Bad Medicine

Did you know you can purchase many prescription medications — such as Pr^pecia, Vi^gr^, C^l^br^x, Vi^xx and more — without a prior prescription and without visiting a doctor? [Names not rendered due to spam filter issues. –Editors]

Numerous online pharmacies offer online consultations with (supposedly) licensed U.S. physicians, often free of charge. On their sites you pick your drug of choice, fill out a form that asks broad questions about your medical history, input your credit card number, and wait for the package to arrive. After the order is submitted, one of those shadowy doctors reviews your history and prescribes the drug.

Hardly a new development. These pharmacies have been around for years. Lately, their marketing volume has increased. One of our pharmaceutical clients recently discovered a Gator-initiated pop-up ad for an online pharmacy on one of its branded product Web sites. The ad promised a drug without need for a prior prescription and made unauthorized use of the manufacturer’s corporate logo.

To legitimate pharmaceutical marketers (such as our client), the increasing presence of these shady pharmacies adds more noise to an already crowded space. Worse, their marketing efforts increase clutter while adding a deceitful, confusing voice to a complex marketplace.

Before going further, I want to make one thing clear: When I refer to online pharmacies, I am specifically talking about pharmacies unethically selling prescription drugs, whatever methodology or legal loophole they use. It may be an online “consultation” or perhaps a non-U.S.-based company illegally shipping drugs to the U.S. There are, of course, many lawful online pharmacies not engaging in these practices. I do not mean to criticize them here.

My company has many large pharmaceutical companies as clients. I speak from experience when I say all pharmaceutical ads go through a rigorous legal review. Our creative folks operate within strict guidelines dictating what can and cannot be said. Dealing with that, then seeing online pharmacies operating this way is exasperatingly frustrating.

It may not technically be illegal — at least not yet (according to the Federal Drug Administration, or FDA, pending legal/regulatory action means to address these practices). It is most certainly unethical. Both the American Medical Association (AMA) and FDA condemn the practice of online consultation without a physical exam, prior doctor-patient relationship, or both. They view it as substandard medical care. Yet it continues, in mass quantities. See for yourself. Go to any major search engine, and type in Pr^pecia or Vi^gr^. Probably four of the top five listings are shady online pharmacies.

And here’s the really sad part — most of those top listings are of the paid variety. That means someone, somewhere, actually accepts payment for running ads from these online pharmacies, in effect, supports and encourages the questionable practices of these companies. Every single search engine on which we buy advertising accepts these ads. Every last one of them.

Now, it’s important to note many search engines’ paid listings are powered by one of the big, paid listings players. In those cases, portals with listings “powered by” another engine are subject to the editorial policies of the powering engine. That should not be an excuse. As a publisher, you are responsible for all content that appears on your site, even if it’s powered by someone else.

The FDA is clear, the AMA agrees: Dispensing prescription medications without a physical exam is dangerous. It’s unsafe. Buying drugs from online pharmacies puts people at risk from contaminated or counterfeit products, incorrect products or dosages, potentially harmful side effects, drug interactions, and other serious health concerns.

One search engine in particular maintains very strict editorial policies. Every time we purchase keywords, we must submit the complete list of words, all related copy, and click-through URLs. Its editors determine whether to accept the ad. These guys are very detailed and always preaching about the high quality of their listings. Yet they allow shady pharmacies to advertise. How can they rationally make that decision? It’s hypocritical and appalling.

The one search engine that got back to me said it instituted a policy earlier this summer to not accept ads that offer prescription drugs without the need for a prescription. It is in the process of removing those ads. As for ads offering prescription meds through online consultations and the like, the acceptance policy is currently under review. Hopefully, a change is forthcoming.

How many times have publishers (print, broadcast, or online) turned away ad dollars because an ad was in appropriate or potentially offensive? It happens frequently, often for very subjective reasons. Broadcast networks have long refused liquor ads. Not because it’s illegal, but because they understand the dangers of hard alcohol and do not want responsibility for pushing sales. When NBC recently announced it would lift the self-imposed ban, the public outcry was massive, and the network backed down. The outcry was such that NBC cancelled its plans and left the ban in place. Think about some recent examples of banned TV spots: Nike and Microsoft are huge global brands with legitimate products, genuine marketing claims, and massive advertising budgets — and they got spiked.

Examples of ad venues turning away ad dollars are numerous. Reasons are not always as elementary as protecting public health. Many online publishers accept ads from online pharmacies engaging in unethical and unsafe practices. This industry is constantly compared to offline media. We continually struggle to demonstrate effectiveness and legitimacy. Why do our leading ad venues accepting these ads?

Our broadcast brethren refused to accept a Nike ad that might offend viewers. Major online portals welcome ads from companies who put their users’ health at risk.

What’s wrong with this picture?