Most of the 35,000 online pharmacies around the world operate illegally and may be selling dangerous or ineffective drugs, according to the US Trade Representative’s annual report “infamous markets” report.

96 percent of online pharmacies were found to be breaking the law, which means they are operating without a license and selling drugs without a prescription. According to a 2024 report published on Wednesday, an estimated 20 new illegal pharmacy websites are created every day around the world.

“The health and safety concerns raised by counterfeit medicines are of particular concern,” Trade Representative Katherine Tai said in a statement.

Over 30 online retailers were identified in the report as being found to be selling counterfeit products. Websites often impersonate legitimate e-commerce platforms, falsely claiming to be approved by the Food and Drug Administration. The compiled report also singled out 19 countries for concerns about counterfeit or pirated products.

Network pharmacies gained in force during the COVID-19 pandemic when demand for prescription drugs was high and many patients may have been confined to their homes. Meanwhile, physical pharmacies are closing its doors and across the US at least 7,000 pharmacies have closed since 2019. The Associated Press reportedciting data from the University of Pittsburgh.

In October, the US Drug Enforcement Administration and the Centers for Disease Control and Prevention issued public safety alert about illegal pharmacy websites that sell and deliver counterfeit pills to patients who believe they are buying genuine pharmaceutical drugs.

Last year, the FDA issued warnings more online pharmacies selling suspected counterfeit products, demanding that the websites stop selling the products.