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By Valeria Aguirre
June 16, 2020
Money; Getty Images

Online pharmacies can provide both affordability and give you easy and safe access to the medications you need without the need to leave the house. Ordering from online pharmacies is a fairly straightforward process, provided you have a computer or smartphone, a working internet connection, and a valid prescription. Many offer the convenience of auto-refills, so that you’ll have a steady supply of your daily medication.

Whether you have frequent or infrequent medication needs, these pharmacies can provide specialized packaging, shipping, and coordination services that make your life easier. And because more and more community pharmacies are riding the telemedicine wave, you might even be able to still shop at your local pharmacy.

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That said, the concept of online pharmacies can be confusing, especially since they have been mired in controversy more than once. Now more than ever, it’s important to be aware of the risks associated with buying from digital drugstores as, for example, more Illegitimate businesses claiming to be selling so-called Covid-19 cures proliferate across the internet. As so, it’s crucial to distinguish fake pharmacies from legitimate ones.

So let’s dive into them to see what they’re really all about.

Online Pharmacies Quick Facts

Yes, online pharmacies can be safe and legal

Online pharmacies are legal in every state, as long as they meet state licensure requirements. A good way to tell is by checking if the pharmacy holds a Digital Pharmacy Accreditation (VIPPS), which signals it met all licensure requirements plus additional ones established by the National Association of Board of Pharmacists (NABP). This logo can usually be found at the bottom part of the website.

Lower cost pharmacies

Online pharmacies can sometimes be cheaper, due to how they choose to process and distribute medication. For example, some online pharmacies will cut out the middleman and produce their own generics, making costs considerably lower for patients.

Pharmaceutical Expertise and Pros

All legitimate online pharmacies have pharmaceutical professionals on staff ready to answer your medication-related doubts and concerns. These experts can usually be contacted by phone, email, live chat, or a combination of all three.

However, not all online pharmacies are legit

Before ordering from an online pharmacy, it’s important to know the signs that they’re not as trustworthy as they claim to be. You should be wary of any online pharmacy that:

  • Is willing to sell you medication without a prescription from your healthcare provider
  • Cannot provide evidence of a U.S.-licensed pharmacist on staff
  • Sends unsolicited emails offering too-good-to-be-true deals or miracle cures
  • Is located outside of the United States and/or claims it can ship to any country around the world

To start with, any pharmacy you choose must be duly accredited and require a valid prescription sent directly by a doctor’s office. If a pharmacy doesn’t explicitly require a valid prescription from a physician, you should think twice about doing business with them, since they may not be legitimate. Also, any online pharmacy must have at least one accessible and responsive line of communication where you can reach them (whether that be by phone or live chat) should any questions or concerns come up. Finally, online pharmacies are required by law to have a physical U.S. address where their headquarters or dispensing facilities are located. This address should be clearly posted on their website.

Buying from an online pharmacy is easy and hassle-free

Before you’re able to purchase from an online pharmacy, you’ll most likely need to make an account first. This process is fairly standard and only takes a few minutes. It usually goes like this:

  1. You create a user account where you enter your credentials, credit card, and shipping information.
  2. Your doctor sends in a valid prescription.
  3. You pick out your meds from their website, just like you would in an online store OR the pharmacy takes care of dispensing and selecting these for you based on your prescription (just like a regular pharmacy).
  4. The pharmacy processes your order.
  5. Your medication arrives anywhere between 8-14 days.

Foreign and Non-Accredited Pharmacies

In your search for online drugstores, you might be tempted to look into foreign pharmacies, in part because of their reputation as considerably cheaper alternatives. However, it’s important to note that ordering prescription medication from a pharmacy outside of the U.S. is technically illegal, and can prove to be dangerous, ultimately outweighing any financial benefits. There are two main reasons as to why you should think carefully before ordering from foreign pharmacies.

First, it’s virtually impossible to verify where these foreign pharmacies are actually located. During our research, we found that many purportedly “Canadian” pharmacies—some of the most popular amongst consumers—have been traced back to countries where companies have deliberately misled patients as to the legitimacy of their operations. Other pharmacies claiming to be American (but that are actually run from foreign locations) have been involved in a multitude of illegal drug operation scandals.

Secondly, it’s hard to determine if what you’re getting in the mail is actually what you’ve ordered. In 2019, the World Health Organization issued a global alert warning patients and physicians of a fake cancer drug making the rounds through Europe and the Americas that turned out to be little more than acetaminophen. Conversely, some drugs can actually be produced using incorrect or imprecise ingredients, something that can result in life-threatening consequences.

In fact, the FDA estimates that only three percent of online pharmacies actually comply with U.S. pharmacy laws, while the NABP found that 95% of websites selling prescription drugs online are doing so illegally. Nelly Conte, professor at the University of Puerto Rico and a licensed pharmacist with over 40 years of experience in community pharmacies, explained that while in the United States all prescription drugs go through a manufacturing quality check known as Good Manufacturing Procedures (GMP), pharmacies that haven’t been verified by the NABP cannot prove they meet those requirements.

According to the FDA, unaccredited and unverifiable pharmacies, which include foreign pharmacies, may sell products that:

  1. Contain harmful ingredients
  2. Contain the wrong doses of ingredients
  3. Contain inactive or fake ingredients

It’s always best to err on the side of caution and instead look for pharmacies that are certified as legitimate and located in the United States. It’s also important to note that buying from foreign pharmacies may make it harder to get any sort of legal remedy against them, in the event that something were to go wrong with your medications. As Conte told us, “all pharmaceutical companies, including generic companies, must have insurance so that in the event of a lawsuit there is insurance available to respond. With foreign companies, you most likely won’t be able to litigate if something happens.”

The Best Online Pharmacies of 2020

Online pharmacies can either be recognizable brick-and-mortar community pharmacies that have added internet platforms, or purely digital pharmacies. Regardless, all legitimate online pharmacies have a registered physical address where they carry out their corporate and distributing business operations.

We focused on choosing pharmacies that have an NABP seal of approval, along with easy-to-use websites and clearly stated contact information. We also made sure to pick those that offer shipping to all 50 States. Most of these pharmacies follow a general pattern when it comes to signing up and ordering your meds.

The 5 Best Online Pharmacies Companies

We recommend these 5 companies for 2020:

Costco: A trusted name that provides accessibility and low-cost medication options with added benefits for members.

Pill Pack: Provides appealing packaging and easy to navigate apps to make the process of taking your medication easier.

Rx Outreach: Specifically tailored services for lower-income individuals with a catalog of over 400 available medications.

Healthwarehouse.com: Provides generic alternatives to pricey prescriptions which can help you save.

BioPlus Specialty Pharmacy: Specialized care with award-winning customer support.

Costco Pharmacy

Best for: Patients on a budget

Ships: All 50 states

Auto Refills: Yes

You may know Costco as one of the largest retailers in America, but it’s also one of the most affordable drugstores in the nation.

Even better, Costco Pharmacy medication is not restricted to Costco members, so that anyone can benefit from their discounted prices. In addition to its affordability, your prices can be even lower if you join the Costco Member Prescription Program (CMPP), which works as a discount card program. Be aware that you must be a Costco member to join CMPP and you must choose between paying your insurance’s copay or the full discounted CMPP price. On the customer support side, Costco has a live online chat where you can speak to pharmaceutical representatives. You can also call during their available service hours. (Please note that, due to the current pandemic, they are no longer accepting emails). Standard free shipping could take between 6-14 days, but they also provide expedited shipping.

PillPack

Best for: Individuals who prefer tech-based interactions

Ships: All 50 states

Auto Refills: Yes

Amazon’s PillPack has become a household name in the world of mail-order pharmacies.

PillPack sends a monthly medication list detailing all your meds and their pertinent doses, along with colorful images of each different pill in order to help you differentiate your medication. Their packet design is especially helpful for patients with visual impairments and those who have to take multiple medications a day, since PillPack uses large and distinct labeling for each of them. You can talk to pharmacists and customer representatives via email or chat through your PillPack web account. As a bonus, the pharmacy offers an iOS app where you can access your full medication list, set reminders, and request new meds or changes to the times listed on the packets.

RX Outreach

Best for: Lower income families

Ships: All 50 states and Puerto Rico

Auto Refills: No

The only non-profit on our list, RX Outreach, has been operating since 2010 and serves around 60,000 patients annually, making medication more affordable for lower income individuals and families. RX Outreach offers more than 400 different medications and displays all of them, along with their price and available strengths, in a Medication List on their website. Pharmaceutical assistance is available to patients during the hours of 7:00 am to 5:30 pm Monday to Saturday (CST).

Healthwarehouse.com

Best for: Patients without health insurance

Ships: All 50 states

Auto Refills: Yes

HealthWarehouse.com has earned a reputation for being one of the most affordable pharmaceutical options out there. The company claims to service more than 500,000 customers while shipping to more than 80% of the U.S. in 2-3 days.

HealthWarehouse.com includes a search bar where you can look up all available products and medications, along with their generic prices. Pharmacists are available Monday through Friday 8 am – 6 pm (ET). Customer support is also available over email and live chat. In addition to their catalog of prescription drugs, HealthWareHouse.com also offers pet medication, home medical supplies, diabetic supplies (such as insulin pens and syringes), and a variety of over-the-counter medication.

Note that Healthwarehouse.com doesn’t accept insurance, stating that they can provide lower prices by cutting out the middleman. However, if you already have health coverage, it’s important to compare the price you’d pay under your insurance plan to how much it would cost without it, as savings could vary depending on the particular medication.

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BioPlus Specialty Pharmacy

Best for: Patients with chronic illnesses

Ships: All 50 states

Auto Refills: N/A

BioPlus Specialty pharmacy focuses on the following conditions:

  • Crohn’s & Ulcerative Colitis
  • Dermatology
  • Hepatitis C
  • HIV
  • Multiple Sclerosis
  • Oncology
  • Oncology – Pediatric
  • Oncology – Urology
  • Osteoporosis
  • Rheumatology
  • Transplant
  • Women’s Health

Pharmacist support is available 24/7. In addition to their traditional phone and email lines, patients also have access to an app where they can ask questions about their medication, possible side effects and interactions, and more.

BioPlus works quickly and has a two-hour Patient Acceptance Guarantee which they claim ensures immediate benefit coordination with the new patient’s insurance company and communication with their doctor’s office. In the event that they are unable to fill out the prescription, they’ll transfer it to the specialty pharmacy approved by your benefits plan and then notify you and your doctor. Finally, they also try to comply with a 2-day processing window in which medications are ready to ship.

Because specialty medication can be some of the most expensive on the market, BioPlus connects eligible customers with financial assistance resources from non-profit foundations. Their financial team will walk you through the enrollment process while also submitting any documents on your behalf. Once enrolled, they also make sure to keep track of how long you’re covered and how much funding you have left along the way.

How We Found the Best Online Pharmacies

There are hundreds of online pharmacies out there claiming to be the best. There are so many, in fact, that the search for a good one—or even a legitimate one—can be overwhelming. The good news is there are easy ways to check if an online pharmacy is trustworthy—mainly, its certifications and license, how they handle prescriptions, and the strength of their pharmaceutical support.

NABP certification and Licensure

Before you check anything else, always verify that the pharmacy you’re considering has a clear NABP or VIPPS seal of approval somewhere on its website. The NABP has developed a strict set of requirements it uses to certify online pharmacies as legitimate. Among other things, this list requires all digital pharmacies to:

  • Be licensed in good standing to operate in all required jurisdictions.
  • Require a valid prescription before dispensing any medication.
  • Provide an accurate U.S. street address of the dispensing pharmacy or corporate headquarters, as well as a responsive phone number or communication mechanism that allows patients an accessible line to a pharmacist on its website.
  • Comply with all federal and state laws, which includes only dispensing drugs that have been approved by the U.S. Food and Drug Administration (FDA).

If you’re unsure about whether or not your pharmacy complies with these requirements, you can always go to the NABP list of verified online pharmacies and check its certification status.

It’s also important to note that the pharmacy must be licensed in all states it ships to. Some online pharmacies don’t make it very clear where they’re able to ship, so be sure to contact them and ask. The FDA has compiled a list of sources where you can verify whether a pharmacy is backed by state licensure.

Prescriptions

An online pharmacy can only distribute medication if physicians provide prescriptions on their patient’s behalf. You should always keep an eye on how a pharmacy accepts and processes your order. All legitimate pharmacies will require doctors themselves to send in their patient’s prescription, either directly to the pharmacy by e-prescribing or via fax. Beware of pharmacies that merely require a questionnaire, or are flexible about the patient sending in a prescription themselves, since this means the pharmacy is not following NABP guidelines and is likely not trustworthy.

Customer Support

Make sure to also take a look at the pharmacy’s customer and pharmaceutical support availability. You want to ensure you have multiple ways of reaching representatives and that they have a broad range of hours in which you can communicate, so that help is at your disposal if something were to go wrong with your medication.

Regardless of which pharmacy you end up choosing, don’t hesitate to contact them for information if you have any doubts as to how they operate. Any legitimate company will provide you with the information you need to prove their reliability and put your mind at ease.

Financial Assistance

While one of the benefits of buying from online pharmacies can be lower prices, some medication will still be unaffordable for many. Luckily, there are several organizations out there that can provide financial assistance, education, and relief.

Some websites, such as GoodRX and RXSaver by RetailMeNot, help get you coupons and additional discounts on your prescription medication. These are almost always redeemable in large retail pharmacies like Costco and CVS, but may also include online pharmacies, such as Healthwarehouse.com.

There are also a variety of other websites that could help you find the best prescription options if you don’t have insurance, such as the Partnership for Prescription Assistance and RX Hope.

Controlled Substances

The U.S. is currently battling one of the worst drug epidemics it has ever faced in the form of the opioid crisis, with a staggering 2 out of 3 overdose deaths in 2018 caused by opioids. According to the National Institute of Health (NIH), roughly 21 to 29 percent of patients that are prescribed opioids for chronic pain misuse them.

It’s no wonder then that there are strict regulations when it comes to ordering controlled substances from online pharmacies. Controlled substances refer to those drugs that are tightly regulated by the government due to how easy it is to become addicted to or abuse them. Examples include Xanax, Oxycontin, and methamphetamines. By and large, one of the biggest dangers caused by illegitimate online pharmacies is their illegal and unregulated distribution of controlled substances. The NABP frequently reports on the rapid proliferation of these and the threat they pose for the millions of Americans currently battling with an opioid use disorder.

So here are two points to keep in mind in your search for online pharmacies.

  1. You won’t be able to get a prescription for a controlled substance solely via a telemedicine appointment. That is, under the current law, you will always need to establish an in-person relationship with your doctor before they can prescribe a controlled substance. Any pharmacy that is willing to sell you controlled substances without the valid prescription sent directly from a doctor’s office is most likely illegitimate and unsafe.
  2. Most pharmacies will not allow auto-refills for controlled substances.

Summary of the Best Online Pharmacies

Rx Outreach– Specifically tailored services for lower-income individuals with a catalog of over 400 available medications.

Pill Pack– Provide appealing packaging and easy to navigate apps to make the process of taking your medication easier.

Costco- A trusted name that provides accessibility and low-cost medication options with added benefits for members.

Healthwarehouse.com- Generic alternatives to pricey prescriptions that help you save.

BioPlus Specialty Pharmacy- Specialized care with award-winning customer support.

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