Online Pharmacy Accessibility of Imatinib, An Oral Chemotherapy Medication

Background: Since prices of imatinib (Gleevec) remain high, patients on oral chemotherapy are looking for alternative methods to access this life-saving medication. We assessed the accessibility of imatinib through online pharmacies and analyzed each website for medication safety, price, and marketing tactics. Methods: We searched the term ???buy imatinib online??? using 4 commonly used internet search engines (Google, Bing, Yahoo!, and DuckDuckGo) and screened web pages dis-played in the first 10 pages. Websites were included if they were pub-lished in English, sold imatinib, were free to access, and offered shipping in the United States. Websites were classified using Legit-Script???s categorization as ???certified,??? ???unclassified,??? ???unapproved,??? or ???rogue.??? We analyzed information on websites??? patient safety charac-teristics, marketing techniques, pricing, domain registration informa-tion, and IP addresses. Results: Of the 44 online pharmacies identified, only 3 (7%) were certified, and the remainder were classified as rogue (52%; n=23), unapproved (30%; n=13), or unclassified (11%; n=5). Thir-teen online pharmacies (30%; 9 rogue, 4 unclassified) sold imatinib with-out a prescription. Nearly one-quarter (n=10) of online pharmacies selling imatinib did not include drug-related warnings on their websites, and nearly half (n=21) did not limit the purchasable quantity. More than three-quarters (n=34) of online pharmacies selling imatinib did not offer pharmacist consultations, even though nearly all websites extended offers to speak with sales associates (91%; n=40). Most online pharma-cies selling imatinib claimed price discounts (95%; n=42), but fewer provided bulk discounts (23%; n=10) or coupons (34%; n=15). One-third of rogue pharmacies selling imatinib (n=7) claimed to be regis-tered or accredited on their websites. Conclusions: The lack of safety measures taken by illegitimate online pharmacies endangers patient safety because they allow patients to purchase imatinib without appropriate evaluation for response, drug interactions, and adverse effects. Healthcare providers need to be aware of this practice and should assure patient access to imatinib through safe and legitimate pharmacies.