The list of email spam seems never ending as it clogs our Inboxes
daily with advertising for products such as:
And apparently, all of these products are…
■Rolex watches■Gucci bags
■Tiffany and Co. jewelry
■Top quality software ■Brand name drugs
INSIDE
5
Alberta Pharmaceutical Strategy Phase 2 takes effect April 1, 2010
6
Saskatchewan next to expand role of pharmacists
6
Provincial dental fee increases
7
In the chair with Dr. Zieba
7
Exciting introductions at
Investigative Report:
Drug-selling websites
Ever wonder where all those
spam drug emails come from?
THE
INSIDE STORY
®Drug selling websites
Affiliate web marketers call them-selves ‘webmasters’. Their job is to drive traffic to their partners’ e-stores through an affiliate
network—and their partners are the actual drug distributors and manu-facturers.
What’s their motivation?
Commissions – hefty commissions in the range of thousands of dollars per
marketing attracts people motivated by the high earning potential and flexibility of self-employment. Some affiliate networks are legitimate, but others focus on the promo-tion of illegal products—and where drugs are concerned— this often means dangerous products.
In our opinion, the myriad of drug-selling websites should not be referred to as ‘online pharmacies’ because the vast majority of them are illegitimate—they have not met the standards of practice within their province or territory and accord-ingly, are not licensed online
pharmacies. They are simply illegiti-mate ‘drug-selling websites’—yet they send hundreds of spam emails each day, sell thousands of drugs each week, and make millions of dollars each year.
How do they do it? To answer this question, we decided to go under-cover—at least our version of undercover—with some extensive googleing and tapping into some reliable sources.
Here’s the inside story on ‘drug-selling websites’
Affiliate web marketing is the answer
It’s a growing multi-million dollar industry
It’s amazing what you can get onlinethese days—all genuine, fast, and cheap—however, that’s if you believe everything that lands in your Inbox. Email subject lines like “70% off wholesale prices”, “Pharmacy Online”, “Meds for men only” from senders with handles like
“Wholesale Viagra Reseller” or “Licensed Pfizer Importer” repeat-edly using words like “Genuine”, “Authentic” and “Cheaper” have become the norm. Illegitimate phar-macies are rampant.
If you don’t have a strong firewall, or if you haven’t been diligent in setting up and then constantly updating email spam filters at work or home, you may be one of the unlucky ones who receives drug spam emails every day, all day long. Ever wonder who is behind them? How do they work?
Counterfiet P
ills in Montr
eal
Officials seiz
ed 15,000
counterfeit p
ills and
arrested nine
people
during raids
in the
Montreal reg
ion. Fake
medications
included
those used to
treat
cancer and e
rectile dysfu
nction. The d
rugs were
being sold in
stores, onlin
e and on the
street,
according to
officials.”
Montreal, Canada Aug
ust, 6, 2009
Here’s a better name for ‘drug selling websites’…
Counterfeit drug peddlers
Counterfeiting of medicines is hugely lucrative because of the continued high demand for medi-cines and low production costs. The Centre for Medicines in the Public Interest (United States) predicts that counterfeit drug sales will reach US$ 75 billion globally in 2010, an increase of more than 90% from 2005. Although precise and detailed data on counterfeit medicines is difficult to obtain, estimates range from around 1% of sales in devel-oped countries to over 10% in developing countries, depending on the geographical area.
To reap the financial rewards, coun-terfeit drug peddlers use whatever means they can to manufacture and sell their fake drugs online. For instance, the key to a successful affiliate web marketing network is to purposefully create a tangled web—a web of affiliates, distributors, and
manufactures—all focused on selling as much as possible while avoiding detection so they disguise their activities through:
■Creating fictitious businesses and front companies,
■Exploiting weak border controls whenever they can, and
■Falsifying documents to purchase pharmaceutical ingredients and equipment necessary to replicate genuine products.
In addition, the majority of counter-feiters apprehended so far carried out their activities in ordinary house-holds, small cottage industries, or in backyards. And although we are getting more sophisticated in terms of how to block out spam email, the Internet offers numerous ways for these highly technical web
marketers to get through to us like blogs, online forums, and social networking sites.
The World Health Organization (WHO) defines counterfeit medicine as “a medicine delib-erately and fraudulently mislabeled with respect to identity and/or source. Counterfeiting can apply to branded and generic products; and counterfeit products may include products with the correct ingredients or with the wrong ingredients, without active ingredients, with insufficient active ingredients or with fake packaging.”
Inquiring minds may need to know…
But everyone must be warned of the dangers of
counterfeit drugs
Although we may not be able to totally block out the spam—or catch all of the counterfeiters—awareness can go a long way in terms of preventing health issues. Using substandard or counterfeit medicines can lead to a wide range of health issues and even death. For example, the WHO reports that during a meningitis epidemic in Niger in 1995, more than 50,000 people were inoculated with fake vaccines resulting in 2500 deaths. The
vaccines were received as a gift from a country that thought they were
safe. In fact, the WHO estimates that medicines purchased over the Internet from sites that conceal their physical address are counterfeit in over 50% of cases. The types of counterfeits reported to WHO include products with:
■no active ingredients
■low content of active ingredients ■poor quality drugs
■wrong ingredients ■wrong source
Buyer Beware
Plan Member Beware
As we touched on in the February2010 Inside Story, Health Canada warns us to be wary of websites and online advertising that promise cheap prescription drugs without physician authorization. In addition to the warning signs like no prescrip-tion, not having DINs, and no street address or telephone number, illegit-imate drug-selling websites often also try to lure customers with claims like:
■All major credit cards accepted ■24/7 customer support
■Discreet packaging ■Secured ordering
For more information about the warning signs access the February 2010 Inside Story at greenshield.ca as well as Health Canada’s overview
hl-vs/iyh-vsv/med/ internet-eng.php. To help you keep up on the situation, our pharmacy experts also provided some helpful sources. You can check out licenses at Health Canada’s Drug Establishment Licence Live Listingat http://webprod. hc-sc.gc.ca/el-le/index-eng.jsp. And, to keep up on what is going on worldwide, they suggest regularly visiting the Counterfeit Drug Incident Encyclopediaat
http://www.safemedicines.org/ counterfeit-drug-incident-encyclopedia.htmlbecause with the mysterious way these unscrupu-lous networks operate, there might be a drug counterfeiter right in our own backyard.
So there you have it: play it safe—
rely on the
pharmacies they have grown to know and trust. If online options become available through an established pharmacy, they should talk to their pharmacist so they are informed consumers.
This is Green Shield Canada, reporting from cyberspace,
WHAT’S NEW
Phase 2 of the Alberta
Pharmaceutical Strategy aims to “reduce prescription drug costs and save money for Albertans, employers and government, improve prescrip-tion drug use, and provide better care to Albertans and improve their health.” As of April 1, 2010, the following come into effect: • Generic drug prices:Prices for existing generic drugs will be reduced to 56% of the brand price. Previously, in October 2009, the price for new generic drugs was reduced to 45% of the brand price. • Transitional allowance:The Alberta government will be
providing transitional allowances to pharmacies to help them make the move to a new payment model for pharmacy services to be introduced July 1, 2010. The allowance will be
added to each prescription less than $75 and will be provided for three years; after March 31, 2013 it will be eliminated:
•$3 per prescription from April 1, 2010 to March 31, 2011
•$2 per prescription from April 1, 2011 to March 31, 2012
•$1 per prescription from April 1, 2012 to March 31, 2013
The transitional allowance will be charged as part of the drug cost.
How this affects you…
The Canadian Life and Health Insurance Association recommends that plan sponsors follow suit by also paying the transitional
allowance over the next 3 years. To minimize any effect on your plan members, Green Shield Canada has incorporated the transitional
allowance into our drug adjudication process. Bottom line, despite the additional expense of the transitional allowance, plan sponsors will realize a net cost savings due to the reduced pricing on generics.
For more information about Phase 2, please visit the Alberta Health and Wellness website Phase 2 page at
http://www.health.alberta.ca/ initiatives/pharmaceutical-strategy-2.html
Alberta Pharmaceutical Strategy
Phase 2 takes effect April 1, 2010
Winner of the draw for a night out on the town
Congratulations to Dan De Athe, of St. Thomas, Ontario, the winner of Green Shield Canada’s monthly draw for gift certificates for a night out onthe town. Through this contest, one name will be drawn each month from plan members who have registered for Plan Member Online Services for that month. To learn more, visit greenshield.ca.
Download additional copies of The Inside Story® on our website
greenshield.ca/English/CorporateOverview/Publications/InsideStory/
More of
The Inside Story
®The list of email spam seems never ending as it clogs our Inboxes daily with advertising for products such as: And apparently, all of these products are…
■
Rolex watches
■
Gucci bags
■Tiffany and Co. jewelry
■
Top quality software
■
Brand name drugs
✔
Authentic! ✔
At a fraction of the price! ✔
Delivered immediately!
INSIDE
5
Alberta Pharmaceutical Strategy Phase 2 takes effect April 1, 2010
6
Saskatchewan next to expand role of pharmacists
6
Provincial dental fee increases
7
In the chair with Dr. Zieba
7
Exciting introductions at Green Shield Canada
Investigative Report: Drug-selling websites
Ever wonder where all th ose spam drug emails come f
rom?
THE
INSIDE STORY®
APRIL 2010 GREENSHIELD.CA ...
Ontario Ministry
of Health
Generic Drugs
Pricing Review
As we conveyed in a previous Inside Story, there are still more questions than answers where Ontario is concerned. We are still in ‘wait and see’ mode regarding how the Ontario government will proceed regarding questions like: ■Will generic costs be reduced as
low as Alberta levels?
■Will private plan pricing remain unregulated?
■Will there be additional charges for clinical pharmacy services? As promised, we will continue to keep a close watch on the situation and provide updates.
WHAT’S NEW
We previously saw British Columbia announce their intent regarding expanding the role of pharmacists, now it’s Saskatchewan’s turn. On March 3rd, 2010, Saskatchewan Health Minister Don McMorris announced the province’s intent to expand prescribing authority for Saskatchewan pharmacists. Expected to take effect by this summer, the amendments authorize pharmacists to provide services such as
extending refills during a physician's absence and providing emergency supplies of prescribed medications. In addition, it sets the scene for future changes, where pharmacists who acquire additional training, and in collaboration with physicians, may be allowed to alter dosages or formulas, or prescribe certain medications for minor ailments.
“Collaborative practice arrange-ments between physicians and pharmacists are an essential step toward a patient- and family-centred health system, and represent a model that can also
be used with other members of the health care team,”
Saskatchewan Medical
Association President Dr. George Miller said. “Enhancing a phar-macist’s authority to write prescriptions in certain circum-stances is an excellent example of how we are putting the needs of the patient first.”
What it means for you…
Your drug plan with Green Shield Canada is not affected because prescription drug benefits are eligible when written or adapted by health professionals with recognized prescribing authority in a given province as permitted by law. For example, this authority could possibly be granted to physicians, dentists, nurse practitioners, and, in the case of Saskatchewan, pharma-cists. However, the prescription must be for a drug that is eligible under your drug plan and similar to physi-cian service fees, pharmacy clinical service fees associated with adapting prescriptions are not eligible.
This chart lists the average weighted increases by province for dental services performed by general practi-tioners from 2009 to 2010 based on information provided by each
provincial dental association. The chart also lists the straight average increase (i.e., not weighted) for all provinces.*
Contact your Green Shield Canada Account Executive or plan advisor for cost containment strategies that can help offset the impact of these annual increases.
Saskatchewan next to expand role
of the pharmacists
Provincial dental fee increases for 2010
BC AB MB SK ON PQ NB NS PE NF 2.42 % 4.00 % 3.36 % 4.07 % 2.45 % 2.90 % 2.00 % 2.04 % 2.07 % 6.00 % 3.13 % STRAIGHT AVERAGE Average Increase 2009-2010
London 1-800-265-4429 Toronto 1-800-268-6613 Customer Service 1-888-711-1119 Vancouver 1-800-665-1494 Windsor 1-800-265-5615 Montreal 1-800-268-6613
greenshield.ca
In the Chair with Dr. Zieba
Dear Dr. Z
In a previous Inside Story, you answered a question about dental implants. In terms of whether an organization should cover them or not, you explained that it all depends on the organization’s overall benefit strategy; whether they are focused on cost containment or looking for ways to enhance employee satisfaction and retention. This got me thinking—my organization is definitely focused on cost containment. Can you give me some tips for areas in our dental plan to review and
potentially change? Signed, Mr. Cost Containment
Dear Mr. C.C.,
The first step to realizing savings is to do exactly what you have suggested – review your dental plan. However, you need to review it in detail by dividing it into two categories: ‘must have” versus ‘nice to have’. Then, drill down each category (no pun intended) by asking yourself, “are they really ‘must haves’ or just included because they have always historically been included?”. Similarly, with the ‘nice to have’ category, ask yourself, “if included, would they build employee satisfaction without necessarily adding costs?”
In addition to reviewing your plan, this might also be a good time to analyze current utilization. Take a look at these areas:
• Recall exams (including exam, scaling, polishing, fluoride): consider extending from 1 exam every 9 months to 1 every 12 months. Why? Some dental providers recall patients based on plan frequency; not neces-sarily based on patient needs.
•Bitewing x-rays: consider extending from 1 x-ray every 9 months to 1 every 12 or 18 months. Why? It reduces unnecessary
exposure to x-rays. Recommendations for x-ray intervals developed jointly by the US Food and Drug
Administration and the American Dental Association range from 6-12 months for those most at risk for cavities to 2-3 years for those least at risk. A 12-month minimum interval satisfies these guidelines.
• Crowns/bridges:consider
extending from 1 crown/bridge every 5 years to 1 every 7 years. Why? Estimates of crown lifespan range from 10 - 20 years. Replacement of
crowns at 5-year intervals is often based on cosmetics rather than therapeutic need.
• Co-pays:consider adding or increasing so that employees are contributing to the cost and involved in decision making regarding their own care.
You will gain a lot of insight by analyzing your dental plan and utilization data, however, to really give it the in-depth ‘once over’ that can lead to concrete savings, contact your plan advisor and your health and dental benefit carrier for help— they have specialized expertise to provide you with additional suggestions and insight.
We are pleased to announce the following appointments to the GSC Sales Teams:
■Robyn Israel
– Product Manager, Toronto
■Claudine Ouellette
–Account Executive, Montreal
