Mail-order pharmacies

With the ever decreasing availability of non-counterfeit black market steroids athletes are increasingly turning to international mail order and the Internet for steroid purchases. The success of purchase attempts varies enormously, as does the reliability of the mail order pharmacies. As the laws in this area remain vague, the following general guidelines should be used in mail order transactions in order to insulate the purchaser from potential problems. 

Mail-order pharmacy programs appear to be growing rapidly among employer-based health care benefit plans. In 1989, about 13 percent of U.S. employees had a mail-order drug benefit by 1990, 20 percent of employees had such a plan (135). 

Dr. Schondelmeyers report to OTA is based on data from the IMS America, Inc. MIDAS system using the United States Drugstore and United States Hospital database. That database does not include sales made directly to mail-order distributors, health maintenance organizations, or Federal Government health purchasers (such as the U.S. Department of Veterans Affairs and the military.) In 1986, IMS America claimed the database reflected 98 percent of ethical pharmaceutical sales in the United States (368), but this share may be declining as mail-order pharmacies become more important. 

Costello, 2(XX)). Different from mail-order-pharmacy, purchasing with the aid of computers appeals to many individuals, especially those who cannot leave their homes or who live in rural areas (Henkel, 2000). With a simple faxed prescription or an on-line request, a client can have his or her medicines delivered the next day to his or her own home. 

Distribution methods differ more between orphans and non-orphans more than the other categories discussed in this section. Conventional drugs are generally sold through wholesalers and directly to institutions. Orphan drugs more often use alternative distribution techniques —these include mail order pharmacies and direct sales to patients, physicians, and institutions. 

In 1990 there were over 650 companies in the United States that manufactured drugs, but the top 10 U.S. companies accounted for 86.5 percent of domestic drug sales. Generic prescription drugs are estimated to be about 20 percent of the total market. Their use is emphasized in hospitals, which account for 20 percent, and health maintenance organizations (HMOs), which are responsible for 15 percent of prescription purchases. Mail order pharmacies dispense an estimated 5 percent of all outpatient prescriptions. In addition, shipments of nonprescription drugs reached an estimated 10.4 billion in 1990. Research expenditures accounted for 16.85 percent of pharmaceutical sales. 

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