[Column] Erik Roos: Are e-pharmacies on the cards for South Africa?
Amazon’s recent entry into the pharmaceutical market, following its acquisition of PillPack – an online US pharmacy, which serves a sizable portion of the US’ prescription market – has got local experts re-evaluating the role of internet pharmacies in SA where many still don’t have access to medication.
One of the most popular uses of the internet is to find health and medical related information and many rely on it as their main resource. Modern times are witnessing a surge in e-commerce and online shopping, which also extends to the sale of a large variety of health-related products, such as complementary, over-the-counter (OTC) and prescription medication. However, given SA’s highly regulated medicines market, internet pharmacies that sell scheduled medication are still by and large considered illegal in our country, despite them having been in operation for nearly 20 years elsewhere in the world.
The advent of online pharmacies creates opportunities for increased access to medicines, convenience, more competitive pricing and patient anonymity. By supplying medicines online, e-pharmacies are able to warehouse large quantities of stock, which reduces the cost of medicines. Most of the daily processes are also automated making it faster for doctors and pharmacists to prescribe and dispense medicines.
Research shows that internet purchases are typically higher in rural areas where the distance to a pharmacy is likely to be greater than in urban areas, which is significant in the South African context where approximately 34.7% of the population live in rural areas and have to travel 25km or more to access healthcare.
With nearly 60% of South Africans having access to the internet, doesn’t an online pharmacy model make sense for SA?
Reputable online pharmacies, such as PillPack delivers medications in pre-sorted dose packaging following the receipt of a doctor’s prescription. It then coordinates refills and renewals and makes sure shipments are sent on time, offering patients a seamless experience with pharmacy staff that can be contacted either online or via the phone 24/7.
Yet, I would caution that although the internet has been widely adopted for business and social communications, online pharmacies carry with them several disadvantages, e.g. lack of face-to-face interaction with a pharmacist, the inappropriate use of medicines, limited personal data protection, while also contributing to the selling of fake or substandard medicines globally, especially in countries where proper controls haven’t been put in place.
The ease with which rogue operators can create, modify and remove websites also makes it difficult for authorities to identify, track and monitor their activities. However, there are ways in which the public can identify illegal websites such as when an online pharmacy allows you to buy scheduled medicine without a valid prescription from your healthcare provider; when they offer prices that seem too good to be true or when they don’t have a licensed pharmacist available to answer your questions.
The medicines that these e-pharmacies sell may look like the genuine product but could have too little of the active ingredient that you need to treat your condition or contain the wrong or even other harmful substances. Legalising the purchasing of medicines online in SA poses unique ethical, legal and quality challenges, which are important from a consumer, healthcare provider and regulator perspective.
As the internet-use becomes more universal in SA, along with increasing healthcare costs, e-pharmacies are an inevitable phenomenon, and many brick-and-mortar pharmacy retailers will have to increase their online presence to remain relevant. The internet provides a viable mechanism to capture actual savings in healthcare and prescription medication, however local legislators would need to focus on developing the right policy with laws regulating it, to enhance the benefits, while minimising the risks to consumers.
Erik Roos is CEO, Pharma Dynamics.