According to a report issued by the FDA, scammers are posing as special agents working on behalf of the agency and other law enforcers including the DEA, FBI, US Secret Service, and US customs service. The scammers target victims who have previously purchased pharmaceuticals over the Internet, contacting them by telephone to tell them that the purchase was illegal. They then demand a fine ranging from $100–250,000. The scammers demand that the money be sent by wire transfer to a designated location, normally in the Dominican Republic.

"If victims refuse to send money, they are often threatened with a search of their property, arrest, deportation, physical harm, or incarceration," said the FDA.

The scammers' ruse is particularly insidious, given the rise in pharmaceutical "brandjacking." Brand protection company MarkMonitor reported in September that online pharmacies had increased their market footprint, growing to an estimated $11 billion in sales last year, compared to just $4 billion in 2007. It found 3,000 online pharmacies targeting six popular prescription drug brands last July.

The H1N1 pandemic has also been linked with a growth in demand for online pharmaceuticals by consumers worried that they will not get local access to vaccinations.