Factors related to the supply chain, such as pricing, origin, or quantities of a product, can indicate the likelihood of a cancer medicine being SF. It is important to be alert when:

• A medicine that was short in supply is suddenly available on the market.
• Prices are unusually low.
• For healthcare providers, documentation on wholesalers or distributor licences are missing or suspicious. More for healthcare providers here.

In the U.S. specifically, the FDA prohibits the purchase of prescription medicines outside of the U.S. supply chain and suppliers must be licensed in the state in which the physician or pharmacist practices. To verify a supplier:

• Use the FDA’s list of state licensing agencies to check distributor credentials.
• Search by business name, license number, location, or state.
• Confirm that the license is valid and active.
• Repeat this check at least twice per year.

If in the U.S., verify the license of your supplier using the FDA’s list of state licensing agencies: http://safedr.ug/fdalicense

Online pharmacies may be convenient and offer unbelievable discounts, things that would interest any cancer patient on a budget. But, most online pharmacies offering prescription drugs operate illegally and are a platform for the dissemination of SF medicines. In the U.S., 95% of online pharmacies are estimated to be illegal, and 24% of Americans who have used an online pharmacy have been exposed to SF medicines. According to the WHO, a legitimate online pharmacy requires a doctor’s prescription and provides the following information:

• Name of the pharmacy providing the service.
• The geographic addresses at which the pharmacy is established and its details (e-mail address, telephone, and fax numbers).
• Professional title of the pharmacist responsible and where title was granted.
• Professional body with which the responsible pharmacist is registered and the relevant supervisory authority.
• Reference to the applicable professional rules in the country of establishment and how to access them.

In the U.S., the NABP Safe Site Search Tool can help you verify any online pharmacy.

If you see a price advertised online that seems too good to be true, it probably is. Talk to a healthcare professional if you are unsure.

It is important to become familiar with the appearance, taste and packaging of your prescribed medicine. Sometimes, healthcare providers can provide a sample of the medicine, especially if it is a brand name medicine. If that is not possible, it’s a good idea to familiarize yourself with images of a product from an official source. WebMD provides photos of several medicines. Look for branding, appearance, the packaging, and expected side effects of the medicine.