Pubdate: Sun, 09 Apr 2006
Source: Des Moines Register (IA)
Copyright: 2006 The Des Moines Register.
Contact:  http://desmoinesregister.com/index.html
Details: http://www.mapinc.org/media/123
Author: Tony Leys

U.S. PROSECUTES DOCTORS IN INTERNET DRUG RING

Prescriptions For People The Physicians Never Met Went Through A 
Small Pharmacy In Dubuque

Cedar Rapids, Ia. -- The physician sitting at the defendant's table 
looked like he could be a kindly colleague of TV's Marcus Welby, M.D.

He had neatly trimmed gray hair, a conservative sport coat and 
silver-framed bifocals. He identified himself as Edward Schwab, a 
71-year-old osteopath from Shreveport, La.

He was in federal court late last month to admit that he also was a 
drug dealer, one of numerous doctors who helped run one of the 
biggest Internet pill-distribution rings ever busted.

A magistrate judge double-checked his calm admission. "Do you 
understand what they're claiming you did wrong?" the judge asked.

"Yes, your honor," Schwab said.

In court papers, the doctor acknowledged illegally approving more 
than 19,000 electronic prescription requests from people wanting to 
buy narcotics or stimulants over the Internet.

Before he pleaded guilty to counts of conspiracy and 
money-laundering, the judge warned him that he could face up to 15 
years in prison when he is sentenced at a future hearing. In return 
for his guilty plea, prosecutors agreed to ask for only about three 
years, but the sentencing judge could order the full term, and there 
will be no parole.

Six other physicians also have pleaded guilty in court here. 
Prosecutors say they expect to charge up to 50 doctors, which could 
make this the broadest such prosecution in U.S. history. None of the 
doctors charged so far is an Iowan, but authorities won't say if any 
Iowans are among the remaining suspects.

The scheme began to unravel in 2003, when regulators noticed that a 
small Dubuque pharmacy suddenly was mailing out huge quantities of 
addictive drugs to addresses throughout the country.

Investigators raided the pharmacy, then tracked many of the drug 
orders to a Web site called BuyMeds.com. The site's owners allegedly 
paid physicians to write prescriptions based on electronic 
questionnaires that customers filled out from their home computers. 
Schwab admitted authorizing a total of more than 1 million doses of 
drugs requested via such Web sites. He admitted approving up to 200 
orders per day, and receiving $8 for each one.

Three Iowa pharmacists surrendered their state licenses, but so far, 
only physicians have faced criminal charges in the investigation. The 
government's broad net represents an increasingly aggressive approach 
against doctors involved in Internet drug schemes, a national expert 
said. "This is one of the biggest, if not the biggest, case of this 
kind that we've seen," said Dale Austin, senior vice president of the 
Federation of State Medical Boards.

Stephanie Rose, an assistant U.S. attorney prosecuting the cases, 
said doctors can provide a veneer of legitimacy to unscrupulous 
Internet drug sites. "The hope of the Department of Justice is to 
stop the flow of legal drugs to the illegal market," she said in an 
interview. "Doctors are a big part of the legal market. We want to 
make sure they're not drawn into the illegal market."

Authorities say it is illegal for a doctor to prescribe drugs without 
examining patients or having a legitimate medical relationship with 
them. It also is illegal for consumers to buy such medicine without a 
valid prescription, but consumers rarely are prosecuted for making 
purchases from the growing array of Web sites offering Vicodin, 
Valium, Ritalin and other addictive drugs.

BuyMeds.com, which was owned by a company in the Virgin Islands, no 
longer sells drugs, but many other sites remain in business. I 
nternet message boards are filled with boastful reports from the 
sites' customers. Here's one posted in 2003 by "Tyler," who related 
his experience buying the narcotic painkiller hydrocodone on 
BuyMeds.com. He ordered 60 pills on a Sunday night, and received them 
by Federal Express Wednesday morning, he said. "These will come in 
useful if ever I should run out of the Tylenol 3's my doctor 
prescribes. I have to say that out of the SIX internet pharmacies I 
have tried, they have ALL come through."

"Tyler" wrote that he spent $168 for the drugs. If he had brought a 
legitimate prescription for the same pills into an Iowa pharmacy, he 
could have bought them for about $35.

Urbandale pharmacist John Forbes said the fact that Internet 
customers will pay so much for the drugs implies they have addiction 
problems. "It runs up a big red flag to me," he said. Forbes 
applauded authorities for aggressively prosecuting the current case. 
"I think they're doing this to set an example. They want to put a 
stop to this."

Rose, the prosecutor, acknowledged that the government lacks 
resources to prosecute every customer who purchases pills illegally. 
"I don't think we're ever going to stop the addicts from wanting to 
buy them," she said. "All we can do is try to shut down the supply."

The leader of Iowa's largest doctors' group said he had no qualms 
about possible imprisonment for physicians in such cases. "This isn't 
about legitimate business. This is about drug-dealing," said Dr. 
Stephen Richards of Algona, president of the Iowa Medical Society.

[Sidebar]

Internet Drug Sites

Countless Web sites sell prescription drugs, but authorities warn 
that many of them are illegitimate and illegal.

Here are ways they say consumers can judge whether a site is 
legitimate: * Consumers should be wary of sites that offer doctors' 
prescriptions based on questionnaires filled out via computer.

* Sites should require that orders for prescription drugs be 
accompanied by a prescription from a doctor licensed in your state 
who has examined you, taken a medical history and determined a need 
for the medicine before writing the order.

* Legitimate sites should accept insurance payments. Many others 
insist on credit-card payments only.

Twelve Internet pharmacies have received the endorsement of the 
National Association of Boards of Pharmacy. The association, which 
represents government regulators, has developed a voluntary program, 
called the Verified Internet Pharmacy Practice Sites. A list of the 
approved sites can be found at www.nabp.net.
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MAP posted-by: Beth Wehrman