Despite the fact that the online channel has become an important point of reference for many people to purchase non-prescription drugs, consumers are only able to correctly classify half (53%) of online advertisements related to medicines as licit or illicit. This is the finding of the Project Capsule, conducted by the Transcrime Research Centre of Università Cattolica del Sacro Cuore of Milan with the support of the Office of Product Quality and Countering Pharmaceutical Crime of the Italian Medicines Agency (AIFA) and with the contribution of the Center for Anti-Counterfeiting and Product Protection (A-CAPP) of Michigan State University.

Capsule aimed to investigate, in particular, market dynamics, after the Covid-19 pandemic saw a significant growth in the illicit market for drugs through online advertisements and misleading websites. The key objective, therefore, was to assess the degree of consumer awareness regarding the risk of purchasing substandard and falsified drugs (SFMs) online by examining the exposure and behaviour of Italian and Spanish consumers. The results obtained form the basis for developing targeted information campaigns and specific interventions.

The main results of the project

Conducted in January 2024, the project Capsule involved a representative sample of regular Internet users in Italy and Spain who were aware of the possibility of purchasing medicines online and exposed to online ads or who had purchased at least one medicine online. The trial involved administering a combination of licit and illicit drug ads to consumers. Ads were correctly classified as legitimate in 63% of the cases; greater, however, was the difficulty in identifying illicit ads (43% in Italy and 42% in Spain). The absence of a Ministry of Health certification label, the absence of a drug description or the presence of errors in the description were identified as the factors exerting the greatest influence on consumer evaluations.

Older participants showed less ability to recognise illicit advertisements, while younger participants showed less trust in pharmacists and doctors and a greater propensity to rely on the Internet to search for health information. Behaviour that could be the subject of specific awareness-raising campaigns targeted at demographic and consumer groups.
On the other hand, awareness was good in both Italy and Spain (73% and 66%, respectively) that in the two countries legal online sales of medicines are restricted to non-prescription medicines only. More difficulty was found in the ability of consumers to correctly distinguish between food supplements and medicines, products that are subject to different regulations.

The Internet continues to be a significant channel for finding medical information (58% in Italy, 52% in Spain); around 40% of the sample indicated that they search online for specific medical solutions or alternative treatments. The rate of online purchases of medicines was higher in Italy (69%) than in Spain (52%). The majority of Italians (85%) and Spaniards (75%) stated that they had viewed at least one type of online advertisement for medicines. In Italy, the majority of online purchases concerned medicines for influenza, followed by medicines for chronic pain and cholesterol treatment. In Spain, consumers mainly bought products to increase performance (sports or concentration) and for weight l