I’d hazard a guess that there is hardly anyone who is not a user of e-commerce platforms to ease the daily grind. From the choicest groceries to the latest fashion accessories, most of us turn online. Then why is there so much ado about buying medicines online? Mirroring the push back to online grocery stores, representatives of the brick and mortar chemist stores point out that unlike a wrong size in shoes, which can be returned after a trial, wrong or worse, counterfeit medicines could have fatal consequences. But can we be sure that those we purchase in a nukkad ka chemist are not fake?
The Express Pharma team has watched the debate over online pharmacies being played out over the past few months in the country. The government responded by forming a sub-committee but sensing that many issues were simmering below the surface, we decided to launch a new platform called Vantage Point, and pose the question: Are Online Pharmacies Game Changers or Trouble Makers? We invited representatives from all sides to meet and thrash out their differences, and hopefully rise above the hype and white noise.
After months of silence, just a week before the event scheduled for January 8, with most offices winding down to bring in the New Year, the Office of the Drug Controller General (India) fired its salvo. The Joint Drug Controller issued a circular on December 30, specifying that online sale of drugs contravened the provisions of the Drugs & Cosmetics Rules, 1945 and asked its officers to ‘put a strict vigil on the online sale of medicines and take action’ against those indulging in such activities. The DCG(I) clearly decided to play safe till the sub-committee came up with suggestions and guidelines.
The circular was hotly debated at the January 8 event. While there was consensus that the consumer should be protected with laws, representatives of the online and traditional chemists stuck doggedly to their stand. Each pointed out the shortcomings of the rival model with the legal eagles on the panel ruing the long drawn out law making process in India. (See full report: https://www.financialexpress.com/article/pharma/latest-updates/sparks-fly-at-express-pharma-debate-on-online-pharmacies/191165/)
India is not the only country where online pharmacies are facing the flak. The backlash to online pharmacies is a lot more organised in the US and EU, where the idea has been around a longer time. The website of the international Alliance for Safe Online Pharmacies, which describes itself as a ‘social welfare organisation dedicated to improving patient safety on the Internet globally’ lists the actions taken against illegal online pharmacies across the world.
Is this merely the backlash that online retail stores faced and still face from local grocery stores? Most online pharmacies first start out as traditional brick and mortar stores, build a clientele and learn the tricks of the trade before they invest in online infrastructure. They then follow the aggregator model, where they aggregate the prescriptions from various chemist stores as well as take orders online. In fact, the panelist who represented traditional chemist stores readily admitted that some of their members are also looking at going online, but are waiting for the regulatory nod.
Given that India is still far from the US system of accredited online pharmacies, how do we detect and check abuse of the system? For instance, a recent study published in the Journal of Medical Internet Research (JMIR), is one of the first studies on how illegal online pharmacies are using Twitter to promote prescription drug abuse of controlled substances. The study authors found over 45,000 tweets that promoted drug abuse even though they only looked at a two-week period of tweets. One of the startling observations quoted in the study is that 76 per cent of the tweets that discussed drug abuse, had links to an online marketing affiliate advertising the sale of valium, a commonly abused tranquilliser that is supposed to be under controlled distribution.
The key word in the JMIR study is ‘illegal’ pharmacies. So, can an online pharmacy be immune from legal action merely by claiming compliance with the IT Act? Not so, claim some legal experts who point out that even as ‘intermediaries’ to a transaction, Section 39 of the IT Act mandates that ‘the intermediary observes due diligence while discharging his duties under this Act and also observes such other guidelines as the Central Government may prescribe in this behalf.’ Which means that they can be held responsible if any of the medicines delivered by them are found to be spurious/ fake, even though they merely delivered them. Have online pharmacies in India put sufficient safeguards into place?
The unwritten rule is that every segment will finally see one big player emerge as the market leader. Will we see bigger online pharmacies unite to weed out the ‘bad sheep’? Online pharmacies have already changed the game. It is now up to the regulators to rein in the troublemakers.