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October 28, 2012

Health and Influence of Online Medications Essay

The Influence of Online Medications on Consumer Health and Habits

     The network and connectivity between pharmacies, prescriptions, doctors, pharmaceutical companies and drugs has always shared a highly intertwined and symbiotic relationship with each other and with the passage of time the relationship between all these components and agents has turned increasingly commercialized and financially oriented. The nexus that all these forces are constituents of have always had a profound influence as far as the health and its related issues from a consumer perspective are concerned, but with increasing percentages of influxing revenues coupled with the advent of the technological renaissance the entire concept of medications and its influence on consumer health and habits has adopted a completely different route of methodological implementation. Through the help of this discussion paper we will be shedding light on numerous such factors which have played a pivotal role in enhancing, jeopardizing and altering the existing relationship along with the intervention of major stakeholders which have kingpin importance in dictating the change in the rules and regulations of the entire scenario.
Executive Summary
The paper by means of establishing a discussion platform will be highlighting some of the key aspects that have changed in the pharmaceutical industry that have subsequently induced a resultant change in the behavior of consumers and in their respective health habits. The emergence and inflation of computer mediated pharmaceutics bubble will also be analyzed from multitude perspectives and the regulations that some developed countries have imposed in the functioning of such mechanisms, along to the extent they are implemented. The implications on health from medicines purchased from online pharmacies and the efforts invested by some of the key players of the entire industry who make all possible endeavors to pursue their policies for safeguarding their own vested interests.

Crime by means of the Internet

The right to privacy-to various extents-is guaranteed by the law. The best-known legal basis for claims to privacy is contained in the Fourth Amendment of the United States Constitution. The Fourth Amendment protects U.S. citizens from, “unreasonable searches and seizures…. Of person, house, papers, and effects” (Bill of Rights). After the advent of Computer and electronic communications, United States government had also announced Electronic Communication Privacy Act (1986). This law provides privacy protection to communication involving new forms of technology. In particular, this legislation clearly identifies electronic mail and makes it a Federal crime to intercept these computer-based transmissions.
Security is always one of the most important concerns in the use of computers. Computers do not invade anybody’s privacy- people do. And because computer systems are designed to be user friendly, it may not be unauthorized people to get access to personal data. People must be able to protect their computer files and limit file access only to authorized users. Companies do not like the idea of giving privacy choices to their clients. They consider it a threat to their influence on customer’s data. Analyst of Meridien Research Inc.
On November 2001 Harris Interactive for Privacy and American Business had conducted a survey titled, “Privacy On and Off the Internet. What Consumers want”, on the privacy issues of online business. Results of the survey revealed that 75 percent of consumers are concerned about the safety of their privacy; 70 percent thought that their transactions are not safe; 69 percent are worried that hackers can steal their confidential information. Kristin Valente, Earnest & Young’s innovative assurance partner said, “One of the things that surprised me the most is the way consumers reacted to suspicion of mistreatment of personal information. It’s a one strike and you are out policy with consumers. There was really very little that they indicated companies can do once you’ve lost their consumers trust, although trust can be built with independent verification. But you have a long row to hoe to get back the trust and confidence of the consumer if you make a mistake.
The concept and Emergence of Online Pharmacies
     Before understanding the dynamics of online pharmacies it is important to have and develop an understanding of online pharmacies. Online pharmacies which are also known as internet pharmacies provide medicine to people by making use of the technological facility and computer mediated environment provided by the internet in order to avoid the consumption of time and saving of medical expense by visiting a doctor as in many of the developed states where this concept is being practiced on a massive scale the medical expenses are not in the range of affordability of every citizen.
With the progress of time the concept and idea of internet pharmacies has proliferated at a rampant pace across the entire world and now many of the developing states have also commenced to practice and extract benefits from such conveniences at public level.  While many of the internet based pharmacies sell prescription based drugs, there are also many of them who do not require or demand any prescription of any doctor before the purchase of any drug. (Carter, 2009)
A simple reason behind this is that in many of the countries such as that of the developing category pharmacies do not ask for a doctor written prescription before selling the drug even for some drugs that are supplied under restricted limitations. Despite the fact that in many of the cases the advent of electronic commerce has played an instrumental role in bolstering the businesses of the pharmaceutical industries, there are also a number of cons and don’ts that are associated with the entire process, the most common being the adverse impact that these non-prescribed and counterfeiting drugs can have on the health of the consumer. Even in the recently published report by the United Nations it has been acknowledged that the mass level circulation of dangerous drugs without any prescription is an issue of immense gravity, it further admitted that the convenient availability of such drugs comprehensibly manifests the undermining of the regulatory mechanism that have been legislated by many of the countries.
In countries like United States where medical expenditure and drug prescriptions are very expensive many people prefer referring to online means of getting hold of the drug they want. It would be a misperception to declare that all of the websites involved in this business sell drugs without any prescription; there are many of them who have employed an in-house physician staff that recommend drugs after thoroughly assessing the medication program. However such an exercise by the websites is viewed as potentially more hazardous and dangerous by many health experts who say that the buyer is completely unaware about the background of the person he is purchasing a medicine from. Any person who has no idea about drugs, medicines and health can recommend any tom, dick or harry kind of medicine and the patient because of his inadequate medical knowledge will not be able to contradict him in any way. (Buttner, Schulz and Silberer, 2005)
Medical facilities and the US Consumer
One of the major reasons as a result of which such prospects have found substantial room for accommodation in developed countries like the US is the inaccessibility towards adequate and well-equipped medical benefits and hence these consumers clinch their hopes towards other sources from where they can get hold of cheap medications, irrespective of the fact as to where they are actually coming from. According to a report that was published in Washington Post, many US citizens look forward towards Mexico in search and acquisition of bargain drugs which inflows from other countries like South Africa, India and Canada also. Out of all these, Canada is the most viable option available due to geographical proximity thus facilitating vast inflow of medications into the US border and is highly attractive options for consumers due to their cheap prices.
It is also worth mentioning here that some of US legislators also advocate the idea of providing access to the flow of foreign drugs into the US territory as it can play a vital role in lowering the cost domestically available drugs in the local market, thus facilitating the affordability range of consumers and lowering their dependency on online counterfeiting prescriptions. These results were later vindicated in an opinion poll that was conducted by Wall Street Journal in which over 80% of American population supported the idea of purchasing drugs from Canadian pharmaceutical companies and it is therefore the current government is taking serious steps in order to refurbish the health sector in order to facilitate the purchase of drugs and other medications within the reach of all people.
The government at the same time is also concentrating to take cohesive measures to slash down the astronomical revenues being registered by internet pharmacies involved in fraudulent sales as their profit margins are anticipated to reach $75billion in the present year.
Another key reason which has acted as a driving force for consumers to move towards internet available prospects of medications has been the economic downturn that the US economy has recently witnessed. When the financial recession struck the US market with tremendous impetus in the mid of the year 2007 stock markets nosedived, investor credibility eroded, mortgage and banks began to show signs of insolvency pushing the government to intervene and rescue them from absolute bankruptcy by releasing gigantic stimulus packages for their economic rejuvenation.
In order to streamline and weather the rampage created by the financial meltdown one of the earliest reforms taken by organizations was to cut their expenditures in the form of axing their employees and from there onwards began a massive campaign of unemployment which seems tedious to handle up to this day. Employees losing their jobs did not possess the financial capacity of paying government taxes, let alone taking benefits from the expensive health programs and doctor fees and it was precisely the opportunity internet pharmacies were looking to attract more customers and consumers.
It is important to notify here that since US lacks a national or government supported health scheme or program, the bulk of the investment made into the health sector comes from the private sector organizations, these organizations in turn provide health coverage and benefits only to the permanent staff of the company rather than prioritizing the poorer or the part-time temporary staff which remains completely deprived from availing the benefits of medical insurance. According to the statistics that were presented by the US census bureau it was estimated that over 15.4% of the US population or 46.3 million people of the country did not have any right to carry out their medical treatments as they were not insured. It is basically the lower middle class or the poor faction of the society that was greatly affected by the incentives offered to them by internet pharmacies. The rising fees to doctors, surging medical expenses and drug prescription all collectively converge to catalyze the process of self-medication that has risen remarkably in recent years among the American citizens. (Lewis, 2005)
Laws and Regulations regarding Internet Pharmacy and Consumer Behavior
     In order to curb the inflow of illegal or illicit drugs in the country the government of US has formulated a number of rules and regulations which have helped them in order to prevent such an activity especially in a sector which is directly concerned with the life or death of an individual. As mentioned earlier US has been taking serious measures to explore import of legitimized drugs and medications from Canada and other European markets mainly with the prospect of providing these drugs and medicines to consumers at a cost where it is easily affordable for a majority of them. Even though importing drugs from these countries leads to the violation of the regulations of the Food and Drug Administration (FDA), it is the international drug suppliers that extract larger chunk of advantage from such trading exercises rather than the consumers.
Many of these low-cost medications are purchased from countries like Mexico and Canada. As far as the international consumers are concerned which include many of the developing countries like India, Pakistan and Philippines they have to pay higher prices for the purchase of medications and many of their international consumers purchase these drugs from online pharmacies some of which offer a prescription while others do not. Some of the internet pharmacy sources which do not demand a prescription advice the consumer to fill out a particular questionnaire along with the drug that they intend to purchase. It is also important to mention here that some of the highly notable and reputed pharmaceutical organizations such as Pfizer, Wyeth and Roche are also included among the major stakeholders that extract considerable revenue from such business.
As far as the United Kingdom is concerned it has been estimated that over 2 million people of the country purchase drugs on regular basis from legitimately created internet pharmacies. It is also interesting to say here that the first internet pharmacy in the country was formed in the year 1999 with support and backing from the British government of that time. Many of the drugs and medications that are prescribed by these internet pharmacies include drugs which are not used in severe circumstances or for life saving purposes but rather encompasses diseases such as abdominal disorders for which a prescription is not provided by doctors mostly. In addition to this in most of the circumstances where internet pharmacies are involved it is legal in United Kingdom for doctors to have affiliations related to consultancy and prescription matters with many of these websites. But it is important for the doctor to be associated with the Care Quality Commission before he can make any such recommendations and even when all these obligations are fulfilled the doctor is only allowed to provide consultancy for a limited number of drugs and medicines.
Relation between Consumer, Medicine and Pharmaceutical Companies
     It has been a popular belief that any prescription made by doctor to the patient is as important, sacred and divine as if it was something written in the Bible or a religious obligation. This is the certain power feeling related with the image of a doctor that actually plays a major role in tailoring and subsequently diverting their commercial interests in case of medicine and pharmaceutical business.
A system that was once monitored and regulated under the most stringent rules and regulations has fallen as an easy prey in the hands of a dangerous mafia that intends to rattle the foundation of a transparently incorporated system in the country previously.

Conveniences of online medications and operations against such websites  
     The consumer is provided a number of benefits when purchasing drugs through online means. These conveniences include cheap costs, privacy or anonymity when purchasing a drug that may not be available easily at a local pharmacy store or without a prescription, convenience factor is also involved as there is no time consuming process involved and medical information that is provided some of the online pharmacies about the medicine they are selling.
     With the rise of counterfeiting and rogue internet medications that have risen to new heights in many countries, many policies have been taken to increase awareness at public level regarding the activities that many of these websites are involved in. One of the steps taken mainly from looming consumer pressure has been to lower drug prices all over the country to increase consumer affordability. Moreover many drug stores and pharmacies are also involved in playing a proactive role in reshaping consumer health by effectively responding to their health niche and stocking medicines that can cheaply be provided to consumers along with superior quality. Since the number of casualties from online pharmacies began to augment, an operation was mandatory to halt their increasing number in the country and defamation of this kind of commercial activity was necessary to bring people back to the conventional method of medicine purchase and with all such efforts betterment has resulted from the picture presented in the past when compared in the present and if efforts like these are periodically introduced and enforced forecast for future can also be optimistic.   
The system is challenged by a powerful lobby of stakeholders which comprises a powerful and vicious nexus of pharmaceutical companies, felons and rogue internet websites selling intensely sensitive drugs and medications without any control, authority or accountability. Due to the prevalence of such a system its adverse ramifications are finally manifested in the form of a trickle-down effect the pinch of which is ultimately felt at consumer level in the form of watered-down drugs to cancer suffering patients and fake medicines to HIV patients.
Strategies used by Pharmaceutical Companies for Drug Marketing
An interesting thing to note here is that the key architects and engineers behind the spinning of this vicious web can be accredited to pharmaceutical companies and organizations which have always been in determining consumer behavior in order to surge the sales of any of their recently launched drugs or medicines. It is not a surprise that pharmaceutical companies have long realized the profound significance of electronic marketing and business since the internet and business activities by making use of these technologies became an integral component of the commercial mainstream. These pharmaceutical companies made use of this technology by offering drugs to patients without any proper prescription method and this is exactly where illicit elements and forces invaded the business to proliferate their corruption and hegemony in the drug manufacturing and distributing sector. (Khodeli, 2004)
Talking about the developing countries where many of the multinational pharmaceutical companies have their various franchises situated not only tend to earn money by means of selling drugs online by employing a special group of doctors which is offered innumerable benefits from the company if they play a proactive role in prescribing their medicines to patients. Since, a person belonging to this vocation cannot be contradicted patients in one way or the other accepts that the prescription written by the doctor is for their own benefit and hence the drug is purchased.
Companies provide extensive incentives to their doctors in the form of mouth-watering and juicy deals such as on the sale of 1,000 medicines a cell phone is awarded on 2,000 sales a trip to a foreign country is awarded and on performing up to 5,000 sales a motor bike or an automobile is awarded to the doctor. In many of the cases doctors make use of outside clients also in order to facilitate and expand the marketing scope of the manufactured medicine.
The doctor through means of the internet and by reviewing the case study of the concerned individual may also find an opportunity which might not be as beneficial for the health status of the patient as for increasing the weight of doctor’s pocket. Through such enthralling and captivating prospects and benefits that are presented at the disposal of the concerned doctor, some of these tactics are among the most prominent influential techniques that are used by companies to increase their doctor lobby. In order to facilitate the method to a greater extent these companies hire special mediators or channel formers that actually pave way for the doctor auction to take place.
For prominent doctors like that of Dr. Rafik Ibrahim presented in the Malaysian case study pharmaceutical companies spread their own web in order to track them as they are considered a source of high reputation and credibility whether it be on an electronic or non-electronic platforms, hence the addition of such doctors will provide them substantial leverage in order to effectively market and skyrocket the sales of their market. And it is an obvious that when a highly reputed and professional doctor would recommend or prescribe any of the medicine manufactured by the company that he has been hired as a marketing agent the customer does not possess the guts to deny any of his prescriptions irrespective whether the prescription is written by hand or presented in the form of an email. (Customer International, 2007)
In a yearlong investigation that was conducted by Washington Post it was revealed that this diabolical game of euthanasia is managed by a number of methods and since much of the commercial activities have now been reduced to computer based platforms all of these components play a vital role in dictating the policies and the tactics played by all these forces in a cumulative fashion to establish and strengthen their hegemony and leverage in the entire sector. Some of the ways that are used on online basis include, formation of sophisticated network systems consisting of middlemen, felons and some opportunists who take hold of these medicines and purchase them at an extremely cheap price as they are mainly intended to be sold to nursing homes and hospices.
These medicines tend to serve no real function rather than enriching the black money accounts of the concerned traders and companies that are involved in the business. Many of such useless and counterfeiting medicines ultimately become the cause of death of many unwitting patients as many of them are sold to them mainly through online and internet means. With the passage of time counterfeiters also advanced themselves and their methods of conducting fraudulent activities to a new completely level.
By making use of the latest pill-punching machines and special inks they are able to produce multiple, duplicated and fabricated copies of the original medicine which are the most expensive in terms of price and therefore such medicines go undetected during inspection and scrutinization of the medicines. In addition to these pharmaceutical companies movers and shakers take advantage of negligent tax reforms and regulations to shift drugs worth millions of dollars from countries like Canada and Mexico into the United States and virtually all of these trade activities are of completely illegal and illegitimate nature. All these attempts pose a huge question mark over the performance of the FDA over imposing and carefully adhering to their regulations and taking strong steps for the implementation of these regulations. However one of their major steps through which they have established their foundation in the strongest way is through the campaigning and launching of rogue internet websites which undertake the responsibility of selling, advertising and marketing of drugs with the help of the internet.
These websites serve as a pipeline for illegal drugs such as narcotics and other harmful drugs by creating easy access for people to get hold of them by not going through medical tests doctor consultancy. However it would be a total misconception to label all websites involved in the business as a stakeholder in this gruesome and horrendous business as there are some of them which are considered as highly credible sources for online prescriptions.
By applying an effective move millions of drugs comprising of Hydrocodone, Xanax and Valium are provided to people without any sense of responsibility leading to the death of numerous innocent people. There have been myriad cases of such nature in which patients have died after they have treated with a fake drug that could not serve the purpose and function it was initially manufactured for.
In St. Charles a 61-year old woman died of a malignant breast tumor received an inactive diluted drug dose which failed to perform the desired function ultimately resulting in her death. Similarly there was another case of an 18-yaer old Ryan Height, a resident of San Diego who passed away after consuming an excess of narcotics that he had purchased from an internet pharmacy without any proper medical prescription. All these habits tend to have a severe impact on the shaping of the health habits of an individual as in most of the cases the situation moves from bad to worse. (Gaul and Mary, 2003)  
     In conclusion it would be appropriate to say that the illegal and illegitimate transmission and proliferation of medicine must come to a halt and that is only possible if all these mafia leaders who do not show any mercy to human life are brought in the court of law and all major stakeholders involved in the business are punished in the most strict way possible. On the flip side it is also the responsibility of the state and of the related and concerned health maintenance authorities to take special notice of the death that is being supplied in the disguise of an antidote.


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