A white paper on 'e-Pharmacy in India' recommends widespread use of the Internet to overcome the barriers of accessibility and affordability, especially for the elderly in urban areas and those living in villages for removed from healthcare service providers.
The white paper by FICCI underlines the need for formulation of comprehensive guidelines to legitimize the operations of e-pharmacy businesses as consumer's health and safety is of prime importance.
The paper notes that India is experiencing a rapid transition with the rising burden of chronic non-communicable diseases (NCDs) which currently accounts for around 60% of the total deaths. Rapid urbanization, increased motorization, mechanization and sedentary lifestyle, especially among the working age groups, predispose the population to premature NCDs.
Thus, accessibility, affordability and lack of awareness are the major challenges for last mile access to medicines. These barriers could be effectively overcome by adopting technology, specifically the Internet, into the healthcare system.
The factors driving the demand for e-Pharmacy in India include rising number of people with unmet medical needs due to large population and increasing penetration of internet in both urban and rural India. With the rapidly changing consumer behavior in India, there is a huge demand for accessing a wide range of products at the click of a button, and at competitive prices. It is expected that the e-Pharmacy model could account for 5-15% of the total pharma sales in India, largely by enhancing adherence and access to the medicines for a lot of under-served population.
E-Pharmacy improves consumer convenience and access. This will most importantly benefit chronic elderly patients living in nuclear families, and patients who are not in a condition to go out to find a pharmacy. E-Pharmacy also offers competitive pricing which thereby enables less affluent people to afford medicines. There are a lot of technology advancements that are coming up in the form of applications which help in bringing price transparency, create awareness, find an appropriate healthcare service provider, medicine reminders, and pregnancy alerts to the consumers.
In addition, e-Pharmacy models are well aligned to address key known issues in pharmacy retail for tracking authenticity, traceability of medicine, abuse prevention, addressing consumption of drugs without prescription, tax loss and value added services for consumer empowerment in healthcare, which are all key areas of national development. This model also increases entrepreneurship and in turn accelerates wealth creation in the country.
Currently, there is a lot of misunderstanding about e-Pharmacies impacting the traditional brick and mortar pharmacies. In reality, e-Pharmacy model enables the existing traditional pharmacies to cater to a broader set of customers and also ensures that the inventory is consolidated by reducing the requirement for working capital, removing wastage from system and increasing margins, thus making the model sustainable.
The white paper observes that a significant proportion of the population is willing to try purchasing medicine and related products over the internet considering the advantages it has and additional value it creates compared to the existing physical retail outlets. Survey reveals that lower prices, discounts, convenience in ordering and home delivery with preferred time and address are some of the major advantages that will prompt consumers to shift towards e-pharmacy.
There is a positive perception regarding e-pharmacy among medical practitioners as almost 90 percent of respondents perceive it as an acceptable means of sale and purchase of pharmaceutical products. The easy access and convenience factors associated with e-Pharmacies happens to be the major determinants for attracting more and more consumers in the view of medical practitioners as mentioned by 85 percent and 75 percent of the respondents respectively.
Since e-Pharmacy is only technology advancement, it is recommended that it should be allowed and its benefits should be made available to the consumers in India but with sufficient safeguards and under stringent regulatory control to protect the interest of the consumers.
Some of the recommendations for due-diligence of the e-Pharmacy model and making it fool-proof include:
• A separate license and registry of e-Pharmacy players should be created • Dispensation of drugs to be undertaken through the physical pharmacy, duly licensed under Part VI of the Drug Rules
• 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 trail (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.
This is the right time for the Government of India to define policies and guidelines for e-Pharmacy and come up with a clear-cut operating model, in line with the concerns of the regulator, while providing benefits to the consumers.
