Internet pharmacy social gains are efficiency, improving pharmaceutical access for isolates, and less cost. Alongside gains, illegal Internet pharmacies and unscrupulous pharmacy practices have made online purchasing a cyber risk for consumers. Industry self-regulation has failed, giving way to U.S. government and transnational intervention. The U.S. assumes “responsible domestic governance” in disrupting Internet crime by passing modern day drug policies (White House, 2011; 2016), and having transnational cooperation. States have joined the federal to pass laws generally on licensed in-state entities processing orders for rogue Internet pharmacies (GAO, 2013) but not uniformly. However, online pharmacy sites continue to dispense without “valid” prescriptions, unapproved drugs are sold online, and illegal pharmacies continue to operate. This chapter explores why some American states have adopted laws regulating Internet pharmacies from 2000 through 2015, using Cox proportional hazards regression.
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Considered e-commerce or digital trade, e-pharmaceutical growth in the U.S. has been rapid with online pharmacies having the highest profile of e-health business for consumer trading, as seen with pharmaceutical and beauty aid sales for 2012 valued at 14.68 billion U.S. dollars (Statista, 2015). However, illegal Internet drug outlets (National Association of Boards of Pharmacy [NABP], April 2015) and unscrupulous pharmacy practices (Schmeida, 2005) have threatened the safety of online medication purchases (Schmeida & McNeal, 2015). Nearly 11,000 websites sold medications to U.S. consumers illegally from 2008 to 2014 (NAPB, January 2015, p.3) most transnational in operation, selling drugs that are counterfeit, substandard, and without a valid prescription (GAO, February 2014). Counterfeit meds lead “patient safety threats perpetuated by rogue websites” (NABP, April 2014, p.7). According to the INTERPOL report of June 18, 2015, 156 worldwide arrests were made of transnational criminal networks selling counterfeit medications through illicit Internet pharmacies (p.1).
Although Internet pharmacy cybercrime regulations constrain e-commerce industry growth, effective law enforcement requires regulatory and administrative law to combat illegal online activity. Traditionally, not all players encourage these federal regulations, with some pharmaceutical industry preferring to avoid government control (Ripley & Franklin, p.123). Conceptually, regulatory controls of individual conduct justify the direct and coercive use of government power over citizens (Lowi, 1979) such as prohibiting dispensing of controlled substances over the Internet without a valid prescription (Public Law 110-425). As there are regulatory policy sub-types, protective-type regulations control societal behavior, while competitive-type regulations can create market winners and losers (Ripley & Franklin, 1980) with Internet prescribers following safety protocol considered the winners, while losers are denied access to the online market. Internet pharmacies not following U.S. Drug Enforcement Agency registration protocol to “operate as an online pharmacy” can potentially be shut down and/ or prosecuted (White House, 2015, p.97), considered losers. Administrative reform laws shape the government rules (Ripley & Franklin, 1980) including how regulatory policies are to be carried out. Both policy types are seen in mitigating the risks of pharmaceutical cybercrime for citizens, although the regulatory laws directly control the criminal conduct. “Policymaking for consumer protection might be labeled ad hoc policy entrepreneurship, because there is a high degree of opportunity for individual participants---interest representatives, bureaucrats, members of Congress, and presidential appointees---to have important impact on what the government does or doesn’t do with specific regulatory activity” (Ripley & Franklin, 1980, p.131).