ONLINE PHARMACIES AROUND THE WORLD AND IN NEPAL

The evolution of the internet has simplified many things in our day-to-day life. Due to the current pandemic, many industries have resorted to online marketing and online stores, pharmaceutical industry not being an exception. We have seen a sudden surge of online pharmacies in Nepal, especially in the metropolitan cities.

Though it has been only in the last few years where the growth in online pharmacies has been exponential, its origins can be traced to as far back as late 1990s [1].

With new channels, come new challenges, and in many developed countries like the US where the adoption has been extensive, governing bodies like the US Food and Drug Administration (FDA) has had to write in new policies around buying medicines online and what could be the challenges and pitfalls for the common man – specially with the prevailing issue of fake medicines and illegitimate sellers.

These days this subject has been a hot topic around the globe. However, despite all concerns, Online Pharmacies do score heavily on convenience and speed of transaction, that cannot be ignored.

So, what does an ‘online pharmacy’ mean? 

Online pharmacy is defined as the trading of dealings with preparing and selling of prescribed and non-prescribed drugs as in conventional pharmacies [1]. Also, an online pharmacy might include selling and supplying healthcare products, providing medical information, providing a healthcare support system, and providing advice about symptoms [2]. 

What do they do?

Generally, online pharmacies use various types of technology to reach and amplify their products, such as apps, videos on different health topics, and text messages for ordering or sending drugs [1,2]. The patients after downloading app or via website create a request for medicines by uploading a copy of scanned prescriptions to the concerned system. Then, the orders by the patients are verified and checked by a certified and registered pharmacists and they forward the validated prescriptions to the online medical store or pharmacy store [5]. Currently, pharmacy assistance is provided by more than 32,500 online pharmacists all around the world [1].  

Adoption of online pharmacies across the world!

With internet penetration increasing, and the advent of 5G, many countries are now adopting tele-health & online pharmacies as the new norm. Due to COVID-19, online pharmacies saw a sudden surge in demand as physical interaction between people became a constraint.

USA is leading the count in this sector with over 50,000 online pharmacies by 2020 already.  In Europe, out of 28 countries in the region including the UK, only 11 countries allow patients to order prescribed medicine online [8]. Apart from that, only some countries like the United Kingdom, Finland, Estonia, Germany, Denmark, Netherland, and Sweden have legalized RX online pharmacies [6]. Also, Amazon is supporting online pharmacies in Europe [7]. 

Pros and Cons of the Online pharmacy Business Model

We have briefly touched upon some of the benefits of Online Pharmacies, but if we were to details them out, they could broadly be classified in the following buckets:

Increased convenience 

It is easy for consumers to order medicines from their mobile phone or a pc. This will significantly help patients who are elderly, disabled one who needs to go a long distance to the conventional pharmacy. 

Improved accessibility 

Traditional pharmacies only keep limited inventory that makes the consumer go to multiple stores to find the medicines. Now, an online pharmacy is even accessible in rural areas and offers to choose a broad range of generic equivalents for a specific drug. 

Price Efficiency

Customers can buy drugs which are prescribed to them at the lowest price possible from online pharmacies. Research says that usually one-third price can be saved by buying online prescribed medicines. Also, online pharmacies can broaden their services with low working capital and costs as well that has cost-benefit for end customers.  

Improved patient compliance and medical information

Many Online pharmacies have details on different drugs on the app or website for customers to read. It provides important information to consumers regarding drugs such as side effects, drug interactions, information on substitutes which helps to improve compliance. 

Though online pharmacies have several benefits, there are also some areas which we need to be cautious about as consumers: [1, 3, 5]. 

Lack of physical evaluation

Online medical store or online pharmacy does not have any means of physical evaluation. Some cases might involve effective analysis but even if there is such a process, that process may not be performed by licensed healthcare professionals. 

Illegal sale of drugs

Many online pharmacies provide good services to the community, but some online pharmacies might dispense medicines without a prescription which could lead to having other problems rather than cure of problem faced by the patient. So, when buying one needs to check with the pharmacy and the working pharmacists must request a prescription. Some illegal online medical stores might deal with dangerous outdated, contaminated drugs that may lead to dangerous complicated drug reactions. 

Personal and financial information

One of the issues with Online pharmacy is the privacy of personal and financial information. Therefore, it is important that online pharmacies publish a privacy policy and guarantee that information is not shared with third parties.

Status of online pharmacy in Nepal

In Nepal as well, several companies have started exploring the opportunity and making their presence felt. The practice is in infancy currently in our country, but signs of rapid expansion are visible. Some local companies in this field that connect with users through either their websites or dedicated apps are: Netmeds, Swashthya, metrohealthcare, epharmacy, Annapurna pharmacy, online aushadhi, clinicone, nepills, ATM pharmacy etc. to name a few. Several anothers are in pilot phases of setting us their brands in this space.

Future Outlook:

It is apparent that online pharmacies in Nepal are facing many challenges like regulatory issues, difficulty in verifying the authenticity of prescriptions, supplying medicines, etc. Additionally, they are facing logistical issues, as well as issues with meeting the delivery timeline. Moreover, the temperature control mechanism is not assured at storage points or while transporting the medicines. Online pharmacies also face problems with offline counterparts as well. 

Unlike physical pharmacies, online pharmacies do not have a specific law to govern and are indirectly governed by multiple laws. DDA is the drug regulatory authority of Nepal which has multiple laws to govern pharmacies and drugs.

Given these challenges, the stakeholders, policymakers, and pharmacists need to work together to establish more clearer guidelines for this evolving business model and address the challenges faced to help new age industries like this not only survive, but also thrive and bring the benefits of healthcare to all parts of the country.

At Pharmalife, it is our endeavour to help establish the infrastructure for both physical and online pharmacies in the country to drive quality of lifestyle and access to healthcare.

References: 

https://www.tigahealth.comadvantages-and-disadvantages-of-e-pharmacy/

2. Gray, N. (2011). The evolution of online pharmacies. Self Care Journal2, 76-86. 

Desai, C. (2016). Online pharmacies: A boon or bane?. Indian journal of pharmacology48(6), 615.

https://www.verywellhealth.com/online-pharmacies-are-they-safe-1738888

Chordiya, S. V., & Garge, B. M. (2019). E-pharmacy vs conventional pharmacy. IJCAAP3, 121-123.

https://consumerchoicecenter.orginfographic-check-if-you-can-buy-medicines-in-your-country-online/

https://www.simon-kucher.com/en/blog/amazon-online-pharmacy-europe

https://s3-us-west-2.amazonaws.com/production-public-wp-content/wp-content/uploads/2016/06/Country_by_Country_-_Internet_Pharmacy_Regulations_-_3-23-15.pdf

Wells, L. (2015). Online pharmacies: a consumer perspective. Australian prescriber38(6), 187.

Ranjit, E. (2016). Pharmacy practice in Nepal. The Canadian journal of hospital pharmacy69(6), 493.

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