Sei sulla pagina 1di 22

A Project Submitted to

University of Mumbai for partial completion of the degree of

Master in Commerce (Business Management) Part 1 Semester 2

Under the Faculty of Commerce

By

JAHNVI BHAVESH DOSHI

For the subject

Research Methodology

Project title

E-PHARMACIES - A BOON OR A BANE?

Submitted to

NARSEE MONJEE COLLEGE OF COMMERCE & ECONOMICS

Swami Bhaktivedant Marg, Bhagubai Mafatlal Complex, Vile Parle West

Mumbai- 400056

June 2020
INTRODUCTION AND BACKGROUND

India is one of the fastest growing Internet markets in the world.The number of Internet users in
India rose from approximately 300million in December 2014 to around 402 million in December
2015, 462 million in 2016, 481 in 2017 and 500 million by 2018. India stands at second position
after China in the case of internet users in the world. There is an enormous surge in the number
of mobile Internet users in India due to increasing adoption of smart phones. The country is
estimated to have around 530 million smart phone users in 2018. China with 1.3 billion is the
only country having more smart phone users than India.

E-Commerce offers many advantages to consumers and the most important is the convenience or
ease with which goods can be procured. Growth of e-Commerce and retail business are
complimentary and reinforce each other. Studies have shown that a significant proportion of the
Indian population is willing to purchase medicine, pharmaceuticals and other related products
over the internet due to its inherent advantages. Quality assurance, economic prices, incentives,
schemes, discounts, convenience in ordering, home delivery with preferred time and address are
some of the important advantages that will motivate consumers/ patients to shift towards
e-pharmacy. The Indian pharmaceuticals market by 2017 has become the third largest in terms of
volume and 13th largest in terms of value, globally. The retail pharmaceutical market in India is
about INR 1,35000 crores ( about 20 billion US $) by 2018 and is at a promising stage with its
three broad sectors of generic drugs, OTC drugs, and patented products. Generic drugs form the
largest segment of the Indian pharmaceutical sector, with around 70% market share in terms of
revenue. OTC medicines and patented drugs constitute 21% and 9%, respectively . It is expected
that the e-pharmacy can have 15% of the total domestic market in India. Anti-infective
medicines have a share of 15.17%, cardiac drugs 12.47%, gastrointestinal drugs 11.75%,
vitamins / minerals / nutrients 8.78%, and anti-diabetic preparations constitute 8.13% of Indian
domestic medicine market

There are about eighty e-pharmacies in India doing good business. Some of the major existing
e-pharmacies in India include 1MG, Netmeds, Bookmeds, mChemist, Medidart, Medlife,
Medstar, Medikoe, Bigchemist, Pluss, Zigy, Pharmeasy, Savemymeds, and SaveOnMedicals.
Traditional pharmacies like Apollo, Medplus, 2,4 Guardian lifecare etc also started on-line
business in India .
WHAT DO WE MEAN BY ONLINE PHARMACIES?

Medicines are available for sale both on sites identifying themselves as ‘pharmacies’ and those
that do not. In parallel with other types of online retailers, the market is split between those who
extended their offline presence (like Boots and Walgreens) and those who entered the market as
a purely online brand (like Pharmacy2U and Kwikmed). Gallagher and Colaizzi asserted in 2000
that ‘As Internet pharmacy has grown in the past year, it has become apparent to the major
pharmacy chains that they must pursue the online route as well to prevent a loss of market
share’1. An online pharmacy might fulfil any or all of a number of functions:
• The sale or supply of medicines, including repeat prescription services
• The sale or supply of other healthcare products
• Providing information about medicines
• Providing advice about symptoms
• Hosting online support groups
Information or advice might be personalised (through personal email/message board/live chat
contact) or general (hosted on static pages and as FAQs). Information might also be
selfgenerated or streamed/syndicated (such as the partnership between Boots UK and WebMD,
or Pharmacy2U and Patient UK). Online pharmacies are utilising different forms of technology
to extend and enhance their site functionality, such as video streaming on health topics and
mobile apps and text reminders for ordering repeat prescriptions. The inclusion of personal
records of regular prescriptions also increases the involvement that a consumer might have with
the online pharmacy
OBJECTIVES OF THE STUDY

● This research aims to highlight the online buying behaviour of medicines.


● To find the factors which influence the e-buying of medicines.
● To investigate the most crucial factors about the same.
● To evaluate the Pros & Cons of E-pharmacy
● To study the initiatives taken by the government of wrt E pharmacies
● To provide new bits of knowledge into Indian consumer behaviour and their viewpoints
for online pharmacies.
● To interpret the future of the E pharmacies in India

IMPORTANCE OF THE STUDY

In this survey we aim to analyse the importance of the growing need of e pharmacies in today’s
era. To meet the set targets and to approve the working hypotheses, the researcher designed and
implemented a quantitative survey among the clients of a selected e-pharmacy in mumbai. The
quantitative survey on which this study is based was conducted among the clients of the
e-pharmacy of the neighbouring areas. The research mainly aimed to identify the clients’
attitudes to the retention support tools, but also the way of choosing an e-pharmacy and the
specifics of the e-pharmacy shopping behaviour. The research was performed using the method
of an internet survey involving the clients of the chosen e-pharmacy. The researcher also used
the help of online e books and reference materials for improving the efficiency of the given data.
SCOPE OF THE STUDY

The study was undertaken to understand the perception of consumers towards ‘E Pharmacy’.
Furthermore, to understand the growing need of E pharmacy in today’s world. It was done
through detailed assessment of feedback from prospective users by conducting a small survey

METHODOLOGY

The study was conducted using secondary as well as an extensive primary survey.

Secondary Research & Research Tool Development


A dedicated researcher was deployed to understand the concept of e-pharmacy by studying
several reference materials on the subject. On the basis of information from secondary sources,
the research tool was developed for primary data collection including ‘Semi-Structured
Questionnaire’ in a preconceived format. The research tool (questionnaire) developed for the
study was administered on the identified target audiences.

Primary Research
Before starting the main survey, the prepared survey tool was pretested through a pilot field
survey. The outcomes of the pilot survey were examined properly and necessary changes were
made. The Final Questionnaire was prepared and an online survey was conducted to gather
responses.
ANALYSIS & INTERPRETATION

FREQUENCY OF BUYING MEDICINES

The survey findings revealed that a considerable share of the respondents tend to buy medicine
either once in a month (46 percent) or once in 15 days (37 percent). Some of the respondent
consumers reported that they buy medicines as and when needed or prescribed by their
respective doctors. Further, it would be required to understand the effect of different parameters
on the medicine buying frequency of consumers to get a detailed insight on the same.

As analyzed, the frequency of buying medicines changed significantly for different age groups. It
can be observed that instances of buying medicines once in 15 days decreases with increase in
age. On the other hand, instances of buying medicines once in a month increases with increasing
age as far as the sample respondents are concerned. In simple words, with increase in age,
consumers tend to have more planned purchases of medicines

SOURCES TO BUY MEDICINE

While analyzing the medicine buying behavior of sample consumers, it was observed that the
majority of them buy medicines on their own. The fact that physical medicine outlets formed the
primary source of medicines was reiterated by the findings, which showed that majority (68
percent) of the surveyed consumers personally visit medical stores, and about 20 percent of the
respondents order medicines over the telephone from such outlets. However, 61 percent
consumers have reported that they resort to online purchase of medicines

As per the responses, personal visits to medical stores was the most adopted mode of purchase
across all age groups except the age group of 55 to 74 years, where the adoption of e-pharmacy
(60 percent) is more as compared to other means of buying medicines. On the other hand, as is
evident from the chart, the preference of buying medicines through physical visits to the medical
stores decreases with increase in age. Subsequently, placing orders for medicines over the
telephone increases with increasing age, as indicated by the sample respondents. Also, it was
observed that majority of the elderly respondents are buying their medicines on their own,
though it has shown a decreasing trend with increase in age.
Adoption of Epharmacy

The willingness of the target consumers towards adopting e-pharmacy needs to be considered to
understand its future potential, as it is one of the major growth drivers in addition to internet
penetration, computer/smartphone penetration, computer literacy, health consciousness and
purchasing power. On enquiring about the willingness of the buyers towards online purchase of
their medicinal requirements in the near future, it was observed that 90 percent of the
respondents showed such inclination whereas 10 percent were averse.

Respondents across all age groups had shown receptiveness towards the concept of e-pharmacy.
Consumers in the age groups 65 to 70 years and 35 to 44 years have shown the highest intent to
use epharmacy in the future. Respondents aged below 35 years (89 percent) have shown the
lowest inclination towards the adoption of e-pharmacy in the times to come

The perception of consumers buying medicines for chronic diseases is expected to have a
significant impact on determining the acceptance as well as growth of e-pharmacy in the future.
Among such respondents, the acceptability for e-pharmacy as an important prospect has been
found to be higher, with 94 percent of the respondents currently buying medicines for chronic
diseases showing the inclination to accept e-pharmacy in the future, reluctance towards the same
being displayed by only 6 percent of the sample.

Features Attracting Consumers towards E-Pharmacy

The convenience factor associated with epharmacies happens to be one of the major
determinants for attracting more and more consumers. Against the routine purchase of
pharmaceutical products from physical outlets, the respondents were enquired as to how much
convenience online purchase of medicines using a mobile based application would potentially
bring. Approximately 76 percent respondents agreed that e-pharmacy will be convenient as
compared to the existing mode of purchase they are using. To find out whether consumers get all
required medicines from a single store or have to go to multiple stores to obtain the same, the
respondents were enquired on those lines. A majority (76 percent) of the respondents stated that
a single store or website sufficed their medicinal requirements. A small percentage of the
respondents i.e. 24 percent indicated that visits to multiple stores for buying

Around 87 percent respondents perceive that home delivery of medicines would be a major
factor propelling the increase in acceptance of online shopping of medicines. According to them,
this would be considerably helpful for the patients/end users as it would reduce their dependency
on other persons for the purchase of medicine. Lower prices of products is also perceived as one
of the biggest advantages of switching to online shopping of medicines. Around 84 percent of the
respondents are of the opinion that low prices, discounts and savings on purchases would be a
big feature that would attract consumers towards e-pharmacy.

Around 74 percent of the respondents agreed that convenience in choosing the date, time and
location for the delivery of orders would improve the acceptability of e-pharmacy in the market,
leading to more takers for this value added service. Quality of medicines on offer happens to be a
crucial determinant for attracting more and more consumers. Around 26 percent of the
respondents think that quality of medicines, which is a key aspect having considerable
ramifications on the health of people, would be compromised if medicine is traded online.
However, a majority of the respondents i.e. 74 percent are of the opinion that quality of
medicines would not be compromised at e-pharmacy stores, and will eventually be key to
attracting consumers to this platform. Approximately 72 percent of the respondents perceive that
ease of tracking orders, convenience in cancellation of orders and the option of reimbursement in
online purchase of medicines are advantages that consumers will enjoy if they opt for
e-pharmacy.
FINDINGS OF THE STUDY

As on date, India does not have any special or specific legal regime which governs E-pharmacy
and the regime governing the conventional model of pharmacy business (i.e. through offline
sale) is applicable to E-pharmacy as well. This has also been clarified by the Office of Drugs
Controller General (India) through its notification dated 30 December 2015 ("Notification"). The
Notification categorically mentions that the Drugs and Cosmetics Act, 1940 ("DCA") does not
distinguish between the conventional and over the internet sale/ distribution of drugs and
accordingly the provisions of Drugs and Cosmetics Act, 1940 ("DCA") must be complied by
E-pharmacy companies as well.

However, before we analyse the impact of the application of the existing legal framework to
E-pharmacy business, it is imperative to understand the different business models in which an
E-pharmacy business is typically structured. Like any other e-commerce enterprise, E-pharmacy
is structured as a marketplace, as a B2C (business to consumer) direct retail platform (i.e. the
inventory model) or a combination of both. In a marketplace model, E-pharmacy is conducted on
a platform (say a website such as Amazon.com), which acts as a facilitator for the sale of
medicines and drugs by pharmacies/chemists to end consumers. The products sold on the
platform are owned by the pharmacies/chemists and the marketplace acts as a mere intermediary
between the pharmacies and the consumers in the matter of price discovery, promotional offers
and logistics. On the other hand, in an inventory model, a pharmacist/chemist sells the products
that are owned by such pharmacist/chemist online to the end consumers through its own
website/app (such as Medicart).

Given this background, it is now noteworthy to assess the challenges that can arise on account of
the blind application of the existing legal regime that governs the sale and storage of drugs in
India to E-pharmacies.

1. Drugs and Cosmetics Act, 1940 and Drugs and Cosmetics Rules, 1945
The Drugs and Cosmetics Act, 1940 ("DCA") read along with the Drugs and Cosmetics Rules,
1945 ("DCR") regulates the sale, distribution and storage of drugs and other pharmaceutical
products. Some of the key legal provisions as set out in DCA and DCR which are relevant from
the standpoint for our discussions herein are as follows: (a) the manufacture and sale of the
prescribed drugs without a license is prohibited; (b) the premises (where drugs are stored or from
where sale/distribution takes place) are required to be equipped with adequate storage facilities
to preserve the properties of drugs and further needs to be licensed in respect of certain classes of
drugs; (c) certain drugs can only be sold through a pharmacy, which pharmacy needs to fulfil
certain prescribed requirements in connection with equipment, furniture and measurements; (d)
the supply or compounding of a certain class of drugs can be done only under the personal
supervision of a registered pharmacist or pursuant to a prescription of a registered medical
practitioner (and such supply has to be strictly in terms of the prescription); (e) the prescription is
required to be stamped / a noting is required to made on the prescription by the seller; and (f) for
certain classes of drugs, the seller is not allowed supply any other preparation even if the said
substitute contains the same substances.

2. Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954


The Drugs and Magic Remedies (Objectionable Advertisements) Act, 1954 ("DMRA")
regulates, inter alia, advertisements which suggest the cure to certain specified diseases and
conditions for which there are normally no accepted remedies and therefore, the DMRA serves
as an additional compliance on advertisements by E-pharmacies. Pertinently, while in the context
of an inventory based e-commerce model, the obligation to ensure compliance with the terms of
DMRA would undoubtedly rest on the pharmacy concerned, in case of a marketplace
E-pharmacy model, would the liability of the marketplace in case of any breach of DMRA by the
seller extend beyond the contours of Section 79 of the Information Technology Act, 2000. The
FIR against Snapdeal in May 2015 for the alleged contravention of Sections 18, 22(1)(cca) and
34 of the DCA read with Sections 3, 4 and 9 of the DMRA and the ensuing court battle before
the Delhi High Court is the perfect example that demonstrates the challenges and the legal risks
an intermediary (i.e. a marketplace E-Pharmacy) can be exposed to for any breach of DCA and
DMRA by a seller that is retailing on the intermediary's e-commerce platform. The arguments
that were advanced on behalf of Snapdeal before the Delhi High Court resonate with the
defences that have been put forth by FICCI in its consultation paper titled "FICCI Stakeholder's
Consultation on Online Sale of Drugs and Medicines". Amongst the other points that have been
raised in the defence of E-pharmacies, FICCI has argued that the companies that are engaged in
marketplace E-Pharmacy should be treated as intermediaries and "been kept outside the purview
of other trade related laws for the products which are specifically sold through the intermediary
platform. Such trade related laws, although apply to the third party buyers and sellers".

3. The Pharmacy Act, 1948 and Pharmacy Practice Regulations 2015


The Pharmacy Act, 1948 ("Pharmacy Act") prescribes for the constitution and composition of a
council at the central and state level, to regulate the profession of pharmacy in India in addition
to prescribing the educational qualifications for pharmacists. Section 42 of the Pharmacy Act
provides that no person other than a registered pharmacist shall compound, prepare, mix, or
dispense any medicine on the prescription of a medical practitioner. This statute is relevant in the
context of those E-pharmacies which deal with sale of drugs which are required to be
compounded, prepared, mixed, or dispensed by a pharmacist. At the same time, the Pharmacy
Council of India has framed the Pharmacy Practice Regulations, 2015 which inter alia, prescribe
the obligations and duties of the pharmacists in connection with the preparation and dispensation
of drugs, maintenance of records, patient care, patient secrecy and patient counselling.

4. Self- Regulation Code of Conduct for the E-pharmacy Sector


On 21 November 2016, the Federation of Indian Chambers of Commerce and Industry had
announced the launch of the "Self- Regulation Code of Conduct for the E Pharmacy Sector"
("Code of Conduct") which formulates the highest professional standards and proper safeguards
to ensure that consumers' health and safety is not compromised. Some of the notable regulations
as formulated under the Code of Conduct are as follows (a) prohibition on the processing of
Schedule X and other habit forming drugs by E-pharmacy entities (which activity is currently
allowed under the DCA and DCR after filing of the appropriate forms and payment of the
prescribed fees); (b) requirement to partner with the government for any recall of medicines
based on the details communicated by the appropriate authorities. While this code does not have
a legal force, we are of the view that the key regulations that are proposed under the Code of
Conduct should be adopted by the Government for the regulation of E-pharmacies.

GOVERNMENT OF INDIA INITIATIVES FOR E-PHARMACY.

In 2016 itself the Government of India initiated the home work to use information technology in
medicine use and distribution in India and for that purpose started steps to launch a centralised
online e-plat form for medicines. An e-platform will act as a tracking system for medicine from
manufacturer to end use by patients, which was totally lacking in the country. The Health
Ministry started utilising the 'Sugam' software for the purpose. According to the plan, the
pharmaceutical manufacturing firms will be required to register themselves with the portal and
enter data related to sale and distribution of drugs to different distributors ( stockists/wholesalers
or otherwise) along with batch number, quantity supplied and expiry date of the batch. All
distributors will, also be required to register themselves on the portal and enter details of stocks
received and supplied by them to other distributors or retailers. The data can be entered online
and by using mobile phones. Pharmacies located in rural and remote areas also can do it through
mobile phones. No retailer, chemist or e-pharmacist outlet shall be permitted to sell any medicine
or drug unless such pharmacy is registered on the e-portal. The GST system introduced on 1st
July, 2017 acted as a catalyst for the scheme as all the pharmacies in the country managed to be
computerised and started issue of computer bills. The e-platform can also be used for the quality
assurance of medicines in different ways like uploading the test reports, billing and moving
details etc. There were repeated efforts from the business and trade organisations to sabotage the
proposal of computerization and e-filing of medicine movements and other documents. The All
India Organisation of Chemists and Druggists Association (AIOCD) conducted a nation wide
agitation on 30th May 2017 against the decision of making e-platform for medicine registry in
the country

MAKING E PHARMACIES LEGAL

In April 2018, the Union Health Ministry has come out with a draft proposal to amend Drugs and
Cosmetics Rules 1945 by inserting Part VI B to it after Rule 67H and before Part VII under the
heading SALE OF DRUGS BY E-PHARMACY which will legalise the e-pharmacies in the
country. Now the Rule defines an epharmacy as a business of distribution or sell, stock, exhibit
or offer for sale of drugs through a web portal or any other electronic media. This definition will
make it clear that e-pharmacy need not be 'bricks and mortar' (B&M) type of physical
pharmacies that deal with patients/ customers face-to-face. Virtual or on-line pharmacies can
now function as e-pharmacies in India. No person can distribute or sale drugs and medicines
unless registered under Rule 67N of the Drugs and Cosmetics Act Rules4. According to the new
Rule, a prescription is defined as an instruction from a Registered Medical Practitioner to a
Pharmacist, written by hand or in electronic mode duly signed to dispense a drug and the
quantity of the drug to a patient. Now the doctors can write legally valid electronic prescriptions
in all electronic modes, specifying the name and quantity of the drug and the details of the
patient. A doctor from any part of the country can write a prescription for any patient of India.
The epharmacies may have to collect the phone number of the patient and the prescriber for the
effective functioning of the epharmacies, though the same is not specifically mentioned in the
Rules

POTENTIAL FOR E-PHARMACY IN INDIA.

At the global level e-Pharmacy was having a market of 29.3 billion US dollars in 2014. Both
North America and Europe shared the market . It is estimated that by 2023, the global market of
epharmacy will be 128 billion US dollars. According to one Boston Group report in 2016, China
was having an e-pharmacy market share of 1.1 billion US dollars. The potential area for the
global epharmacy market lies in the Asia Pacific market. Though epharmacy is a newly born
baby in India, it has the potential to become a very large industry segment in the very near future.
Rapidly changing consumer behaviour , increasing penetration of internet to the rural areas and
the availability of smartphones are some of the major driving forces for the popularisation of
ecommerce and e-pharmacies in India.

● CHALLENGES AND CONCERNS

A plain reading of the key provisions of the DCA and DCR unequivocally suggests that the
overarching legislation for the regulation of pharmacies is agnostic to the way an E-pharmacy is
structured. In other words, DCA and DCR, which have been enacted keeping in view the
challenges and risks underlying the operations of a traditional brick-and-mortar pharmacy,
cannot be relied upon (at least in its existing form) to regulate the operations of E-pharmacies.
The reason is simple - the existing legal framework lacks the teeth to ensure / monitor continuous
compliance on part of a business venture that virtually just needs a computer machine (or even a
tablet) to provide access to scheduled medicines and drugs to the public. Having said that some
other key challenges and concerns that arise in the backdrop of the application of the existing
legal regime to E-pharmacies are as follows:

1. Storage conditions: Before a pharmacy can undertake sale of drugs and medicines, it
needs to obtain the requisite licenses under DCA. Such licenses are pegged to a particular
physical store from where the sale is proposed to take place and/or where the drugs and
medicines are proposed to be stored. Such premises are required to satisfy the prescribed
standards in terms of hygiene, temperature control etc. However, as opposed to sale from
a brick and mortar store, in case of online sale of medicines, it is very difficult to ensure
that the medicine or drug is being delivered/sold from a licensed premise, as the
consumer is not physically present to verify this. This in turn raises concerns as to
conditions of the place wherein the drugs could be stocked by e-pharmacy to tackle costs.
2. Misuse of prescription: At the same time, there is a risk of the same medical prescription
being used multiple times for procuring drugs across different pharmacies (whether brick
or mortar stores or E-pharmacies). This is especially a red flag in case of narcotic and
psychotropic drugs, tranquilizers, habit forming drugs and Schedule X drugs.
3. Regulatory machinery and supervision: Drug sale is regulated by state licensing
authorities, which is feasible for brick and mortar stores, given they are expected to be
approached by the consumers who reside within the vicinity of the location of the stores
(and hence within state borders). However, such a model of regulation may not be
feasible for E-pharmacies inasmuch as an online marketplace is accessible from any
location or state, without there being any checks or control on cross border sales etc.
4. Storage and transportation: Absence of a framework or guidelines ensuring the protection
of the drugs and medicines at the time of storage and transportation. There is a possibility
of pilferage, loss of potency and degradation of drugs and medicines during
transportation to the consumer's house, especially if they are being transported over long
distances or are of certain specification that requires safe handling, cold storage etc.
5. Given the absence of any physical interface between the consumer and a pharmacist,
concerns arise as to the compliance with the obligation of the provisions of Pharmacy Act
and the regulations made thereunder on part of the E-pharmacies. One way to address this
concern is to restrict the online sale of drugs to only over-the-counter medicines and other
products that do not require compounding, preparation, mixing or dispensation from a
pharmacist.
6. There are also concerns with regard to the interface between a patient and a pharmacist in
the matter of patient care, secrecy and counselling.

Besides the concerns listed above, it is also not clear if the legal implications for E-pharmacies
will differ based on how they are structured. While there is no doubt that E-pharmacies following
the inventory model and the pharmacies selling their products on an online marketplace will be
required to ensure full compliance with the DCA and the rules made thereunder, it is debatable if
an E-pharmacy operating on a marketplace model will also be required to comply with the DCA
and consequently obtain a license thereunder. The reason being that the DCA regulates not only
the "manufacture and/or sale of drugs", but it also regulates the "exhibition, offer for sale and
distribution" of drugs. Accordingly, one can argue that an E-pharmacy operating on a
marketplace model engages in "exhibit for sale" and/or "distribution" of drugs (if such
E-pharmacy is also engaging in providing logistical support for the delivery of drugs and
medicines to online customers) and hence is required to be registered under DCA. Interestingly,
this was one of the objections that was advanced by Food and Drug Administration, Maharashtra
in litigation against Snapdeal - that Snapdeal was engaging in exhibition and distribution of
drugs and medicines without having obtained the relevant licenses under the DCA.

Furthermore, it is noteworthy that the Office of Drugs Controller General (India) had also
constituted a committee to examine the issue of the online sale of drugs16. The committee in its
report dated 30 September 2016 had concluded that the existing legal regime was inadequate and
incompatible with the E-pharmacy business and consequently had made several
recommendations for an amendment in the existing legal regime to ensure a strict supervision is
maintained over the E-pharmacy business. A few significant recommendations were as follows:

1. creation of a national portal to act as the nodal platform for transacting and monitoring
online sale of drugs;
2. geographical restrictions on the operation of E-pharmacies; and
3. restriction on the online sale of certain categories of drugs, namely, the narcotic and
psychotropic drugs, tranquilizers, habit forming drugs and Schedule X drugs that are
prone to being abused or misused
● ADVANTAGES OF E-PHARMACY

Compared to the existing physical community pharmacies, epharmacies will have many good
aspects including professional services. Some of them are noted below

I) Medicine Authenticity and Quality.


The IT based tracking systems of e-pharmacies will help in backtracking the manufacturer/
channel / supplier of the sub-standard or low quality medicines and counterfeit medicines. This
will help to make the medicine market transparent and authentic. The display of the quality
control test report of the manufacturer and the bar-coding in the labels of medicines will help to
ensure the quality of medicines supplied. Since e-pharmacies are supposed to get most of their
items from the manufacturers directly and are supposed to dispense medicines of selected few
manufacturers, e-pharmacies can play an important role in ensuring quality medicines to the
society. As the Government of India is working on the introduction of bar codes for all
medicines and has already introduced the system of generic dispensing in the country,
e-pharmacies can act as a catalyst in cost reduction, quality assurance and availability of
medicines at economic costs.

ii) Improved Accessibility.


With the use of information technology and access to inventory of multiple stores at a time,
e-pharmacies can aggregate supplies, making otherwise difficult-to-find medicines available to
consumers across the country. Community pharmacies can generally keep only a limited
inventory forcing the consumer to visit multiple pharmacies to procure the medicines.
E-Pharmacies also enable access to rural areas where there is a shortage of community
pharmacies. E-pharmacies will be much helpful and useful for regular users of medicines and
also for senior citizens and disabled who find it difficult to travel to the community pharmacies.
Medicines will reach their door steps, quite often at less costs. Consumers can order medicines in
a convenient manner from their mobile phones or computers. This will significantly help the old
and sick who are not in a condition to go out to find a pharmacy. Working couples will also
benefit out of e-pharmacies.

iii) Tracking of Data.


All the details regarding the e-pharmacy transactions will be properly documented on
e-platforms. All transactions could be efficiently tracked with details of the medicines, batch
number, date of manufacture and expiry, e-pharmacy name and address, prescribing doctor,
dispensing pharmacist, name and address of the patient, etc., thereby reducing many unethical
issues and practices. E-Pharmacies can store and analyze data on consumers across the state or
nation, which would be useful for planning public health policies.

iv) Generic Dispensing by professional Pharmacists


India has already introduced the system of generic prescriptions and dispensing. Doctors who
were not taught about brand names or trade names during the education period, are prescribing
costly brands to poor people in the name of quality. Quality is not related to brand or generic
names, but to the manufacturers and their process. If consumer movements become strong
nobody will dare to prescribe costly medicines, if low cost alternative generics are available.
However it is essential that pharmacies and pharmacists maintain professional ethics in pricing
and dispensing activities. E-pharmacies allow the consumer to choose from a wide range of
generic equivalents for a particular branded drug. This is currently not possible in the Indian
community pharmacies. OTC medicines can be sold through the e-pharmacies without
prescriptions as in the case of other pharmacies, but have to maintain the records as in the case of
prescription medicines.

v) Cost Benefit
E-Pharmacies will help pharmacy entrepreneurs to broaden their customer base while reducing
financial investment, working capital and overhead costs. They will also get an increased
margins. Patients and consumers will get quality medicines at lower costs. Qualified pharmacist
can practice the principles of pharmacoeconomics in pharmacies which will help to translate into
cost advantage to end consumers.

vi) Drug Information and Patient Counselling .


Through e-pharmacies society will get value-added services like drug information, patient
counselling and education and pharmaceutical care. Pharmacists can provide advice regarding
drug interactions, side effects, quality of medicines, medicine regimens, and information on
storage and proper use of medicines. This power of knowledge will enable the consumer to
promote prudent and rational use of medicines.

vii) Issue of Medicine safety.


Questions about medications could be answered by e- pharmacists using e-mail, Whatsapp or
other real-time chat options. As pharmacists at the e- pharmacy will be the final decision maker
for dispensing a drug, e-Pharmacy shall have a team of qualified pharmacists for validation of a
prescription and for handling any drug related queries from the patients. People with M.Pharm/
Pharm.D qualification would be necessary in e-pharmacies to provide value added professional
services. Name, phone number and other contact information of the pharmacists may be
necessitated to provide while answering drug related query from the customer. Medication errors
can be more effectively addressed through e-pharmacies than the existing Indian community
pharmacies.
viii) Promotion of national development and digital India.
Digital India is a flagship program of the Government of India. It aims to transform India into a
digitally empowered nation with the support of creating digital infrastructure, digital literacy and
digital delivery of services. It aims to empower the society to avail Government services,
transparently, conveniently and easily. Digital India is expected to boost the economic growth of
the nation and improve the lives of people. There is dramatic growth in the number of online
transactions involving citizens and the Government ( e-governance) after 2013. If it was 840
million in 2013, it became 2580 millions in 2015 and increased many folds during 2017-181,3.
E-pharmacy can very well align with the national development objectives and has clear and
tangible benefits to the consumers as well as the industry.

ix) Promotion of e-prescriptions.


E-pharmacies would also enable the doctors to adopt e prescriptions in a big way, which in turn
can address issues of errors due to misreading of doctors' bad handwriting and also help to
recording of data for public health planning programs.
SUGGESTIONS

• A separate license and registry of e-Pharmacy players should be created

• The dispensation of scheduled drugs should be against a valid prescription from a Registered
Medical Practitioner (“Prescription Drugs”) and must be undertaken by, or under the direction
and personal supervision, of a registered pharmacist.

• The e-Pharmacy would be permitted to process the order for prescription drugs only after
obtaining (i) the original prescription (ii) a scanned copy of such original prescription.

• Audit trails (including the address and name of the patient) should be digitally stored to
prevent abuse and ensure tracking in case there is any adverse event to a medicine.

• Narcotic medicines (like morphine) and other habit-forming drugs (like sleeping pills) should
be restricted to be sold through an e-Pharmacy model.

• Suitable arrangements must be made to ensure that the medicines are packed, transported, and
delivered in such a way that their integrity, quality, and effectiveness are preserved.

• The website / mobile application must clearly provide information regarding the logo, license
number, and contact details of pharmacists for addressing patients’ queries and grievances.

• New optimization strategy leveraging big data and machine learning algorithms to automate
operations, supply chain and address business challenges will be the area that will impact long
term sustainability of ePharmacy initiatives.

• Integrating the value chain of demography, disease, diagnostics, doctors consultation and
delivery of Drugs would be a key value differentiators and will create niche players able to lead a
PAN India operations.
CONCLUSION

Breaking the barrier of information lying with the experts, such services are brought to the
common man anywhere at any time6. A unique feature of information technology is its ability to
break barriers E-governance, e-health, e-pharmacy are all its beneficiaries. In an era of
globalisation, e-pharmacy is a need of the land. It is essential to develop concrete infrastructure
for the epharmacies in the coming years. E-Pharmacies enhances the services of pharmacists to
the society. It can provide easy and affordable access of medicines to the consumer at their
doorstep and is expected to create huge demand in the days to come. Easy access and
convenience factors associated with e-pharmacies are very much helpful for not only old and
sick, but also for the rural population who have to travel for buying medicines. Indian
pharmacists have a responsibility to make the e-pharmacies professional and ethical in its
activities. ​The Indian Judiciary and regulatory authorities on E-pharmacies should take into
consideration the measures introduced by various other developed countries like USA and EU
with common logo mark, online tracking system, E-Prescription for certain drugs for handling
problems related to online sale of medicine in India.
Online pharmacies should take initiatives to improve their delivery system as medicines can be a
matter of emergency. Many respondents had faced bad experience with online pharmacies
related to late delivery. When people search for medicines, suggestions for generic medicines
should be provided in order to serve customers better. Payment terms and conditions could be
revised with facilities like 15-day credit to make it hassle-free for people in case of urgency.
Selling medicine over the net also adds to a lot of responsibilities on the part of the seller.
Incomplete information can lead to major problems. Warnings regarding consumption should
also be stated clearly. Detail of every medicine, including dosage as per age group and probable
side effects, should also be reflected to educate the customers. Mishandling of drugs can lead to
serious health hazards; hence, online pharmacies should not just sell rather spread awareness and
educate their customers as well, as medicine consumption is no fun. Uploading scanned
prescriptions should be made mandatory for certain drugs (Schedule H and Schedule X drugs
according to the Drugs and Cosmetics Act, 1940) (Prashanti, Sravani and Noorie, 2017).
To sum up, both the buyer and seller of online medicines should be made aware of the pros and
cons. To develop the e-pharmacy system, sound e-health and telemedicine laws should be
incorporated in India. Online pharmacy could encourage self-medication, which can lead to
irrational use of medicines. Not many people are aware of the availability of medicines online
and the offers are given by online pharmacists, care should be taken for effective communication
among the masses. Online pharmacy gives access to a wider range of medicines 24 × 7 along
with information and offers. It also gives the customers privacy. It is bringing in the trend of
self-medication
Moreover, it is difficult for customers to find if the online pharmacy is legitimate or not. The
Government of India should define policies and guidelines for e-pharmacies and establish a
model that could be beneficial for the customers

● THE FUTURE FOR ONLINE PHARMACIES

Pharmacies fulfil a number of roles, many of which are linked to other parts of the health
service, and a sustainable future for pharmacy includes an online platform. There are examples
of plans for integrated e-healthcare systems incorporating web-based pharmacy interfaces that
are accessible by pharmacists and patients alike. There has been a call to develop secure ‘patient
portals’ that offer communication, content, commerce and community – what the authors of the
paper called the “4 basic Cs” of the Internet. This perspective was offered in the context of
supporting independent living for older people, focusing on wellness rather than anticipating
illness. There are acute situations for which online pharmacies will never be the first choice, but
consumers of long-term medicines and health care products have compelling reasons to favour
an online channel. Beyond the supply of product, online pharmacies may wish to consider how
they might provide services online for which payment is made. As yet, online pharmacies are not
actively promoting online adherence support for patients. Rather, some provide information
about compliance support devices that can be accessed in-store. It would be interesting to see
programmes available through online pharmacies to provide online support for people taking
medicines, be it through group support for people taking certain medicines (like statins, where
the risk of discontinuation at the beginning of therapy is considerable), or through reminders and
live chat contact with a member of the pharmacy team trained in motivational interviewing and
adherence support. Just as bricks-and-mortar pharmacies have moved in recent years from a
focus on products to services, there is scope for developing the online cognitive pharmacy
service sector. For example, if patients build an online medicines portfolio, what would then
prevent their pharmacist from engaging in online chat with housebound patients to undertake
periodic medication review? Many pharmacies are extending their online functionality, and some
have a presence within social network systems like Facebook. Whilst writing this review, some
of the UK and US pharmacy facebook sites were visited: features were associated with wellness
and a wider range of healthcare products. A social networking role for pharmacists in “micro and
macroscale projects that inform the public about health issues, mobilize partnerships to confront
public health issues, and engage in research about new insights into health solutions” has already
been proposed. Pharmacy staff need to focus on the extra value that they bring to a face-to-face
transaction. If customers perceive that they get personalised advice and treatment from staff, they
are arguably less likely to look elsewhere. Some consumer literature has highlighted the greater
preference of younger consumers for online medicines distribution. There is a risk of losing a
generation who have a ‘wired lifestyle’ and do not have the chance to build relationships with
health care staff – missing out on preventive opportunities. The combination of the online and
offline presence – with people starting a conversation online and then having the chance to
follow it up in person – is worth exploring. Nutbeam’s domain of interactive health literacy is
about acting upon information obtained, and yet one of the most difficult things to find on the
Internet has been information about local support. Pharmacies with online and offline presence
could capitalise upon this combination, beyond the ‘store locator’ function. Isaac Montoya
insightfully summarises the current dilemma of the online pharmacy: ‘Healthcare marketing
concepts guide business owners to identify the patients’ wants and distinguish them from their
needs. Some Internet pharmacies misinterpret proven marketing principles and become overly
aggressive in the marketplace and focus on sales and profit only, rather than focusing on the big
picture that includes concern for patient safety and long term success for the Internet pharmacy.’
Wagner et al. advised community pharmacies to reflect: ‘The growing presence of Internet
pharmacies should motivate community pharmacists to foster more personal relationships with
patients by increasing educational programs, counseling, and disease state monitoring, as patients
will use the pharmacy that best fits their needs. In many studies and commentaries we see
reference to online pharmacy operators who were maintaining high standards. Even the earliest
studies, in perhaps the most anarchic phase, reported a ‘surprisingly high’ number of online
pharmacies who refused to supply sildenafil without prescription. There is no doubt that there is
a place for good online pharmacies as choices available to consumers. It will be a combination of
sharing good practice (including regulatory practice) and empowering medicine consumers that
will influence the spread of high quality online pharmacy provision.
REFERENCES

● Dey, S. (2016, July 7). 61% of people prefer buying drugs online. The Time of
India. Retrieved from
https://timesofindia.indiatimes.com/india/61-of-people-preferbuying-drugs-onlin
e/articleshow/53090765.cms

● Raghavan, P., &Vignesh, J. (2018, April 10). Why the government's new draft
rule could make or break e- pharmacies like NetMeds, PharmEasy. The Economic
Times. Retrieved from
https://economictimes.indiatimes.com/industry/healthcare/biotech/pharmaceutic
als/why-governments-new-draft-rule-could-makeor-break-e-pharmacies-like-net
meds-pharmeasy/articleshow/63690489.cms Reddy, M. (2017, June 14).

● Do you buy medicines online? Know these risks [Panache]. The Economic Times.
Retrieved from
https://economictimes.indiatimes.com/magazines/panache/do-you-buy-medicine
sonline-know-these-risks/articleshow/59119019.cms

● Ministry of Chemicals and Fertilizers. (2017). Annual report 2017–18. Retrieved


from
http://pharmaceuticals.gov.in/sites/default/files/Annual%20Report%202017–
18%20%28E%29_3.pdf

● General Pharmaceutical Council (GPhC). Internet Pharmacy. Available at


http://www.pharmacyregulation.org/regulatingpharmacy/registration/internetph
armacy/index.aspx.

● 23. National Association of Boards of Pharmacy (NABP). VIPPS. Available at


http://www.nabp.net/programs/accreditation/vipps/.

Potrebbero piacerti anche