The Canadian International Pharmacy Association (CIPA) recently commented on the Competition, Consumer Trust and Consumer Choice Review Team (CCTRT) Draft Report of Recommendations for New gTLDs. In particular, on the primary questions posed: The CCTRT is seeking input on its Draft Report, which assesses whether the introduction or expansion of gTLDs has promoted competition, consumer trust and consumer choice in the DNS, as well as effectiveness of (a) the application and evaluation process, and (b) safeguards put in place to mitigate issues involved in the introduction or expansion [emphasis added]. CIPA’s experience (in the case of .PHARMACY) demonstrates the registry operator has failed in promoting competition (within this specific TLD); indeed CIPA contends the opposite is true, i.e. that NABP has fostered anti-competitive behaviour through its restrictive registration policies. In addition, certain .PHARMACY safeguards are effectively the institution of shadow regulation intended to undermine the viability of CIPA members’ businesses through the erosion of merited consumer confidence in CIPA’s trusted brand.

Formed in 2002, using the Internet as the main marketing tool, the Canadian International Pharmacy Association represents licensed Canadian pharmacies that sell pharmaceuticals and maintenance medications to individuals upon receipt of a valid prescription. In addition to dispensing from Canada, CIPA members have business relationships with licensed pharmacies in other countries that sell medications approved by their respective health authority in the country where they are located (e.g. the equivalent of the U.S. FDA—Health Canada, UK MHRA, Australian TGA). CIPA members provide international mail order dispensing to people in numerous countries; predominantly United States residents^[1] who cannot afford high cost medications where they live. Setting the standard for consumer trust, CIPA serves approximately one million patients annually. CIPA’s superior standards for safety and privacy protection, along with its members’ track record and commitment to improving patient health have established CIPA member pharmacies as the most trusted online sources for safe and affordable prescription medications. CIPA members have maintained a 100% perfect safety record for 15 years. It is for this reason that rogue Internet pharmacies so often masquerade as “Canadian” for their nefarious purposes, and why CIPA spends a significant amount of its time informing and protecting consumers.

In 2015, the National Association of Boards of Pharmacy (NABP), a United States-based trade organization funded in large measure by big pharmaceutical companies, was given the right by ICANN to manage the generic top level domain (gTLD) .PHARMACY. NABP announced that they would implement the gTLD to distinguish legitimate from fake pharmacies around the world. Without any consultation with the broader, global community of legitimate online pharmacies, yet theoretically on behalf of all pharmacies around the world, the NABP, a single national body, created exclusionary and restrictive eligibility criteria that, purely from a financial perspective, are impossible to meet. In practice, .PHARMACY domain registration policies are anti-competitive on their face because they explicitly exclude bona fide licensed pharmacies outside of a country’s borders.

For the past 15 years, CIPA Certification^[2] and CIPA’s public education have guided consumers away from rogue operators. CIPA members have steadfastly built their businesses and trustworthy reputations using the .com gTLD; itself a trusted identifier for legitimate businesses around the world. The notion that NABP can arbitrarily insert itself as a barrier between CIPA member pharmacies and the millions of patients they serve by creating an aura of distrust around all pharmacies that use .com domains—particularly when they cannot meet .PHARMACY’s anti-competitive registration criteria—is not just unfair to the community of pharmacies around the world, but to every company that relies on the Internet to do business.

CIPA members comply with all fundamental licensed pharmacy requirements and have built a reputation over 15 years of safe dispensing to millions of consumers, yet do not qualify to register with .PHARMACY.

This chilling effect on free and open competition is disturbing, however such shadow regulation (whereby a domestic trade association implicitly becomes the regulator for a global industry by virtue of managing a gTLD) undermines the viability of CIPA members’ businesses and erodes merited consumer confidence in CIPA’s trusted brand. Without revisions made to certain NABP registration policies, the current policies serve only to put legitimate pharmacies out of business solely because they are unable to meet the narrow rules. The fears of those who opposed NABP being given the right to manage .PHARMACY during the application phase in 2013 have indeed come to pass: https://gtldcomment.icann.org/applicationcomment/commentdetails/12145 and https://www.pharmacycheckerblog.com/nabp-registry-opposition.

Erosion of CIPA’s reputation and market presence will severely reduce consumers’ choice of safe and affordable prescription fulfillment services performed by CIPA members. Furthermore, casting unwarranted suspicion on CIPA pharmacies only serves to exacerbate the well-documented problem CIPA and others combat daily, i.e. rogue pharmacy websites with their predatory, deceptive practices that lure consumers into the purchase of counterfeit medications. Any further blurring of the lines and needy patients will pay the price of confusion between real and fake “Canadian” pharmacies. If the current NABP eligibility criteria are allowed to stand, then safe and affordable CIPA pharmacies, and perhaps other wholly-qualified licensed pharmacies from other nations, will undoubtedly be rapidly replaced by rogues.

NABP’s stated Public Interest Commitment notes: “Registry Operator will operate the TLD in a transparent manner consistent with general principles of openness and non-discrimination by establishing, publishing and adhering to clear registration policies…” CIPA’s experience, however, demonstrates that exactly the opposite is true: Discrimination fuels NABP’s anti-competitive policies. Therefore, CIPA members (along with many other impacted pharmacies around the world) find themselves feeling powerless to bring about essential .PHARMACY policy changes that protect consumers, as well as CIPA member businesses simply because NABP refuses any dialogue with end-users of the gTLD they are contracted by ICANN to manage on our constituency’s behalf.

The .PHARMACY ICANN Registry Agreement details the Covenants of the Registry Operator; Article 2.19, Obligations of Registry Operator to TLD Community [it represents]:

“Registry Operator shall operate the TLD in a manner that allows the TLD community to discuss and participate in the development and modification of policies and practices for the TLD.”

CIPA therefore calls upon ICANN to convene an open and transparent review of the .PHARMACY domain name registration policies to compel the registry operator to bring said policies in line with the representations made by NAPB et al. in their application, so that this highly-regulated industry domain will be managed—as should be expected of NAPB—in a non-discriminatory manner, free of shadow regulation, in-keeping with ICANN Bylaws.

^[1] Today, in the United States, some 35 million patients forgo their prescribed medications due to an inability to pay the prohibitive cost. Source—At least 35 million Americans failed to adhere to their prescribed drug regimens in 2014, due to cost of their medications. (S. R. Collins, P. W. Rasmussen, M. M. Doty, and S. Beutel, The Rise in Health Care Coverage and Affordability Since Health Reform Took Effect, The Commonwealth Fund, January 2015. [Last accessed 12/11/2016].)

^[2] CIPA trademarked Certification Mark (CIPA Seal) is given only to pharmacy businesses that are vetted and verified for authenticity by our Association. It is the consumer’s assurance that all prescriptions filled are genuine, safe and dispensed from a licensed pharmacy that is in 100% compliance with all of the protocols of the jurisdiction where it is located, as well as in accordance with CIPA’s policies and Standards of Practice. For example, such policies require:

• A valid prescription before dispensing medications;
• Demographic and medical information be obtained from the patient along with the maintenance of a health profile with medication history to avoid adverse drug interactions;
• Licensed pharmacists on staff to supervise dispensing of medications and available for consultation upon patient request; and
• Procedures to ensure patient privacy and confidentiality of personal records and contact information are strictly maintained.