Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies.

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.