AG wants ND crackdown on online pharmacies
Janell Cole, N.D. State Capitol Bureau
Published Monday, February 09, 2009

BISMARCK — North Dakotans are getting addicted to prescription pain killers at increasingly alarming rates, Attorney General Wayne Stenehjem told a legislative panel Monday, and the drugs they’re taking are often obtained over the Internet.

Stenehjem said that’s why the state needs its own law to crack down on rogue online pharmacies that sell addictive prescription painkillers and other drugs with bogus doctor’s prescriptions.

The Senate Human Services Committee agreed and immediately gave Senate Bill 2218 a do-pass recommendation after a hearing.

Federal laws already prohibit Internet sales of prescription drugs without an in-person doctor’s visit, Stenehjem said, but federal resources are limited and federal officials may choose to investigate or prosecute only major cases, he told the legislators.

If SB 2218 goes into law, Stenehjem’s office, Bureau of Criminal Investigation, local state’s attorneys, police and sheriffs can investigate and prosecute no matter what the federal government is doing, he said.

The rogue pharmacies often have business agreements with doctors who issue prescriptions to “patients” who submit an online questionnaire. These doctors don’t see the patients, and, Stenehjem said, one television news program two months ago interviewed a doctor who worked for such a Web site and had a database of more than 32,000 “patients,” none of whom he had ever seen in person.

The state Medical Association, state Board of Pharmacy and Board of Medical Examiners told the legislators they support the law.

Minnesota already has a similar law named for Justin Pearson of St. Cloud, who died of a prescription painkiller overdose after obtaining the drugs online through a questionnaire that passed for a doctor’s visit.

MPhA PRESS RELEASE - May 15, 2008

GOVERNOR PAWLENTY SIGNS “JUSTIN’S BILL”
Legislation Addressing Dangerous Illicit Internet Pharmacies

Roseville, Minn. – Today Minnesota Governor Tim Pawlenty signed “Justin’s Bill.” Representative Steve Gottwalt, R-St. Cloud and Senator John Marty, D-Roseville authored this bipartisan effort to prevent the operation of illicit online pharmacies in Minnesota.

Chief authors Gottwalt and Marty, are joined by Sen. Tarryl Clark, D-St. Cloud, and Reps. Tom Huntley, D-Duluth, Paul Thissen, D-Minneapolis, Jim Abeler, R-Anoka, and Bob Dettmer, R-Forest Lake, as co-authors. This bill passed out of both the House and Senate with overwhelming support and was welcomed in the governor’s office.

During the 2007 session, legislation was passed that attempted to define a legally valid prescription. This legislation stated a prescription is not valid if it is based solely on an online questionnaire. The bill was brought forward as a result of the unfortunate death of a Minnesota man who obtained a prescription for a controlled substance by filling out an online questionnaire without any medical evaluation. After completing the questionnaire a prescription was “written” by an out-of-state physician and subsequently filled by a pharmacy that agreed to be a fulfillment center for the online pharmacy site. Justin Pearson died on Christmas morning in 2006.

The new legislation was needed because illicit operators began shifting their methods based on the changing regulatory environment. For example, after the Minnesota law passed clarifying a prescription is not legally valid if based solely on an online questionnaire, some illicit sites began adding a telephone call in order to adhere to the law, and claim a legitimate patient-prescriber relationship.

“Justin’s Bill” includes a clear definition of a legitimate prescriber-patient relationship. This definition is critical for the FDA and DEA’s ability to effectively assist states with enforcement. Language specifically indicating failure to adhere to these standards renders the prescription invalid is necessary to assist in multi-state enforcement and would allow for federal charges to be brought.

Now, a prescription or drug-order for commonly abused prescription drugs is not valid unless it can be established the prescription or drug order was also based on a documented physical patient evaluation. The new language helps clarify the prescriber-patient relationship that enforcement officials need to stop the abuse occurring from illicit online pharmacy sites.

According to a recent Columbia University study, 15.2 million people age 12 and over reported abusing prescription drugs in the past year. The report indicates a 70 percent increase from 2006 in the number of websites that advertise or sell controlled substances, many of them without a prescription or medical evaluation. The National Association of Boards of Pharmacy currently certifies 14 internet pharmacies through its Verified Internet Pharmacy Practice Sites (VIPPS) program. This is a staggeringly small number compared to the 187 sites examined in the study.

The Minnesota Pharmacists Association (MPhA) has been involved in the process of crafting this new language from the beginning. Over the summer, MPhA hosted two meetings with Rep. Gottwalt, FDA, DEA, and other interested healthcare organizations. MPhA President Tim Gallagher stated, “Illicit internet pharmacies pose a serious threat to the health and welfare of our patients. As healthcare professionals we have an absolute obligation to fight for legislation that would outlaw these rogue internet sites. We must reestablish a personal physician-patient relationship as the best and only legitimate source of prescriptions.”

“This law does not seek to limit legitimate online sales of prescription drug,” stated Gottwalt. “It simply does a better job of detailing the medical assessment necessary to support a legal, valid prescription, giving law enforcement authorities the tool they need to crack down on pharmacies in our state that choose to distribute powerful prescription drugs to people who’ve done little more than fill out an online order form.”

“MPhA applauds the bipartisan efforts of the legislature to acknowledge this serious issue and work swiftly and diligently to ensure the passage of this important piece of legislation. All those involved should be proud of participating in this groundbreaking effort. Minnesota has taken a bold stance against the dangerous, illicit online drug trade,” stated Gallagher.

https://www.revisor.leg.state.mn.us/statutes/?id=151.37&year=2008
(link to new Minnesota statute)