Google, Facebook, PayPal, and MasterCard may become the next set of Fortune 500 companies to get involved in the national conversation surrounding rising health-care costs.
They attended the Food and Drug Administration’s opioid summit June 27, where they collaborated with the agency on best steps to curb illegal online opioid sales—a trend the agency is worried has grown significantly over the last several years.
Scott Gottlieb, head of the agency, said industry guidance for non-opioid pain treatments is in the works. The agency’s priority is now fighting the use of fentanyl, a strong pain killer that’s often a cheaper—and more dangerous—alternative to prescription opioids like oxycontin or vicodin.
“We’re going to hit back hard against fentanyl, which is “bought and sold online and flowing through international mail facilities,” he said June 27. The agency already committed to increasing the number of employees dedicated to investigating suspicious packages, and is cracking down on online pharmacies as well.
The summit ended with a closed-door meeting between agency staff and leaders from internet companies. The FDA told Bloomberg Law it was releasing a detailed recap of the meeting June 28, but declined to comment on the summit June 27.
Disagreement Among Stakeholders
Most of the illegitimate online pharmacies aren’t peddling controlled substances, Marjorie Clifton, executive director of the Center for Safe Internet Pharmacies, told Bloomberg Law June 26. The nonprofit tries to prevent consumer access to illegitimate drugs from illegal online pharmacies, and its members include Google, Facebook, PayPal, and MasterCard.
None of those companies replied to requests for comment June 27.
Fifty-eight percent of the medications bought from any online source are “lifesaving drugs” like heart statins and antibiotics, she said, citing a small survey of consumers the center did in 2015. Those findings have sparked concern among CSIP’s members surrounding drug costs, she said.
Patients are going online to buy their medication because it’s cheaper, but the lower cost comes with its own set of risks: patients may have their credit card information stolen, they could not get their medicine on time, or they could get counterfeit drugs.
“We’re not in the business of endorsing any public policy or pushing any kind of drug policy,” Clifton said, but “one of the things we’ll be asking for direction on from the FDA is what is being done about the cost of prescription drugs and how we can help.”
None of the companies specializes in pharmaceutical prices. But they now have stakes in drug retail because “our focus is consumer protection and consumer safety online, and what we’re observing is patients are willing to take risks based on the cost of prescription drugs,” Clifton said.
Those companies’ concern is another example of how the rising cost of drugs is splintering off into every corner of the economy. Amazon, JP Morgan, and Berkshire Hathaway—none of whom had any experience with health care—launched their own initiative to find new ways to approach the U.S. health-care system in January. The FDA itself doesn’t even directly regulate drug prices, but made lowering prices a priority this past year because of public pressure to make medicine more accessible.
Importation Laws Also on Table
CSIP also wants some industry guidance from the FDA on how internet companies should guide consumers on “some of the trickier issues plaguing the prescription drug space, like importation law,” Clifton said.
State laws aren’t aligned with federal laws. In Vermont, drug importation from Canada is legal. Clifton found most American consumers trust Canadian drugs, making them more susceptible to click on fake Canadian pharmacy websites. In most instances, consumers purporting to sell opioids or controlled substances get their identities or credit card numbers stolen. They typically don’t receive actual products.
The dark web is where dangerous counterfeit drugs lie, Clifton said. It’s the underbelly of the internet, where illegal commerce thrives.
“The biggest problem is demand,” she said. “Until consumers aren’t buying from fake sites, criminals will come to them.”
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(Sixth paragraph corrected to say most illegitimate online pharmacies aren't peddling controlled substances.)