Bitter pills - risks with online medicines

As a general rule, medicines may only be dispensed to customers by pharmacies and should therefore only ever be obtained there. In recent months, some (smaller) pharmacies have set up a web shop in addition to their on-site pharmacy in order to also supply their customers by mail order. In Austria, however, only the ordering and dispatch of over-the-counter medicines is allowed. In addition to the web shops of the public pharmacies, there are also some internationally operating groups that are more warehouse than pharmacy and operate exclusively online shops.

They deliver centrally from an EU country and orders are placed via a website adapted for the respective country. Buying from pharmacies in third countries, such as the USA or China, is not permitted. So-called "dropshippers" also fall into this category. They mainly buy from manufacturers in third countries - mostly in the Far East - at factory prices, and sell the medicines via a website that is designed as if it came from a domestic supplier in order to appear more credible. In these cases, the risk of counterfeit products is all the greater and there is usually no customer service, as dropshippers do not even have a warehouse and often do not know exactly what their own goods are.

The most problems, however, are with fake shops, which often present themselves as "internet pharmacies" in a reputable guise. Either the goods are not delivered at all and they just cash in, or the goods are counterfeited and mixed with problematic active ingredients and substances. These fakes often look deceptively real. There are some indications how you can recognise that this is a fake shop or a brand counterfeiter. For example, the shop only has a limited range, which is concentrated on product groups such as potency, slimming and hair growth products. But particularly expensive painkillers or sleeping pills, available domestically only with a prescription, are also suspicious. An advertised "100% guarantee of efficacy", a dedicated note "available without prescription" or texts in poor German (or English) are further clear indications.

Before placing an order, check the imprint and the payment methods of the online shop. Testimonials and warnings on consumer sites or review portals (such as Trustpilot) also provide important information about the provider. With just a few clicks, you can save yourself a lot of trouble. The imprint should contain information about the online shop, the postal address, the e-mail address and a contact for queries. A good web shop offers several payment methods, ideally also "purchase on account", a particularly secure payment method. If a shop only delivers against prepayment, this is a pretty clear indication of a fake shop. We recommend that - if purchase on account is not possible - you prefer to pay by credit card or PayPal. This way you have a recourse in case of fraud.

"This "medicine" may endanger your health!" - This notice would be appropriate on the packaging of many products purchased in good faith from an "internet pharmacy". Customs seized around 350,000 counterfeit and other illegal medicines in the previous year, and the number is rising sharply. The pharmacy advertises itself as an online pharmacy in order to give the sales a respectable However, the Medicines Act clearly states that only pharmacies based in Austria or the rest of the European Economic Area (EEA) may sell medicines ("medicinal products") via the Internet.

But not only the trade in counterfeits is a problem. The Chamber of Pharmacists warns in particular about questionable production conditions and ingredients in medicines that are not registered and authorised in Austria. Proper transport and professional storage are also not ensured. Counterfeits sometimes appear deceptively genuine and cannot be immediately distinguished visually from the originals. Products are considered counterfeit if they are copied from an original brand-name medicine and appear under the same or similar name and in the same or similar packaging. One speaks of illegal medicines if the goods are produced and sold outside the legal regulations.

In both cases, the buyers run a high health risk when they take or use these products due to a lack of quality control. Either the promised active ingredient is not contained at all or in the wrong dosage. For example, antibiotics that are dosed too weakly can lead to a higher resistance of bacteria in the long run. In the worst case, unknown ingredients have been used to which you may be allergic. In the absence of medical advice on dosage, use and interactions, you are thus literally "taking the medicine at your own risk". On the other hand, when buying medicines from a local pharmacy or a registered mail-order pharmacy, you can usually be sure that you will not receive any counterfeits due to the closely controlled supply chain.

If you buy banned medicines on the internet, you can get into a lot of trouble. Surprising import fees, steep return costs, even an administrative fine are possible. The sale of illegal medicines is big business internationally. The pandemic year 2020 unfortunately marks a peak when it comes to seizures of counterfeit medicines. In about 3,420 seizures, 350,000 counterfeit and other illegal medicines were seized, the second highest amount ever seized by customs in Austria. This was certainly also due to the fact that dubious promises of salvation were able to expand their assortment to include the "Corona" line in addition to well-known "classics" such as potency, diet and nutritional supplements.

Behind this illegal business is above all organised crime, which has no regard for the health or financial damage to the defrauded customers or the consequential costs to society. The pharmaceutical industry, which invests a lot of money in research and the development of new drugs, is also harmed. The health system is also burdened. Those who order supposedly cheaper or promising medicines abroad have no certainty that the composition of the active ingredients meets European standards. Time and again, dangerous ingredients are also found in product tests. In order to circumvent import restrictions, smuggling gangs organise transport into the EU area, which always find new smuggling routes when customs are successful.

If one looks at the list of confiscated drugs in detail, one could come to the conclusion that health care in Austria is in a very bad state. As already mentioned, "potency enhancers" and "fertility-enhancing products" of all kinds are at the top of the list. But also antidepressants, sleeping pills and tranquillisers as well as medicines against pain are in great demand. An astonishingly high share of the most popular smuggled medicines, 10 percent, are supplements that strengthen joints and protect bones. This is astonishing above all because these products - with or without a prescription - are easily available in a wide range of products. In general, one wonders about the trust that is placed in sometimes adventurous formulations instead of relying on the strict approval procedure in this country and a consultation with a doctor.

What are the legal consequences if a parcel is intercepted by customs as suspicious and subsequently confiscated? In the lesser case, the goods are either returned at the customer's expense or destroyed. Depending on the quantity imported, administrative fines of up to 3,600 euros can be imposed, and up to 7,260 euros in the case of a repeat offence. In the case of shipments of smaller quantities to private individuals, an administrative penalty is usually waived if the medicines are returned. Customs mainly targets professional smugglers who import large quantities.

Order a pack of ginseng capsules "cheaper" from an Asian supplier? Thanks to a generous exemption limit for import duties for goods worth less than 22 euros, this was previously possible without further costs. The EU has now put a stop to this tax advantage by requiring import VAT to be paid even for "bargain purchases" from third countries. The new regulation, which is intended to ensure more tax justice, has been in effect since 1 July 2021 and has already caused some excitement among surprised consumers. From now on, import VAT will be due for shipments from third countries (e.g. USA, Great Britain, China) if the sender has not already charged this amount directly when placing the order. There was no change in the customs limit, which remains at a value of 150 euros.