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Search engine redirection convert patients to illegal online drug distribution websites

  • At: PPR 2022 (2022)
  • Type: Poster
  • Poster code: PT-10
  • By: PACZOLAI, Peter (University of Pécs Faculity of Pharmacy Department of Pharmaceutics and Central Clinical Pharmacy)
  • Co-author(s): Peter Paczolai, University of Pécs Faculity of Pharmacy, Hungary
    András Fitler, associate professor

  • Abstract:

    Background information: Illegal drug distribution websites apply dishonest marketing techniques to attract customers via search engines. Search redirection attack is one of these, where vulnerable web pages appearing in is search queries are hacked and individuals are presented with the unwanted final page selling prescription medications online without restrictions or adhering to professional standards. Previous studies have reported the issue only in relation to oral medications for the treatment of erectile dysfunction.
    Purpose: We aim to measure the prevalence of search engine redirection in query results of regularly prescribed medications for chronic conditions, visualize redirection networks referring patients to illegal internet pharmacy websites, and propose an intervention to prevent consumers from the dangers of illegal online pharmacies.
    Methods: First 20 search query results of 15 prescription drugs regularly used in chronic drug therapy were documented in October and November 2021, further in March 2022. We searched online in incognito mode using the name of the active ingredient and “buy” as search terms them. Redirection network visualization was done using Gephi. Redirected pages have been collected and the owners of the compromised domains have been notified via email in February 2022, links affected by redirection were reported to the National Cyber-Security Center of Hungary in March 2022 to resolve the issue.
    Results: Nearly half (47%) of prescription drugs for chronic conditions have showed redirected sites in October 2021 and increased to 53% by March 2022. Highest prevalence of hacked links was observed in case of salbutamol (40%), atorvastatin (35%), metformin (35%), levothyroxine (30%). Although only 2 out of 16 hacked website owners responded on successfully resolving the issue, the number of redirects among results have decreased notably following our proposed intervention method.
    Conclusions: Search engine redirection attacks do not only affect potency-enhancing drugs but is present in a much broader range of drug searches. Coordinated interventions by authorities, search providers and individual stakeholders is required to increase the control of search engine results and to block redirected pages.
    Topic area: Patient and medication safety
    Keywords: Online medicines, illegal internet pharmacy, drug distribution, search engine redirection
    The research has been supported by Ildikó Kriszbacher student scholarship (PTE-KITEP-2021-80) of the University of Pécs and the János Bolyai Research Scholarship of the Hungarian Academy of Sciences (BO/00238/20/5).

Last update 28 September 2023

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