Online Pharmacy Accessibility of Imatinib, An Oral Chemotherapy Medication

Authors: Yujiao Sun PharmD1, Adam Hendrix PharmD1, Benyam Muluneh PharmD, BCOP, CPP2, and Sachiko Ozawa PhD, MHS1,3
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  • 1 Division of Practice Advancement and Clinical Education, and
  • | 2 Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina, and
  • | 3 Department of Maternal Child Health, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.

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 displayed in the first 10 pages. Websites were included if they were published in English, sold imatinib, were free to access, and offered shipping in the United States. Websites were classified using LegitScript’s categorization as “certified,” “unclassified,” “unapproved,” or “rogue.” We analyzed information on websites’ patient safety characteristics, marketing techniques, pricing, domain registration information, 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). Thirteen online pharmacies (30%; 9 rogue, 4 unclassified) sold imatinib without 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 pharmacies 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 registered 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.

Submitted October 25, 2021; final revision received January 20, 2022; accepted for publication January 24, 2022.

Author contributions: Conceptualization: Ozawa. Data curation: Sun, Hendrix. Formal analysis: Sun, Hendrix, Ozawa. Investigation: Sun, Hendrix. Methodology: Muluneh, Ozawa. Supervision: Ozawa. Writing—original draft: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization regarding the preparation, analysis, results, or discussion of this article.

Correspondence: Sachiko Ozawa, PhD, MHS, Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, CB#7574, Beard Hall 115G, Chapel Hill, NC 27599. Email: ozawa@unc.edu
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