By Stephen Hawkes
BBC News Online
As the government gives the green light to internet-only pharmacies in England, BBC News Online looks at how unscrupulous online pharmacies in the US could be putting people's health at risk.
There are risks in buying drugs online
The UK's Department of Health has promised there will be strict restrictions to ensure internet-only pharmacies provided a professional service.
And in the US, there have been concerns raised about certain operators.
In the first six months of 2004, researchers working for the US Government ordered drugs - including "highly addictive narcotic painkillers" - from 90 internet pharmacies, by posing as patients.
One out of every two supplied them without asking for a prescription.
And one out of every three that supplied them did so without instructions for use.
Most of the drugs received were unapproved for sale in the US.
Thirteen of the orders were "shipped improperly, packaged unconventionally, or arrived damaged".
Tests revealed four of the pharmacies had sent counterfeit versions of brand-name drugs.
Others sent return addresses that, when traced, turned out to be private residences
And six took more than $700 (£384) of the "patients'" money but sent them nothing at all.
But the possibility of being ripped off has not halted internet pharmacies' growing popularity in the US.
In response to concern about public safety, the US National Association of Boards of Pharmacy (NABP) developed the Verified Internet Pharmacy Practice Sites (Vipps) programme in the spring of 1999.
To be Vipps certified, a pharmacy must comply with the licensing and inspection requirements of their state and each state to which they supply drugs.
Pharmacies displaying the Vipps hyperlink on their websites must satisfy NABP criteria including "patient rights to privacy, authentication and security of prescription orders, adherence to a recognized quality assurance policy, and provision of meaningful consultation between patients and pharmacists".
But most patients remain unaware of the risks of using uncertified internet pharmacies.
Last month, a US National Consumers League (NCL) survey of 1,013 adults conducted by Opinion Research Corporation found 15% - and one out of every four of those aged above 54 - had bought prescription drugs online.
Most of those who had, admitted there was no way of telling if they were genuine.
And 12% of them said they had "never or almost never" had a prescription from their doctors for the drugs they were buying.
One out of every three said they had been given a prescription by an online doctor.
And almost as many said they had not been asked for a prescription at all.
NCL president Linda F Golodner said: "Getting fooled by counterfeit drugs could mean wasting your money on ineffective medicine - but it could also mean taking grave health risks with drugs that aren't what they pretend to be."
Leading drug company Pfizer has also warned about the dangers of buying medicines over the internet.
A spokesman said: "In one case which came to light, one man in China was dealing in counterfeit Viagra, supplying over a quarter of a million pills a month.
"He had infiltrated about nine European and Middle Eastern countries and around 10 US states."