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Online Pharmacy Vs Traditional Pharmacy: What is the Next Step?

21-12-2016 06:52 AM

ePharmacy is an idea whose time has come, and yet it fails to garner widespread acceptance as operational and policy gaps need to be filled. M Neelam Kachhap speaks to various stakeholders to find out how this segment is placed and how will it grow in future.


The recent demonitisation drive spearheaded by Prime Minister Narendra Modi has given an impetus to cashless transactions. In healthcare sector, one segment that stands to benefit from this move is online pharmacy or ePharmacy. Over the last one year e-pharmacy has come up as an important alternative to traditional pharmacies for the sale of medicines.  According to news reports epharmacy market in India is pegged at USD18 billion and is expected to grow to USD55 billion by 2020. In last year alone ePahrmacy players in India attracted $70 million funding with investors coming from all walks of life..

Many experts in India believe that ePharmacy is an idea whose time has come and yet others point out various gaps that still need to be filled if India is to embrace this model. A recent survey commissioned by Consumer Online Foundation and conducted by Bureau of Research on Industry & Economic Fundamentals (BRIEF), revealed a major shift in consumer preference in buying medicines from offline to online mediums as 61 percent consumers reported their preference to purchase medicines themselves online.  In addition, the survey found that majority of online orders were placed by senior citizens due to convenience, proper systems facilitating easy validation of prescriptions and choice of affordable options. However, the survey also brought to front various drawbacks of Indian pharma retail segment. Key elements of patient safety measures are often neglected by pharma retailers in India. Not having qualified pharmacists on board, lack of counselling about medicine, dosage, usage etc., getting substitutes when brands written on prescription is not available at the chemist shop are some of the common practices as reported by respondents in survey.

In this environment ePharmacies are seen as a relief by some and a problem by the others. Amongst allegations of misconduct, inadequacies, what will be the future of online pharmacies in India? Global best practices and enabling legal framework is the need of the hour for ePharmacies but when and how these will be adopted is anyone’s guess. We at Healthcare Executive try to bring some prominent voices to the front.

Prashant Tandon, Founder and MD, 1mg

Prashant Tandon

Healthcare in our country has multiple pain points, and the structural opacity and lack of knowledge with the consumer has led to a situation where the consumer is misled by multiple intermediaries. With the help of technology, online pharmacies can address multiple issues at many levels. I feel that there are lot of digital evolutions happening and with innovations in digital space going up, we can take healthcare to the next level. The next phase would be gathering of information and leading to more specific and personalized healthcare. Online pharmacies can solve a bunch of these problems:

Access to Information/Products: Consumers will be able to make more informed decisions. With the use of technology, consumers can know about the medicines, its side effects, interactions and find out cheaper substitutes. They can understand their condition and how best to manage it better (regardless of his location or his financial condition).

Convenience & better access: Through ePharmacy, consumers in different parts of the country can access medication at their doorstep, through a well tracked system which will strengthen authenticity in the supply chain, ensure better access, provide convenience to the patient and also make sure that the deep rooted issues of middlemen taking commission to procure medicines (often fake and without a bill) is addressed. Across the country, an online model to procure health services ensures everything is tracked, recorded and hence organized and operated in a professional manner

Transparency: ePharmacy will ensure there is all the information available at the patient’s fingertips. Hence a consumer can compare prices, learn about more cost effective options and make sure they are not taken for a ride.

Data Records (Electronic Medical Reports): Healthcare is a data-intensive and data driven industry. Hence, it becomes important to not only store this data accurately but also use it to improve patient experience. Availability of all reports and prescriptions of an individual on her/his account is one of the biggest benefits of technology. The possibility of losing a particular report or prescription will be eliminated. Digitizing all the information can make it accessible anywhere and everywhere and would not require any individual to look for his medical reports all over her/his place. Also, the information which one tends to usually forget about one’s health will be available at one place making it easier for all to give the exact information that a doctor needs to suggest ‘the perfect solution’. More precise the information, better will be the chances of doctor understanding the exact problem and thus, suggesting ‘the perfect solution’.

I firmly believe that if healthcare is to be changed (and for sure it is going to be changed), then it will move to a model where the consumer will have the power of knowledge and will demand better service, more transparency and optimum quality for the money he/she pays. We look forward to create and develop the model of eHealthcare which will be built around solving problems for the consumer, in the most optimized manner which works at scale for a country like ours.

Sunita Kishnani, COO, Easymedico

Sunita Kishnani, COO, Easymedico

Online/ Internet pharmacies are typically useful for patients who are on regular or long term medication like Diabetic, cardiac, hypertensive etc.If we just consider Diabetic patients in India then an estimated 69.2 million are diabetic (Ref. International Diabetes Federation Atlas 2015). Such patients need same set of medicines almost every month for a longer period. Now keeping this segment in perspective, let’s ask two simple questions.

  • Is it possible that whenever medicines are required, a patient himself can visit the chemist shop in person?
  • Is it possible that every time they wish to purchase, they will remember to carry the prescription?

Practically speaking, it is not. In most cases, patient might order medicines over phone from his nearby chemist shop or will ask family member to buy on their behalf. Obviously in this situation, transaction is mostly verbal i.e. patient or his relative will say I need this and this medicine and chemist will also dispense or deliver at home.

India is unlike West where the pharmacy retains the prescription which is forwarded to them by the physician directly. Therefore Pharmacy/pharmacist knows which medicines are to be dispensed and for how long. They stop dispensing whenever patient’s revisit to the physician is due.

This is absolutely achievable by an online pharmacy because entire transaction happens on the basis of the prescription. A prescription is mandatory to be submitted to the online pharmacy. It is reviewed, approved by the pharmacist and carries validity dates. Chances of dispensing error are zero because medicines are dispensed /packed seeing approved prescription under pharmacist supervision. Here entire transaction flow is on the basis of referable reference in contrast to verbal where chances of overhearing and dispensing wrong medicines are more

Therefore apart from providing convenience of buying remotely and making sure that all required medicines are made available to the patient from one single pharmacy (availability of all medicines in one single pharmacy is generally an issue owing to some lakhs of brands in medicines in India), online pharmacies also follow entire rules and regulations. They ensure that patient is adhering to medication as is prescribed by the doctor which is what the exact role of a pharmacist is.

The argument might be that patient can re-upload same prescription on multiple online pharmacies and get medicines in desired quantity. But remember he can do so in a similar way in physical world too.

In fact, in online transaction utmost precaution is taken to adhere to guideline. If the guideline mentions that a prescription should be produced in original like for Schedule H1 or X medicines then such prescriptions are not fulfilled by online pharmacy. Patient needs to walk into physical pharmacy with original prescription to buy these medicines.

Online pharmacy is sale for regular and long term medications for Diabetic, Hypertensive and cholesterol patients only and not Schedule H1 or X medicines.

Government of India understands that they need to bring in transparency hence are in favor of “Digital India” but at the same time they need to revisit and amend age old acts and laws in light of the new way of doing business which is over the Internet.  Whole India should have one Law/Act governing any business. GST is definitely a good move towards this. It’s a debate so people use colloquial language. Also gives credibility to debate as people know you don’t edit views.

Nishi Gandotra, Co founder,

Nishi Gandotra, Co founder,

Online pharmacy in India is still at a budding stage, yet it has a great potential in the coming years. Healthcare startups have bagged the maximum number of deals accounting to a funding amount of more than $154.5 million as investors see a lot of opportunity in the sector due to paradigm shift. Online pharmacies are leveraging cutting edge technology to make medicines and other healthcare facilities available in remote areas, where availability of healthcare services is an issue. Coupled with this, are other benefits like availability of vast range of medicines. With the increase in use of internet we can see people buying drugs and consulting doctors online.

Though there has been opposition from traditional channel, online pharmacies are actually adding to their business. We see offline and online pharmacies as complimentary to each other, rather than a competition. We, at The Indian Internet Pharmacy Association (IIPA), have made various recommendations to the government to facilitate the smooth running of the business. We have received assurance from government on the issue, which in turn is set to attract investors in the sector.

Anshuman Chaudhary, Co-founder at Zelthy

Anshuman Chaudhary, Co-founder at Zelthy

Specialty medicines are those that are used for treatment and management of complex chronic ailments such as Cancer, Hepatitis, HIV/AIDS, Rheumatoid Arthritis etc. These medicines are not stocked/dispensed at regular neighborhood pharmacies and they have specific storage and transportation requirement, often much more stringent than regular medicines. These medicines are much more expensive than regular medicines, often costing upwards of INR50,000 per month. Patients undergoing treatment with these medicines require specialized support and handholding as they are difficult administration, have side-effect profiles, etc.  As such, patient support program is important for achieving optimum treatment outcomes.

Currently, specialty medicines in India constitute a USD 1 Billion market (2015). It is the fastest growing segment (30% p.a.) expected to reach USD 5 Billion by 2020.  In the US, specialty medicines constitute ~30% of pharma market and is expected to reach 50% by 2030. Globally, specialty medicines are catered to by the specialty pharmacies whose service go much beyond dispensing to patient support, disease management, affordability solutions etc. Specialty pharmacies operate in anomni-channel format that is they interact with customers over web, phone and also physically if required.

Specialty medicines as a domain is difficult to be catered to by local drug stores as it involves aspects as discussed above, that can only be catered to by larger organized players.

Sujit Paul, Specialist, Retail Pharmacy and VP, Pvt Hospital, Bangalore

Sujit Paul, Specialist, Retail Pharmacy

Pharmacy works on a model where they get a prescription, validate it and then dispense the medicine. There is a gap in this model where online pharmacies are concerned. Some online pharmacies are trying to address this gap by requesting for scanned copy of the prescription. However, in the Indian market not many people are conversant with technology, enough to scan and send prescription. Besides if they are old or chronic patients it’s even more difficult for them. Even if patients are able to send the scanned prescription how do you ascertain the authenticity of the prescription? Let me assume that even this is solved and everything goes off well and medicines are dispensed too. The prescription has to be kept with the dispenser how do you do that? So there are multiple gaps that need to filled for online pharmacies. In time these gaps will be filled as some of the companies are already working on this. Online pharmacies should have a decent number of pharmacists employed with them, who can check the prescription and guide the patient on how to take the medicines. Technology again will play a huge role in filling this gap, be it a hand held scanner or an IOT-based device; technology will lead the game for online pharmacies. Huge amount of data will be generated through these pharmacies and data security, customer confidentiality should be preserved and adequate checks and balances have to be employed. Policy for online pharmacies has to be fine tuned and this should be an enabler and not scare away people wanting to enter this market.

Pradeep Dadha, CEO & Founder, NETMEDS.COM

Pradeep Dadha, CEO & Founder, NETMEDS.COM

The future of online pharmacies has never been brighter. The forthcoming regulations will tighten up the process and although they may create some restrictions and barriers to entry for start-ups, they will generally be in the best interests of the public. It will give a final seal of legitimacy to the industry, leading to a whole new wave of consumer acceptance. Combine this with the new energy provided by the burgeoning digital mobile consumer class, the heightened interest in e-commerce brought about by demonetisation and new cashless economy. The future looks encouraging.

That ePharmacies are here to stay is a given, but what needs to be understood is the best model that safeguards patients and the interest of the pharmacist. The Indian Internet Pharmacy Association (IIPA) has forwarded a code-of-conduct for members and future eparmacies; uniting to have self-regulatory model until the government takes heed and forms their own regulations. There is no doubt that online pharmacies have carved a niche for themselves in the Indian pharma retail market. It needs to be seen how this niche business will grow and affect healthcare delivery in future.


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