Recent reports from ABC News and the UK’s Mail on Sunday suggest eBay is providing a platform for sellers engaged in an illegal prescription drug trade. An ecommerce pioneer now ranked number 250 on the Forbes magazine rankings of the largest public companies on Earth, eBay’s corporate success doesn’t appear to translate into sufficient success in keeping illegal goods off of its own network. Earlier this summer, I reported similar news about Amazon for Slate.

eBay headquarters in San Jose, California. (CoolCeasar via Flickr)

In the wake of the Slate expose, numerous discussion threads on Amazon’s own seller forums point to a house cleaning, with sellers complaining about Amazon holding suspect goods in its warehouses, freezing payments and blacklisting sellers suspected of stocking prescription products. Last month top Amazon brass met with the Food and Drug Administration, according to an article at Modern Healthcare, and although it’s unknown what was discussed, there was speculation that the conversation might have touched on FDA-regulated healthcare products and/or pharmaceuticals.

Now there is eBay, the second powerful corporation in America’s ecommerce economy to face high-profile accusations of facilitating illegal drug sales. The two companies have generated enormous wealth and power by constructing a kind of golden electronic goose. Unlike traditional, brick-and-mortar storefronts, the elaborate contracts with third-party sellers used by online retailers shield them from risk, so it’s no wonder they haven’t been concerned with verifying that the medical products on offer are authentic, safe or legally distributed. In the case of a defective, dangerous or illegal product, companies like eBay will place blame on the small-time sellers they work with. Equivalent brick-and-mortar stores (or even flea market) can typically count on attracting the attention of local police forces if they’re reputed to facilitate and profit from illegal sales.

Vitara Glinda Gel, which the author's wife found for sale on Amazon. An acre treatment, the gel contains clindamycin, a prescription drug that cause Clostridium difficile diarrhea. (Screenshot courtesy of Ford Vox)

I’m pleased to have played a role in bringing forward the news about eBay. Nancy White, the highly methodical source at the center of ABC’s story, first reached out to me after I discussed illegal drug sales on Amazon on CNN. I decided to connect her with ABC News. The result is a powerful story that should alert policymakers to the fact that there’s a serious public health problem we’ve inadequately addressed. The Mail on Sunday reporters searched eBay themselves, similar to my digging on Amazon, and discovered a number of prescription-only infertility drugs with dangerous side effects being sold without the necessary prescription. The paper found the drugs listed at deep discounts compared to what consumers can expect at properly licensed pharmacies.

So far, the FDA’s oversight of companies like Amazon has been piecemeal. After I wrote the story about Amazon, the FDA told me in an email that it had previously held discussions with the company and other retailers about the problem. Such retailers have even been known to assist the agency by providing information about third-party sellers engaged in illegal drug sales. According to the email:

The FDA has engaged with larger online companies that offer their websites as a marketplace to host third-party vendors selling their products. In some cases, the agency has identified potentially harmful products on these websites and worked with the online companies to remove the offer for these products from the website and to obtain information about the vendor. These online companies have often been responsive in addressing the agency’s concerns. We will continue to work with both the online companies and the vendors to ensure that harmful products identified on these websites during routine surveillance are removed to minimize the risk to consumers.”

Yet this strategy neglects to address the fact that eBay and Amazon are somehow allowed to create and maintain the venues where the highly profitable illegal activity occurs. They’re allowed to sell first and ask questions later, unlike the stores and catalogues that came before them, where consumers could expect consciously selected inventories.

So how can with fix this problem? Here’s my prescription:

1) Coalesce online drug trade enforcement in a single agency with an assigned program head. Currently three agencies already charged to deal with a variety of other important aspects drug regulation have a piece of this puzzle (FDA, Customs and Border Protection and the Drug Enforcement Administration). Nobody’s in charge of the big picture. CBP deals primarily with borders, and many transactions don’t cross national borders. DEA deals with scheduled drugs like narcotics, and many of these drugs, while prescription only, aren’t scheduled. FDA deals mostly with drug makers rather than drug sellers. One agency not taking a lead that could do the job of coordinating the needed expertise of the other agencies for this single goal is the Federal Trade Commission. FTC is already charged with protecting consumers from unlawful commercial activities. Whether or not the FTC takes the lead, a single coordinating agency can make a larger impact.

2) Ecommerce companies like Amazon and eBay must recognize that they have the same duty to avoid activities for which they are unlicensed (such as the pharmacy trade) as any real-world store. If you walked into your local coffee shop and found prescription stimulants alongside the java, the police wouldn’t be far behind. Online companies need to employ however many people it takes to thoroughly review each medical listing before it goes live. It’s their job to stay on the straight and narrow.

3) It’s a challenge to keep track of every prescription-only product, so the FDA should provide non-pharmacy retailers an easily navigable Do Not Sell list, with similar principles to the national Do Not Call list. Companies who call numbers on the Do Not Call list face stiff fines and other penalties. The same should apply to anyone who doesn’t obey the Do Not Sell list.

4) Give the planned “.pharmacy” domain protocol the force of law. Backed by the National Association of Boards of Pharmacy, only properly licensed pharmacies will be allowed to use the “dot pharmacy” web address. To assist consumers and simplify enforcement, federal law should make it illegal to sell prescription drugs via any other web address than “.pharmacy.”

5) Use the recent FedEx indictment as a model for going after online retailers engaged in shady drug deals. The Department of Justice warned FedEx it was distributing drugs illegally, and kept warning, but the delivery giant didn’t take heed. Now it’s under federal indictment for illegal distribution as well as money laundering. To some extent, big companies only pay attention to big threats. Protecting the health of all Americans deserves such high-stakes oversight.

With these five measures in play, I’m confident we can clean up the online drug market.