Thinking of ordering discount prescriptions? Buyer beware

RX roulette: Inside the lab
RX roulette: Inside the lab

They claim to be safe, low-cost alternatives to traditional pharmacies. But Internet drugstores and so-called facilitators—brick-and-mortar locations that place orders for consumers wary of ordering drugs online—are not created equal. And some of them readily acknowledge that.

"I cannot comment on the safeguards employed by any other organizations," said William Hepscher, owner of The Canadian Medstore in Tampa, Florida, in an e-mail to CNBC.

Hepscher claims his business ensures product safety by requiring the overseas pharmacies he orders from are licensed in their home country. Undercover, CNBC ordered brand name Lipitor from the company. The manufacturer, Pfizer, found the medication we purchased to be authentic and safe, but a version of the drug produced overseas and intended for sale outside the U.S.

"Ultimately our clients rely on the safeguards put in place by these governing authorities in the same way that they rely on the U.S. FDA," Hepscher said.

But the Food and Drug Administration takes a different view.

"The drugs you receive may look real, but they could be counterfeit, contaminated, expired or otherwise unsafe," the FDA says on a section of its website, devoted to online pharmacies.

Prescription drugs: Risk vs. cost
Prescription drugs: Risk vs. cost

The FDA and advocates for the discounters do agree on some basic tips:

  • Avoid services that do not require a prescription.
  • Confirm that the seller will not share your personal, medical or financial information with others.
  • Make certain the seller is licensed and verified by a reputable third party.

Indeed, we filled another Lipitor prescription through a website called Canadian Neighbor Pharmacy. The site did not require a prescription, and it offered a "bonus" of four Viagra tablets with every order. We received what Pfizer found to be a generic version of Lipitor—likely safe, but not the brand name version we had specified. Pfizer determined the four Viagra tablets to be counterfeit. Repeated calls to the pharmacy went unanswered.

So how can you tell if the Internet pharmacy or facilitator you are dealing with is reputable?

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The National Association of Boards of Pharmacy checks Internet pharmacies through a program it calls "VIPPS," or Verified Internet Pharmacy Practice Sites. The standards are strict. Qualifying sites must prove, among other things, that they are licensed in every jurisdiction where they operate, and that the drugs they dispense are stored and shipped properly, and that they protect patient privacy.

The NABP's Executive Director Carmen Catizone says few sites make the grade.

"Of more than 10,000 sites that we've looked at, 97 percent of those are illegal or rogue sites that are operating dangerously," Catizone said in an interview.

That would mean only about 300 sites are legitimate. Even fewer—just 34—meet the VIPPS standard, according to the NABP website, and many of those are affiliated with insurance plans requiring membership.

The FDA recommends checking with your state board of pharmacy to see if the site is licensed, and the agency offers a handy site to do just that.

The problem is that discount sites and facilitators generally do not claim to be pharmacies. Instead, sites and facilitators operate under a narrow legal provision allowing individuals to import up to a 90-day supply of prescription drugs not authorized for sale in the U.S., as long as it is for their "personal use." While drug companies say the discounters are misusing a law meant for things like experimental cancer drugs, the discounters say the law makes no distinction.

The result for people looking for relief from high drug prices is an even trickier game of prescription roulette.

Read MorePrescription roulette: Are discount drug sellers safe?

—By CNBC's Scott Cohn

For more on this story, watch Power Lunch, 1:00 p.m. ET, Monday on CNBC.

This story has been updated to reflect that the name of the group is the National Association of Boards of Pharmacy.