Though buying medicines online has become a convenience for the patients, the reliability and the authenticity of such online chemists have regularly been questioned by the experts By Sachin Jagdale
Ensuring availability of medicines to every needy person in a geographically vast country like India is a big challenge. Retail drug outlets have been the source of medicines for patients. But with the rise in population, broader disease portfolio and introduction of new brands, procuring medicines have become a big worry. This is where online chemists have come into the picture and were able to resolve this problem to a much greater extent. However, buying medicines online has its own share of doubts and arguments as well.
Besides providing easy procurement of medicines, there are many benefits, which online chemists offer. Cost effective medicines prompt patients to buy online. Many times information regarding a particular type of disease, possible medications to treat etc. is easily available online, which prevents patients from visiting a clinic. A considerable number of online chemists even offer teleconference facility for patients where specialist doctors would talk with them over the phone. After all, the medicine is home delivered and as a result the patient is able to save on travelling expenses.
“Acquiring medicines online may initially offer some cost benefits and will minimise the stress and the time which usually happens in Western countries. In Western countries laws are very strict and a lot of time is spent in queues where patients have to wait for pharmacists to fill their prescriptions,” says Dilip Kadam, Executive Member, All India Organisation of Chemists and Druggists (AIOCD).
“Privacy or anonymity is the key benefit offered by online chemists,” opines Shashank Sandu, Director, Sandu Pharma.
Though online medicines look like a promising trend today, still, the penetration of this concept in India is negligible. Urban areas might have been connected with online chemists, however, rural areas are yet to get their deserving share.
Sudhir Deshpande, Legal Consultant, Pharmalex, opines, “If operated within the legal framework, online medicines or Internet pharmacy provides easy and convenient tool for the consumers to procure medicines required by them. As prescription drugs will be supplied against scanned copy of the prescription which will be retained by the Internet pharmacy operator. Compliance of conditions of licenses will be better. It will also be easier for the regulatory officers to verify the compliance by going through the prescription copies retained by the Internet pharmacy unlike the conventional pharmacy. This will also help regulatory officers to ascertain as to whether the medicines were prescribed by a registered medical practitioner or otherwise. The online medicines or Internet pharmacy will enable needy patients to procure medicines easily and will prevent them from moving around to look out for drugs during an emergency situation.”
Besides the advantages, online chemists is something like a double-edged sword. Video or telecalling can’t replace valuable time and personal interaction between a doctor and a patient.
Kadam opines, “According to a new study, consumers are increasingly experiencing less satisfaction as far as online shopping of medicines is concerned. It is not the case in India as there are an ample number of retail shops to take care of stress and time of people. Besides this, there will not be personal touch that the retailer has with his customer. You cannot satisfy yourself by personally asking your queries about the prescription medicines, its effects, side effects, dosage regime etc.”
Spurious drugs have made inroads into retail medicine shops, which is still the biggest source of medicines for patients in India. However, according to industry experts, online chemists will be the easiest gateway for spurious drugs than their retail counterparts.
Kadam informs, “There are many websites that operate illegally and offer to sell all sort of medicines which can be misbranded, spurious, counterfeit and whose quality and safety is unknown. There have been many instances where during online purchasing of bulk drugs, the seller has deceived buyer by supplying sub-standard drugs.”
“Purchasing of online medicines increases the risk of consuming spurious drugs,” cautions Dr CR Revankar, Independent Public Health Medical Consultant. He adds, “Online purchase of medicines should be avoided by the patients/ their family members since one do not know how authentic the supplier and the products are. I recommend and encourage the patients to buy from the retail/ authorised pharmacy shops. Since antimicrobial resistance is on the increase due to irrational use of them (prescribed and self prescription), patients should be well educated on this issue so that microbial resistance will not be unmanageable in the future.”
Online pharmacies do have a considerable number of ayurvedic products for sale. Such products, even from the branded companies, are already under scrutiny for their composition. Online sale of such drugs increase the chances of dispensing spurious ayurvedic drugs to the patients.
“Many ayurvedic formulations which lack appropriate standardisation may be sold through online sale techniques. Many small scale pharmacies don’t claim complete composition of the products on the labels. Sometimes brand names, outer packing and physical appearance of some medicines may match the leading brands in the market to misguide the patients,” says Sandu.
According to experts, online chemists stand on shaky legal grounds. They are more prone to legal scrutiny, thanks to frequent reporting of illegal operation by them. In India, electronically business transaction of prescription medicine is not included in the Drugs & Cosmetics Act and Rules there under. Therefore sale of medicines by online shopping will not be legally permitted by the Food & Drugs Department. Even online correspondence, scanned copies are also not permitted by the law. Such system is not approved by the Drug Department.
Kadam gives details of what is mentioned in the Drugs & Cosmetics Act. He says, “Drugs & Cosmetics Act clearly mentions that any supply of drugs is to be made by the direct supervision of a registered pharmacist against the written prescription of a registered medical practitioner. Such supply, carbon copies duly signed by registered pharmacists are compelled to be maintained by the law. Even today, you cannot say that the sale copy (second copy) of the sale bills are recorded and preserved in the computer and can be provided as and when asked for inspection unlike other businesses. The definition of the nature of prescription, legal procedure to sell medicines and to maintain its records are well specified in the Act and it is mandatory.”
Deshpande’s assessment of the situation might give some relief to online pharmacy operators. However, he is of the view that any sort of illegal behaviour by online chemists would invite legal action on them.
Deshpande says, “The concept of online medicines or Internet pharmacy is relatively new in India. Internet pharmacy per-se is not illegal, however, unfortunately, due to alleged illegal activities committed through Internet pharmacy, the system is considered by the regulatory officers as a system prone to abuse. As a result, the system is subjected to intense scrutiny. A major disadvantage of the system is its difficulties in complying with certain provisions of the Drugs and Cosmetics Rules, 1945 e.g. Rules requiring stamping the original prescription at the time of dispensing of medicines by the pharmacist.”
An alternative to retail pharmacy?
Retail pharmacy has so far remained the biggest source of medicines for the Indian population. Remote areas in the country too are benefited with retail pharmacies only. Perhaps, since they are not aware of the concept called online pharmacy or lack of basic requirements like Internet, a huge section of the Indian population is not buying medicines online. However, now things are changing. With the introduction of devices like smart phones, coupled with government and private sector initiatives, Internet is reaching almost every nook and corners of the country. Are these changes indicators of online pharmacies outweighing retail pharmacies in the future?
“It’s too early to say whether online medical consultation will see its boom or not in India like other forms of online shopping. It does have its share of advantages and disadvantages. But, with time, people will rely on online facilities for medical help. It is time-saving and cost effective. With technology making life simple and easier all across the spectrum, online healthcare will also gain its popularity immensely by the convenience it offers,” opines Sandu.
According to Kadam, retail pharmacist is the mediator between the patient and the doctor. Personal interaction makes the entire process more reliable. And since such interaction lacks with online pharmacy business, the latter is no match to retail medicine shops.
However, Kadam makes unpleasant statement for few doctors. He says, “Today’s biggest threat to retailers are from the doctors who have become traders in this business.”
Deshpande is confident that Internet pharmacy or online medicines will certainly not replace the retail stores because the concept of Internet pharmacy is not recognised under the Drugs and Cosmetics Act, 1940 and Rules, 1945. He explains further, “Any firm / person setting up web platform for receiving orders online will also have to provide physical store duly licensed and have to comply with the necessary conditions of retail licenses such as ensuring supervision of registered pharmacist, selling drugs on prescription etc. or will have to tie-up with licensed dealers to execute orders received online.”
Overall, as of now there seems to be no big threat to online chemists’ business. They will survive but their growth depends on how much they will manage to fit themselves in the legal framework. Internet pharmacy will be a win-win situation for consumers and dealers. However, certain changes in law and change of mind-set of the regulators are necessary for this concept to succeed.