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Consumer Health Digest #19-37
September 15, 2019

Consumer Health Digest is a free weekly e-mail newsletter edited by William M. London, Ed.D., M.P.H
http://www.calstatela.edu/faculty/william-m-london
., with help from Stephen Barrett, M.D
http://www.quackwatch.org/10Bio/bio.html
. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making. Its primary focus is on health, but occasionally it includes non-health scams and practical tips.

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Lawsuit alleges conspiracy to limit access to affordable medicines

Allegations in a lawsuit filed by PharmacyChecker.com
http://www.pharmacychecker.com/
in the Southern District Court of New York include:

• The National Association of Boards of Pharmacy (NABP), LegitScript, and three Pharma front groups are operating a coordinated campaign to suppress market competition, artificially inflate the price of prescription drugs, and spread misinformation to scare consumers away from international online pharmacies. As part of this, they have targeted PharmacyChecker.com, which operates a rigorous online pharmacy verification program that helps consumers identify accredited online pharmacies, including those in Canada, and provides comparisons of their drug prices.
  
• A month's supply of the diabetes medication, Januvia, costs around $479 in the U.S. but, as shown on PharmacyChecker.com
  https://www.pharmacychecker.com/januvia/50+mg/
  , only $114 from a Canadian pharmacy and as little as $25 from licensed pharmacies in other countries. Online pharmacies accredited through the PharmacyChecker Verification Program
  https://www.pharmacychecker.com/online-pharmacy-ratings/
  process prescription drug orders that are filled by licensed pharmacies that require a valid prescription and do not sell controlled drugs into the United States.
  
• A hub of the alleged conspiracy is a blacklist—the "Not Recommended Sites" list—created by the NABP with a grant from Pfizer. NABP claims that sites on this blacklist put "you and your family at risk" and it warns consumers to "Avoid These Websites." However, in addition to listing dangerous, rogue pharmacy sites, the NABP list includes dozens of sites that PharmacyChecker has found to be safe international online pharmacies.
  
• The NABP, working through a co-conspirator, the Center for Safe Internet Pharmacies (CSIP), succeeded in convincing Internet search giants Google and Bing to penalize "Not Recommended Sites" in their search results. Two co-defendants had a foundational role in establishing CSIP's work: LegitScript (a competitor of PharmacyChecker.com that does not accredit pharmacies that ship to Americans from abroad) and the Alliance for Safe Online Pharmacies (ASOP), an organization founded with money from LegitScript, the drug company Eli Lilly, and the National Association of Chain Drug Stores.
  
• The other named co-conspirator, The Partnership for Safe Medicines, is a listed observer to ASOP, has deep ties to Big Pharma and has orchestrated a wide-reaching campaign against foreign drug imports, including misinformation about PharmacyChecker.com.
  
• In December 2018, the NABP added PharmacyChecker.com to its blacklist, despite the fact that PharmacyChecker.com is not a pharmacy, not involved in selling medicine, is purely informational, operates lawfully, and poses no risks. The NABP even added PharmacyChecker.com's news blog site (
  http://www.pharmacycheckerblog.com
  ) to the blacklist.
  
• The results attributed to this blacklisting in the suit have been devastating for PharmacyChecker and those seeking information about safe and affordable medicine. For example, the top results for "online pharmacies" in a Google search previously included a link to PharmacyChecker.com's directory of accredited online pharmacies. But those results have been moved many pages down, virtually out-of-sight.
  
• On July 21, 2019, a WARNING box started appearing when users clicked search results for PharmacyChecker on Microsoft's Bing, denying the link and directing users instead to information from the NABP, CSIP, and LegitScript, three of the co-conspirators in the suit.
  

PharmacyChecker.com is requesting a preliminary injunction
http://www.casewatch.net/civil/pharmacychecker/injunction_memo.pdf
requiring that its Web site and blog site be immediately removed from the NABP's "Not Recommended List" and requiring CSIP's members, including Google, Microsoft, and other Internet gatekeepers, to reverse their censoring.

[Pharma front groups have conspired to keep drug prices high by blocking online information about lower-priced options
https://www.pharmwatch.org/news/pharmacychecker.shtml
PharmacyChecker.com news release, Aug 14, 2019]

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Problem of tainted drugs examined

An impurity called N-nitrosodimethylamine (NDMA) that may cause cancer has been found at low levels along with other nitrosamine impurities in blood pressure and heart-failure medicines of the class known as angiotensin II receptor blockers (ARBs) since last year. Recalls were announced. Last week, the U.S. Food and Drug Administration (FDA) announced that some medicines with ranitidine as the active ingredient including the brand name drug Zantac have been found to contain NDMA.
 [Statement alerting patients and health care professionals of NDMA found in samples of ranitidine
https://www.fda.gov/news-events/press-announcements/statement-alerting-patients-and-health-care-professionals-ndma-found-samples-ranitidine
FDA statement, Sept 13, 2019]

Congress has asked the U.S. Government Accountability Office to evaluate FDA's supervision of the relevant factories. As noted in a Bloomberg Businessweek report:

"Until recently, regulators were confident they were properly assessing the potential risk in generics production. Now they're realizing that a system so dependent on trust and self-regulation has vulnerabilities. They know the process sometimes ends with potentially dangerous pills in bottles. Now they have to uncover how it begins."
[Edney A and others. Carcinogens have infiltrated the generic drug supply in the U.S.
https://www.bloomberg.com/news/features/2019-09-12/how-carcinogen-tainted-generic-drug-valsartan-got-past-the-fda
Bloomberg Businessweek, Sept 12, 2019]

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CVS brand Algal-900 DHA dietary supplement settlement reached

A proposed settlement has been reached with CVS Pharmacy, Inc. ("CVS") in a class action lawsuit about the statements made on the labels and packaging of a CVS-branded Algal-900 docosahexaenoic acid (DHA) dietary supplement.

People who purchased the product in the United States between November 15, 2008 and September 30, 2016 that contained claims of "clinically shown to improve memory" or "clinically shown memory improvement" on the label or packaging can submit a claim form to receive a refund and other benefits at the Worth v. CVS Pharmacy, Inc. Settlement Website
http://www.cvsdhasettlement.com/

=================================
Stephen Barrett, M.D.
Consumer Advocate
287 Fearrington Post
Pittsboro, NC 27312

Telephone: (919) 533-6009

http://www.quackwatch.org (health fraud and quackery)
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