One solution that some families have used in response to the soaring cost of Mylan’s EpiPen, an essential product for people with life-threatening allergies, is to order the product from a cheaper pharmacy in Canada instead. While this might appear to be a solid plan, the problem is that “Canadian” pharmacies aren’t always necessarily what they claim to be online.

Real-life pharmacies in Canada aren’t the problem. Where consumers can encounter problems are online pharmacies that claim to be legit retailers in Canada or in another country with standards and laws comparable to the United States, but they aren’t. The problem with an emergency product like the EpiPen is that you won’t know that the product is counterfeit or compromised until it’s too late.

Our colleagues down the hall at Consumer Reports discussed this problem with the executive director of the National Association of Boards of Pharmacy, and learned that the NABP has conducted its own research on legit-seeming online pharmacies, finding that only 4% of sites that the organization reviewed were operating using U.S. standards.

The Food and Drug Administration and the Government Accountability Office have studied online pharmacies pretending to be legitimate foreign drugstores, and received medications that didn’t contain the stated dosages or that were contaminated with other substances.

There are legitimate online pharmacies and online outlets of existing pharmacies. What you should look for are sites that use the top-level domain “.pharmacy,” which means that the NABP has approved them, or membership in the NABP’s voluntary Verified Internet Pharmacy Practice Sites (VIPPS) program.

As for the EpiPen, you have other options too: there’s a patient assistance program for patients without insurance coverage for the device, and the drug maker has a copay coupon program to lower the cost even for patients who do have coverage. These programs have their limits, though: patients on Medicaid, Medicare, or whose health insurance comes through the military aren’t eligible.

Other options include Mylan’s forthcoming generic version of the drug and the Adrenaclick, a competing epinephrine auto-injector that lacks the brand recognition of EpiPen but works in the same way.

Don’t Order EpiPens From Canada [Consumer Reports]

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