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Rogue pharmacies still a problem for search engines

A recent report on sponsored search ads on Bing highlights the ongoing challenges posed by shady drug vendors to Microsoft, Google, and Yahoo.

With Bing, Microsoft is trying to reinvigorate its role in the search business. It has also inadvertently brought renewed attention to the problem of illicit pharmacies operating on the Internet.

The attention on Bing came earlier this month with the results of a study that examined Internet pharmacy ads (PDF) on Microsoft's revamped search engine. The study, conducted by LegitScript, an online pharmacy verification service, and KnujOn, an Internet compliance company, found that 90 percent of the reviewed Internet pharmacy advertisements were from fake or illegal Internet pharmacies. It also found that most of the Internet pharmacies reached through sponsored ads on Bing did not require a valid prescription.

Sponsored ads are links, paid for by companies hawking products and services, that turn up at the top of search results pages alongside noncommercial links.

A study by LegitScript and KnujOn takes Microsoft to task for sponsored search ads on its Bing site that lead to sketchy Internet pharmacies. (Click image to enlarge.) LegitScript

"We were able to purchase potentially addictive drugs without a prescription or any age verification via ads," LegitScript President John Horton told CNET News. "We also received counterfeit medication. Microsoft profits from these illegal ads, which put Internet users at risk."

But the problem isn't confined to Bing. For all the buzz generated by Bing--which debuted in June, replacing Microsoft's Live Search--it's still only the third most-used search tool, dwarfed by first-place Google and also well behind Yahoo. And those search engines themselves are no strangers to ads for illicit pharmacies.

The problem has also been around since consumers began flocking to the Internet more than a decade ago. In 2003, for instance, Yahoo's Overture unit bowed to pressure from pharmacy groups and stopped selling search-related advertising to unlicensed online pharmacies. That also spelled an end to the troublesome ads on Microsoft's MSN portal, at that time a significant partner of Overture.

Over the last decade, the situation has evolved to bring new challenges.

"In the early years of the Internet, it was a case of entrepreneurs not understanding the legal requirements for the dispensing of drugs. Later, it was the push by senior citizens and public officials to obtain drugs that were cheaper than medications available in the U.S.," said Carmen Catizone, executive director of the trade group National Association of Boards of Pharmacies.

"At the present time," said Catizone, who vouched for the research by LegitScript, "the Internet has become a haven for drug seekers and abusers, particularly (regarding) controlled substances. It is a much more serious and dangerous phase of the Internet."

Rogue online pharmacies sell a wide range of medications, from the sleep aid Ambien to the muscle relaxant Soma and the erectile dysfunction treatments Viagra and Cialis. The NABP lists only 18 certified and recommended online drugstores at its Web site, while more than 3,800 are non-compliant and not recommended

The response from Redmond
Microsoft disputes LegitScript's claim that 90 percent of the sponsored Internet pharmacy ads on Bing are fake or illegal, adding that it is working to weed out the rogue advertisers that do slip through. The company uses an Internet pharmacy verification service called PharmacyChecker--a competitor of LegitScript--to ensure that its sponsored prescription drug advertisements are legitimate.

"Our editorial system used PharmacyChecker's list of approved advertisers as our guideline in this case," Microsoft said in a statement to CNET News. "During a quality analysis of the sponsored results for the most frequently used Pharma terms (a more exhaustive set than was used in the study), we found that the actual rate of violation was closer to 15 (percent)."

No prescription required.
A significant risk posed by sketchy online pharmacies, according to groups that monitor such sites, is that they don't require a prescription for potentially dangerous medications. LegitScript

The Bing study is supposed to be the first in a series of reports from LegitScript, but it's unclear who'll be next on the list, or when such a report might come out. Asked if LegitScript had tracked or plans to track ads on Google or Yahoo, Horton said he couldn't comment. (Editors' note, 5:47 a.m. PDT: On Tuesday, LegitScript and KnujOn released their report on Yahoo (PDF), charging that more than 80 percent of the pharmacy ads that turn up in Yahoo searches violated state or federal laws.)

The NABP's own analysis of search results from Google and Yahoo turned up many drug ads from sketchy purveyors.

In an April 2008 study of 558 Internet drug outlets, the NABP discovered that nearly half were selling prescription drugs illegally or unprofessionally. Out of 258 rogue pharmacies, 191 did not require a valid prescription, 118 offered foreign or non-FDA approved drugs, and 91 were located outside the U.S. but offered to ship to U.S. customers, all of which is illegal.

The NABP says that when informed of the study, Google responded that it would start using the association's list of certified Internet pharmacies to filter out rogue sites, while Yahoo said it was relying on PharmacyChecker to help screen out illegal drug vendors.

Washington jumps in
It's not just the private sector that's targeting rogue pharmacies. Congress last year passed the Ryan Haight Online Pharmacy Consumer Protection Act, which went into effect this past April. Named for an 18-year-old who died from an accidental overdose of drugs he bought online, the legislation bans the sale of prescription drugs over the Internet without a valid prescription.

The Ryan Haight act should be a significant step in the right direction of trying to control this open channel of distribution, according to Susan Foster, director of policy research and analysis for Columbia University's National Center for Addiction and Substance Abuse (CASA).

"It will clarify the law," she said. "The problem was that the Controlled Substances Act (passed in 1970) was written prior to the Internet, so there were questions about the online sale of drugs and what was a legitimate doctor/patient relationship."

Foster is familiar with the LegitScript study and said that its results were consistent with her organization's own findings.

CASA's July 2008 report was its fifth annual study examining the online availability of prescription drugs, and it focused on substances including Valium, Xanax, and Ritalin. CASA found that the number of Web sites selling prescription drugs rose each year from 2004 to 2007, then dipped somewhat in 2008.

In 2008, the number of online drugstores CASA found that didn't require a prescription was around 85 percent. Out of 365 sites discovered advertising or selling prescription drugs, only two were certified by the NABP as legitimate. The group found sponsored ads for rogue pharmacies prominently displayed on both Google and Yahoo, and also spotted similar ads on MSN/Live Search. CASA was unable to issue another study this year due to lack of funding.

When asked by CNET News to discuss this issue, Google declined to comment. The company's Pharmacy Qualification requirements are available online. Yahoo did not respond to a request for comment.

Back to Bing
Overseas pharmacy sites are a stubborn problem when it comes to online drug ads, as is the involvement of criminal networks responsible for a significant portion of the world's spam, fake drugs, and cybercrime. (The Ryan Haight act regulates only online drugstores in the U.S.)

Lots of fake or illegal pharmacy sites.
LegitScript says that nearly 90 percent of the sponsored ads on Bing for online pharmacies were from fake or illegal sites. Microsoft says the rate of violation is closer to 15 percent and that it's taking steps to combat the abuses. LegitScript

"These ads aren't real pharmacies," said Garth Bruen, president of KnujOn, which tracks spam and other online and e-mail-based threats and conducted the Bing study along with LegitScript. "These types of sites are usually the product of organized crime and vast illicit drug networks, many of them based in Russia and Eastern Europe, that deceive, defraud, and poison Internet users."

In the LegitScript study, researchers found a total of 69 pharmacies by running random searches on Bing for prescription drugs, using terms such as "online pharmacy" and "buy Viagra" to find sponsored ads. Of the 69 drug vendors uncovered, only seven were certified as legitimate by LegitScript. The rest were considered to be operating illegally in one way or another.

The authors took a closer look at 10 of the 69 online drugstores. None of the 10 required a valid prescription. Orders were placed with two of them. Of the two drugs received, both were tested and one was found to be counterfeit.

"It is important to emphasize that the ten advertisers analyzed are not engaged in minor violations of pharmacy law," the report says. "Rather, they are wholly fraudulent websites run, in most cases, by criminal networks. They sell unapproved or counterfeit drugs, including addictive medications, without any requirement of a prescription. The drugs come from places like Calcutta, India, which is a violation of US drug safety regulations. In several cases, the websites are operated by individuals in Russia or Eastern Europe, not US-based pharmacists. In short, these 'Internet pharmacies' are neither pharmacies at all, nor run by pharmacists: they are simply online street corners run by drug dealers."

Horton said that LegitScript has tracked more than 41,000 Internet pharmacies, and at best only about 2 percent to 3 percent of those are legitimate.

The authors said they also uncovered security holes in Microsoft's online advertising program. A rogue Internet pharmacy called was able to advertise under the name of a U.S.-licensed pharmacy but redirect traffic to the fake Web site. This same security flaw was found in other cases.

In response to the LegitScript/KnujOn study, an August 7 blog post written by Microsoft AdCenter Community blogger Carolyn Miller said the company believes "the advertisers noted in the report found a way to work around the verification process after being validated to advertise on Bing. These rogue advertisers manipulated the system by 'hijacking' and/or misusing landing pages. Our internal teams are continuing to investigate how these advertisers sidestepped the policy."

As immediate fixes, the blog noted that Microsoft has reviewed all pharma-related keywords to filter out any advertisers in violation of company policy. Microsoft also said its editorial team is validating the claims in the LegitScript report to investigate the hijacking and misuse of landing pages. For the longer term, the company said it is reviewing its processes to document how these advertisers got onto the system.

Microsoft says that its guidelines clearly require online pharmacies that advertise on Bing to adhere to U.S. laws.

And in a statement this week to CNET News, Microsoft said: "At this point, we believe that PharmacyChecker's system worked as designed. It is important to note, however, that PharmacyChecker's list of validated pharmacies is only one part of a complex system of editorial processes that enforce policy. We do expect this experience will drive system-wide improvements."