Americans spend more than twice the average for industrialized nations on pharmaceuticals, according to OECD data. A major reason is that prescription drugs in the U.S. are so expensive. But people who venture outside the U.S. system—either online or through facilitators—are taking a big risk according to Carmen Catizone, executive director of the National Association of Boards of Pharmacy, which monitors the industry.
"The dose is too high, too low. Some of these medications, the coloring has been from highway paint, they've been manufactured in facilities that are infested by rats, rodents. There are no sanitary conditions, no oversight of how that product is prepared. So it really is Russian roulette."
A six-month CNBC investigation has found that while there are considerable weaknesses in the alternative sales outlets, the risks are not always as serious as some in the industry claim. As a result, consumers are often left with a difficult choice: pay high prices for near-certain safety, or pay deep discounts and take a calculated gamble that can—and sometimes does—pay off, beating big pharmaceutical companies at their own game.