Ever Wondered Who – s Behind Those Viagra Emails? POLITICO Magazine

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Ever Wondered Who’s Behind Those Viagra Emails?
The dark and deadly world of pharma spam.
December 16, 2014.
Marcia Bergeron’s body was discovered by a neighbor the day after Christmas 2006. The coroner didn’t have to look far for a cause of death: More than a hundred generic pills were found in her home, including a sedative, an anti-anxiety drug and acetaminophen.
Bergeron, a 57-year-old resident of Quadra Island in British Columbia, Canada, started losing her hair and experiencing blurred vision in the days before her death. According to the coroner’s report, “Mrs. Bergeron had been suffering from a range of symptoms. In emails to a friend, she described … ongoing nausea, diarrhea, aching joints, and other issues. Her friends locally were aware she was losing her hair and having vision problems. … She was extremely fatigued and sick.”
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An autopsy report showed that Bergeron had been slowly poisoned by extremely hazardous chemicals included in the pills, which the Coroners Service of British Columbia said were ordered from an online pharmacy. Tests revealed the pills contained uranium and lead, both of which can be lethal or severely damaging even in small doses.
Martha Bergeron, it seems, was the unfortunate victim of pharma spam. Almost all of us have gotten pill spam or pharma spam at some point in our lives—those emails that show up in our inboxes, spam filters and junk folders, offering cheap prescription drugs or enhancement drugs. While many of us delete these, hundreds of thousands of Americans, like Bergeron, don’t. Instead, for a variety of reasons, they buy from rogue pharmacy websites, such as GlavMed and Rx Promotion—two of the biggest ones that promote cheap drugs like those Bergeron took.
It remains unclear which rogue Internet pharmacy program sponsored the site from which Bergeron ordered. But one thing is clear: By taking a risk and buying from these rogue suppliers, Bergeron was playing a dangerous game of Russian roulette. Drugs purchased by GlavMed and other rogue pharmacy partnerships are marketed as if they come from pharmacies in Canada, which is world-renowned for its affordable medications. But most of the drugs from GlavMed appear to have been shipped from a half-dozen pharmacies or suppliers in India, a nation that is also now among the world’s largest sources of legitimate branded and generic medications. The rest seem to have come from more than 40 manufacturers and suppliers in China, India and Pakistan, some of whom appeared to resell legitimate, branded drugs at bargain basement prices and some who didn’t.
India has the brains, manpower and infrastructure to manufacture huge quantities of pills each year, and it has fostered a booming, $10 billion-a-year pharmaceutical industry even though the country has routinely denied the patents for many drugs. The Western drugmakers who hold these patents have charged that by limiting them in specific cases and fostering the development of inexpensive, generic knockoffs, the Indian government and the pharmaceutical industry there are stifling innovation and reducing profits that are essential to continued research and development on lifesaving drugs. Indian drug companies say their practices ensure that poorer nations maintain affordable access to drugs for scourges like HIV and cancer.
The problem is that India’s admirable, if self-serving fight to produce affordable generic drugs for the rest of the world does not address the safety and efficacy of these non-brand drugs. But to hear the U.S. pharmaceutical industry tell it, any prescription drugs produced outside the so-called “approved supply chain” are counterfeit at least, probably substandard, and quite possibly harmful or lethal. Whether or not that’s always the case, the U.S. drugmakers are right about one thing: Most drugs sold by rogue online pharmaceutical companies are not produced in regulated facilities—and therefore pose serious risks to anyone who decides to take them. And yet neither the drugmakers nor the U.S. government will examine these allegedly substandard products to weed out these dangerous online suppliers.
Statistics about the rogue pharmaceutical industry —and their implications for the health of its customers—are truly terrifying. According to the World Health Organization, approximately 8 percent of the bulk drugs imported into the United States are counterfeit, unapproved or substandard, and 10 percent of global pharmaceutical commerce—or $21 billion—involves counterfeit drugs. A study led by the International Journal of Clinical Practice (IJCP) published in 2012 puts the number at more than three times that amount. The Alliance for Safe Online Pharmacies estimates that 30,000 to 40,000 active online drug sellers operate at any given time, and that only a fraction are legitimate.
Pharmaceutical giant Merck recently analyzed more than 2,500 Internet pharmacies and found that more than 80 percent of those sites were selling their drugs without requiring a prescription. Online pharmacies run by pharmacy affiliate networks like Rx-Promotion and GlavMed-SpamIt never asked customers to produce a prescription, although legitimate online pharmacies selling prescription drugs to Americans must by law require a prescription. What’s more, Merck discovered that nearly 600 of those pharmacies were selling the drugs at a price below the lowest wholesale average price available to any market anywhere, strongly indicating that the drugs were counterfeit—and very possibly unsafe.