Fraud
Squad
by Corey Senn |
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Sounds
pretty good, doesn't it? The only problem--it's a lie. Ads like
this fall under the category of health care fraud, a problem
that swindles consumers out of billions of dollars each year.
And the emergence of the Internet has provided a new and dynamic
medium to market all sorts of these fraudulent wares. Health
fraud can be loosely defined as anything that claims to improve
an individual's health, well being, or appearance when, in fact,
the claim cannot be proven. This includes a range of drugs,
devices, foods, alternative therapies, and cosmetics that, oftentimes,
target conditions such as arthritis, cancer, HIV/AIDS, diet
or weight loss, and baldness.
Currently,
the Federal Trade Commission (FTC) and Food and Drug Administration
(FDA) oversee the laws that prohibit health fraud in the marketplace.
The following are excerpted transcripts from exclusive VAB
Your Health interviews conducted with Richard Cleland (Supervisor
of the FTC's Operation Cure.All), Thomas McGinnis (FDA Director
of Pharmacy Affairs in the Office of Policy), and Betty Dodson
(FDA National Health Fraud Coordinator):
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"The
Internet has changed the way snake oil salesmen market
their product from town to town. Literally every marketer
on the Internet is now a potential national or international
marketer."
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Q:
Do you think the advent of the Internet has heightened the
incidence of health fraud?
RC:
The Internet has changed the way snake oil salesmen market
their product from town to town. Literally every marketer
on the Internet is now a potential national or international
marketer. 34 million Americans searched for health care information
last year, 67% of these Internet users are unable to distinguish
between what is credible and what is not credible health information.
TM: You're bound to find unscrupulous characters moving
into this medium to try to sell their products to consumers
and get them to buy these products.
BD:
The Internet provides [the perpetrators of health fraud] with
innovative and new ways of presenting their product. And it
allows them to establish web sites without much oversight.
Q: What sorts of things are hot beds for fraudulent
products, claims, and services?
RC:
The products tend to be faddish. Many times, there is something
reported in the scientific press or in the media about some
ingredient that might be useful or preliminary evidence that
it might be useful. That is followed by a whole host of marketers
trying to sell products that claim to treat those diseases,
and generally not pointing out that there is no solid scientific
evidence to that effect. The major areas that get targeted
now are cancer, arthritis, diabetes, AIDS/HIV, and multiple
sclerosis.
Q:
Could you describe what the FTC's Operation Cure.All is about?
RC: Operation Cure.All is a three-part initiative focusing
on enforceable actions against egregious health care fraud,
as well as industry education and consumer education. It was
initiated in the fall of 1997 with a "surf day" we conducted.where
we identified some 400 sites making questionable claims for
cures or treatments of diseases. After each of these surfs,
we advised the companies that the claims they were making
had to have competent, reliable, scientific evidence to support
them. And if they didn't have this, it was illegal. Many involve
ingredients like CMO (purports to treat and/or cure arthritis),
cat's claw, shark cartilage, and ESSIAC (which claims to be
a cancer and AIDS cure).
Q:
How do you determine which sites to investigate first?
TM:
The (FDA) commissioner has set three priorities. The first
is anything that can be really harmful to consumers, the GBL,
GBH type drug products, the so-called "date rape" type drugs.
Those have been our highest priority, anything that could
harm someone. Prescription drugs sold online that may be coming
from illegitimate or rogue sites have been another of our
highest priorities. And finally, health fraud in general,
anything that tries to fool the American consumer into using
their product before other traditional treatments are used.
Q: What is the most egregious practice that you've
heard of?
RC:
I think that physicians issuing prescriptions based on online
questionnaires, when they have no chance of discovering latent
diseases that may be contraindicated for the drug that's being
pushed on the site. An example is Viagra. Impotence may be
a symptom of heart disease, and the consumer may not be aware
that they are in the early, or later, stages of heart disease.
[Consumers] are not going to be providing that kind of information
on the questionnaire. And they're going to be getting a drug
that could be potentially fatal for them. Just as egregious
are those companies targeting vulnerable groups like cancer
sufferers or arthritis sufferers.
Q:
Do perpetrators of health fraud target certain populations
of people?
BD:
Yes, I believe they do. Most people who are taken in by health
fraud are looking for a miracle cure. Vulnerability is a big
factor there. Depending on what [the perpetrators of health
fraud] are promoting, that will usually determine the audience.
RC: More and more we're seeing products being talked
about that claim to treat childhood problems, particularly
like ADD and ADHD (attention deficit disorders). We've mainly
started seeing these products appear in the last two to three
years.
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"It's
important that the consumer not rely on one source of
information about a product. If you go to a web site and
find a mystery ingredient, do a search on that ingredient;
see if anyone has done any serious work on its efficacy
and safety."
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Q:
Is it difficult to find and stop those who are engaging in
clever Internet health fraud?
RC:
Yes and no. So far, we have not had an instance in which we
were unable to locate the culpable party. Having said that,
it is much more difficult to locate the culpable party than
it used to be. With an ad on TV, it's pretty easy to track
down the people who placed the ad. It's not always that easy
on the Internet. It requires more work and investigation on
our part. There are the potential problems of sites not staying
around long enough and disappearing before we can perform
the investigation.
Q:
With this in mind, would you say that it is ultimately up
to the individual to educate themselves and protect themselves
from health fraud?
RC:
The consumer is the first line of defense. And that's not
just a cliché. One of the worst things a consumer can do is
make an assumption that a product or service wouldn't be [on
the Internet] unless the government had somehow looked at
and approved the ad. That's no longer the case. It is a buyer
beware market on the Internet. It's important that the consumer
not rely on one source of information about a product. If
you go to a web site and find a mystery ingredient, do a search
on that ingredient; see if anyone has done any serious work
on its efficacy and safety. Don't rely just on the hype of
the company trying to sell you the product.
Q:
What advice would you give to online consumers to protect
themselves from online fraud?
TM:
We've told consumers to be careful of those sites that don't
show you where they're operating from, an address or a phone
number, how to contact them, or the name of a pharmacist to
call with questions if your going to buy medication. Typically,
legitimate pharmacy sites want you to know who they are, where
they are, and how to contact them.
Q:
And if people do find something online they feel is fraudulent
or suspect, are there places they can go to report it?
TM:
A special FDA site just went up on last year (fda.gov/medwatch).
We have gotten [a few hundred] reports of consumers finding
things on the Internet that don't look legitimate. Those reports
go directly to our office of enforcement and then they are
investigated.
RC:
If consumers go to [the FTC's site], there is a complaint
form they can fill out and give the [domain name] of the site.
We go through and take a look at those sites on a monthly
basis.
Protecting
yourself from health fraud
Do's and Don'ts for online users:
•
Avoid sites with products claiming to be "cure-alls"
• Be wary of testimonials from patients claiming amazing
results
• Watch out for catch-all phrases such as "scientific
breakthrough," "miraculous cure," or "secret ingredient,"
etc.
• Don't trust sites with claims that sound too good to
be true
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Consult with your pharmacist, doctor, or other health professional
before using "alternative" medical devices or products.
Online patient education
Where
to go to get the skinny on health fraud:
•
FDA (fda.gov)
• FTC (ftc.gov)
• Healthfinder (healthfinder.com)
• Quackwatch (quackwatch.com)
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