U.S. PROSECUTES DOCTORS IN INTERNET DRUG RING

Prescriptions For People The Physicians Never Met Went Through A
Small Pharmacy In Dubuque

Cedar Rapids, Ia. -- The physician sitting at the defendant's table
looked like he could be a kindly colleague of TV's Marcus Welby, M.D.

He had neatly trimmed gray hair, a conservative sport coat and
silver-framed bifocals. He identified himself as Edward Schwab, a
71-year-old osteopath from Shreveport, La.

He was in federal court late last month to admit that he also was a
drug dealer, one of numerous doctors who helped run one of the
biggest Internet pill-distribution rings ever busted.

A magistrate judge double-checked his calm admission. "Do you
understand what they're claiming you did wrong?" the judge asked.

"Yes, your honor," Schwab said.

In court papers, the doctor acknowledged illegally approving more
than 19,000 electronic prescription requests from people wanting to
buy narcotics or stimulants over the Internet.

Before he pleaded guilty to counts of conspiracy and
money-laundering, the judge warned him that he could face up to 15
years in prison when he is sentenced at a future hearing. In return
for his guilty plea, prosecutors agreed to ask for only about three
years, but the sentencing judge could order the full term, and there
will be no parole.

Six other physicians also have pleaded guilty in court here.
Prosecutors say they expect to charge up to 50 doctors, which could
make this the broadest such prosecution in U.S. history. None of the
doctors charged so far is an Iowan, but authorities won't say if any
Iowans are among the remaining suspects.

The scheme began to unravel in 2003, when regulators noticed that a
small Dubuque pharmacy suddenly was mailing out huge quantities of
addictive drugs to addresses throughout the country.

Investigators raided the pharmacy, then tracked many of the drug
orders to a Web site called BuyMeds.com. The site's owners allegedly
paid physicians to write prescriptions based on electronic
questionnaires that customers filled out from their home computers.
Schwab admitted authorizing a total of more than 1 million doses of
drugs requested via such Web sites. He admitted approving up to 200
orders per day, and receiving $8 for each one.

Three Iowa pharmacists surrendered their state licenses, but so far,
only physicians have faced criminal charges in the investigation. The
government's broad net represents an increasingly aggressive approach
against doctors involved in Internet drug schemes, a national expert
said. "This is one of the biggest, if not the biggest, case of this
kind that we've seen," said Dale Austin, senior vice president of the
Federation of State Medical Boards.

Stephanie Rose, an assistant U.S. attorney prosecuting the cases,
said doctors can provide a veneer of legitimacy to unscrupulous
Internet drug sites. "The hope of the Department of Justice is to
stop the flow of legal drugs to the illegal market," she said in an
interview. "Doctors are a big part of the legal market. We want to
make sure they're not drawn into the illegal market."

Authorities say it is illegal for a doctor to prescribe drugs without
examining patients or having a legitimate medical relationship with
them. It also is illegal for consumers to buy such medicine without a
valid prescription, but consumers rarely are prosecuted for making
purchases from the growing array of Web sites offering Vicodin,
Valium, Ritalin and other addictive drugs.

BuyMeds.com, which was owned by a company in the Virgin Islands, no
longer sells drugs, but many other sites remain in business. I
nternet message boards are filled with boastful reports from the
sites' customers. Here's one posted in 2003 by "Tyler," who related
his experience buying the narcotic painkiller hydrocodone on
BuyMeds.com. He ordered 60 pills on a Sunday night, and received them
by Federal Express Wednesday morning, he said. "These will come in
useful if ever I should run out of the Tylenol 3's my doctor
prescribes. I have to say that out of the SIX internet pharmacies I
have tried, they have ALL come through."

"Tyler" wrote that he spent $168 for the drugs. If he had brought a
legitimate prescription for the same pills into an Iowa pharmacy, he
could have bought them for about $35.

Urbandale pharmacist John Forbes said the fact that Internet
customers will pay so much for the drugs implies they have addiction
problems. "It runs up a big red flag to me," he said. Forbes
applauded authorities for aggressively prosecuting the current case.
"I think they're doing this to set an example. They want to put a
stop to this."

Rose, the prosecutor, acknowledged that the government lacks
resources to prosecute every customer who purchases pills illegally.
"I don't think we're ever going to stop the addicts from wanting to
buy them," she said. "All we can do is try to shut down the supply."

The leader of Iowa's largest doctors' group said he had no qualms
about possible imprisonment for physicians in such cases. "This isn't
about legitimate business. This is about drug-dealing," said Dr.
Stephen Richards of Algona, president of the Iowa Medical Society.

[Sidebar]

Internet Drug Sites

Countless Web sites sell prescription drugs, but authorities warn
that many of them are illegitimate and illegal.

Here are ways they say consumers can judge whether a site is
legitimate: * Consumers should be wary of sites that offer doctors'
prescriptions based on questionnaires filled out via computer.

* Sites should require that orders for prescription drugs be
accompanied by a prescription from a doctor licensed in your state
who has examined you, taken a medical history and determined a need
for the medicine before writing the order.

* Legitimate sites should accept insurance payments. Many others
insist on credit-card payments only.

Twelve Internet pharmacies have received the endorsement of the
National Association of Boards of Pharmacy. The association, which
represents government regulators, has developed a voluntary program,
called the Verified Internet Pharmacy Practice Sites. A list of the
approved sites can be found at www.nabp.net.