Background: Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses.
Sources of data: A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005.
Areas of agreement: Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors.
Areas of controversy: Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime.
Growing points: Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective.
Areas timely for developing research: There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies.
Keywords: Internet governance; Internet pharmacies; cybercrime; cyberpharmacies; cybersecurity; e-pharmacy; online patient safety; online pharmacies.
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