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There is a lot of fraud to be found online, so it helps to establish your reputation as soon as possible.

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You will also need to be on top of any compliance or industry changes when it comes to your business. For example, you can't sell an imported drug to a patient unless they've been seen in-person by a doctor. Poorly run online pharmacies have left a bad taste in both the public's and the government's mouth, so harsher changes and regulations may be on the horizon. And with the popularity and profitability of prescriptions, you'll want to be careful of potential competitors. CVS recently acquired Aetna, which has sparked rumors that Amazon may be looking to get into the prescription business. It will be difficult to compete with a juggernaut like Amazon when it comes to price, but online pharmacists can choose to establish local loyalty first before branching out.

The Canadian International Pharmacy Association runs a site (cipa.com) that allows you to compare drug prices among dozens of pharmacies whose legitimacy it has certified. Its customers "tend to be people who live in the U.S., are on fixed income or low income and can't afford the medications where they live," says Tim Smith, the association's general manager. To buy through one of CIPA's certified pharmacies, you must have a valid prescription and submit a medical profile to help guard against adverse drug interactions. The site also maintains a list of "rogue" online pharmacies. offers a similar service, linking customers to a broader range of online pharmacies abroad and in the U.S.