Friday, August 11, 2006

Doctors highlight risks of buying drugs from online pharmacies

A woman who bought drugs on the internet and took them for four years went blind as a result, doctors say.

The case highlights the dangers of the multimillion-pound international market in prescription medicines available from online pharmacies across the globe.The easy availability of drugs has allowed many people to bypass their doctors and self-prescribe medicines which they hope will boost their energy, improve their sex life or help them lose weight.

The 64-year-old woman from Sunderland diagnosed herself with chronic fatigue syndrome and, on the advice of a neighbour, bought oral steroids from an online pharmacy in Thailand. She later complained of loss of vision and doctors at Sunderland Eye Infirmary found cataracts in both eyes and signs of glaucoma (high pressure), both side effects of steroid use.

Dr Philip Severn and Dr Scott Fraser, consultant ophthalmologists, writing in The Lancet, warn colleagues to watch for patients who may have bought drugs online. "Some of the drug therapies can be counterfeit and contain a concoction of compounds that bear little resemblance to the drug named on the bottle," they say.

"Even if the patient receives the actual drug, there are many problems with this unchecked availability, including interactions with coexisting treatment, side effects and the lack of careful medical monitoring."

Popular lifestyle drugs including Viagra for impotence, Reductil for weight loss and Prozac for depression are among the biggest internet sellers. Many internet pharmacies offer online prescriptions allowing patients to consult a doctor by e-mail instead. The British Medical Association is opposed to the practice but it is not against the law.

The General Medical Council has successfully prosecuted doctors for inappropriate prescribing and failing to make adequate diagnoses over the internet.

Websites based abroad, which may use a "" address, are not subject to British jurisdiction, and many sell medicines without a prescription as well as controlled drugs, such as stimulants and opiate-based painkillers.

The Medicines and Healthcare Products Regulatory Agency has warned of the growing problem of counterfeit drugs. Every year, the agency seizes £3m of stolen or faked Viagra, the best-selling internet drug.

Dr Fraser said he had heard of the dangers of buying drugs over the internet but it was the first time he had seen the effects. "Most patients aren't going to say if they have bought drugs over the Net," he said. "Buying drugs in this way is a gamble. Even if it is the right drug and it is not a counterfeit, because she wasn't monitored, she suffered the side effects.

"I am not saying doctors must be in control of all prescriptions, but with steroids, although they are life-saving drugs, patients must be monitored because of the side effects, which included diabetes, bone loss and eye problems."

The woman had catar-acts removed from both eyes and will require treatment for glaucoma for the rest of her life, Dr Fraser added.

The Royal Pharmaceutical Society said it was developing a register of approved online pharmacies.

Available onthe internet

* Viagra, made by Pfizer, for impotence. About £50 for four tablets. Most widely sold prescription drug on the internet.

* Xenical, made by Roche, for weight loss. About £65 for 85 capsules. Marketed as a potential panacea for the obesity epidemic.

* Prozac, made by Eli Lilley, for depression. About £20 for 30 tablets. The best known anti-depressant, with low toxicity compared to older drugs.

* Valium, made by Roche, for anxiety. About £50 for 30 tablets. Known as mother's little helper, it is effective but addictive.

* Ritalin, made by Novartis, for attention deficit disorder. About £20 for 60 tablets. Abused by students and others to increase concentration.

* Lipitor, made by Pfizer, for high cholesterol. About £40 for 30 tablets. The world's best-selling drug - counterfeit versions exist.


You can find the complete article:
The Independent online
By Jeremy Laurance, Health Editor
Published: 11 August 2006

Friday, August 04, 2006

French lead in drugs consumption

According to a recent study of the structure and evolution of the five main EU pharmaceutical markets, the French spend the most on drugs per inhabitant, 284 euros annually, followed by the Germans (244 euros) and the British, Italians and Spanish (around 200 euros each). The French also consume the most medicines in quantities.

The drugs sales increased in all countries and, in total, these five countries counted for 70 billion euros in pharmaceutical sales in 2004. According to the study, conducted by the French Ministry of Health, the increase in turnover was mainly due to increased average price of medicines, around 10% in France and Germany between 2003-2004. The drugs for treating cardiovascular disease get the biggest market share in all five countries, around 25%, followed by medicines for treating the nervous and the digestive systems.

According to the study, the medicines are the cheapest in the UK, due to high generic drugs penetration and to parallel imports, whereas the medicines are, on average, the most expensive in Italy. Germany leads in consumption of generic drugs, which cast up for 22,7% of the pharmaceutical sales.

In some EU countries there has been a shift in national policies to promote the prescribtion of generic drugs as part of overall healthcare reforms to cut costs. In France, for example, doctors who sign up to an agreement with social insurance are required to prescribe cheaper medicines, a proportion of which must be generics.


Tuesday, August 01, 2006

New and updated PRODIGY guidance

PRODIGY Knowledge is an up-to-date source of clinical knowledge that can help healthcare professionals and patients in managing the common conditions generally seen in primary and first-contact care. PRODIGY Knowledge is practical and reliable, supporting safe and effective clinical practice.

11 updated PRODIGY full guidance topics have been issued onto the PRODIGY Knowledge website To view a list and a summary of the changes to the updated guidance please see the summary of guidance changes.

Updated PRODIGY guidance
Acne vulgaris
Benzodiazepines/Z drugs - withdrawing treatment
Hypertension in pregnancy
Opioid dependence
Pelvic inflammatory disease
Urethritis male
Urinary tract infection - children
Urinary tract infection (lower) - men
Urinary tract infection (lower) - women

Updated PRODIGY Patient Information Leaflets (PILs)
Updated patient information leaflets (PILs) for the PRODIGY guidance topics which were issued in May 2006 have been issued onto the PRODIGY website. To view a list of the updated PILs please click here