Online purchasers foolishly endanger their health besides wasting money in a gamble more risky than roulette. They need to stop and think: How can prices be so low if not for the likelihood that the items are imitations or of dubious efficacy? They multiply the danger if they buy without a doctor's examination and prescription. According to EAASM, over 90 per cent of websites sell prescription-only drugs without a prescription, and only 6 per cent of them have a named, verifiable pharmacist. Fly-by-night vendors, with no traceable brick-and-mortar addresses, open and close sites with regularity. Meanwhile those who buy from them end up with no relief - or worse, drug interaction, overdose, addiction or poisoning.

Sites that look authentic, with advertised host countries and endorsements by big pharma brands, are no guarantee of reliability. These can be fabricated. Pharmaceutical companies have tried without much success to combat counterfeits by tightening their supply chain, packaging with holograms and printed digital devices, and inserting electro-magnetic, radio-frequency or bio-molecular tags. International or regional initiatives, such as the EAASM effort, could help the national authorities identify and take down offending websites. The drug industry, credit card companies and shippers can also do their bit, but such action is not an effective substitute for consumer awareness. As always, buyers beware.