site in 2001 by the Pennsylvania attorney general’s office, which was working on a case involving the Web site.

Pennsylvania officials told California officials that the building that handled the credit card calls and shipping was in Glendale, but it had moved, Harris said.

The medications were mailed in a professional fashion, in standard vials and accompanied by literature, Harris said.

That’s not always the case with Internet drug sales, according to the National Assn. of Boards of Pharmacy, a professional organization representing pharmacy boards in all 50 states. The association said Web sites and associated boiler room operations began proliferating five years ago.

Many are set up and dismantled within a matter of months or weeks and offer sales of all manner of drugs with minimal requirements and without a doctor’s advice, leaving consumers to self-medicate without any instruction.

“It scares the heck out of us,” said Carmen Catizone, executive director of the association.

Catizone recalled the recent story of a Florida woman who contacted an Internet drug sales site and asked for a medication to help her lose weight.

The woman was sent a powerful amphetamine called Didrex that quickly sent her blood pressure soaring. Catizone said the woman stopped taking the drug, but the Internet drug seller would not refund her money.

Catizone said the operators of such sites in the U.S. and overseas often mail unpackaged pills in an envelope or a plastic sandwich bag, without any information such as dosage, possible interactions or, sometimes, even the name of the drug.

The association maintains a Web site, www.nabp.net, with a link to its Verified Internet Pharmacy Practice Sites, which lists the pharmacy sites that meet its 17 criteria for trustworthy and safe service.

Harris said she was aware of a California case in which a woman received Prozac from another Web site and went into shock when she self-medicated.

When asked why a state law passed and signed in 2000 was only now being used to target a serious problem, Harris said the task was undertaken without a boost in her budget.

Harris said she had a staff of 55, about half of them field inspectors, to police the state’s pharmacies and Internet drug sales sites. She added that her offices “could always use more resources.”

“We have other irons in the fire now. We’re working on it,” Harris said.