The world is changing fast. Rest assured; technology is changing even faster. Within that, let’s just talk about the segment of medicines, drugs, and healthcare. The day I thought of writing this blog entry, (sometime in May 2013) to introduce the concept of ‘An Online Pharmacy in India’ (OR Online Medical Store, Chemist, Drug store, Internet pharmacies, e-pharmacy etc.), apparently there was no such thing happening at that time. A search on Google would yield a couple of online shops for healthcare products selling nutritional supplements, blood pressure monitors, sexual wellness products, cosmetics, fitness equipment, and even diagnostic health checkups plans that looked attractive. However, none of them had on their offerings what I was specifically looking for .i.e. the prescription drugs. Put simply: These are the medicines for which you require a prescription from a doctor to buy and use them for treating an ailment e.g. Antibiotics for treating infection and Antihypertensive tablets for lowering high blood pressure.
The only website that actually caught my attention was an internet forum called NextBigWhat, where a couple of people had shared comments on “why there is no online pharmacy store in India?” Many of the comments did make sense. Some were aggressively complaining the lack of such concept and the absence of online pharmacies having prescription medicines on their list, while others were justifying it providing logistics, regulatory, authenticity, risk of counterfeit and substandard drugs etc. as key reasons.
No doubts, today, you can buy almost anything via eCommerce websites with goods ranging from a few hundred to several thousands of dollars (or Rupees!). Today, when you can purchase items of daily usage of just any category like smartphones, chocolates, books, CDs, and even organically grown vegetables, all this while sitting in the comfort of your home/home-office, it’s strange that there’s no option to buy the medicines which forms a daily necessity for millions of people suffering from various chronic diseases like hypertension, diabetes, asthma, etc.
There are the genuine sounding reasons for those against it. Not to miss the fact, FDA recently shut down 1,677 online pharmacies for selling counterfeit or substandard medication or for selling drugs without appropriate safeguards. Speaking of a highly regulated market like the U.S. (Unlike India which is say not-so-regulated on the ground), a professional organization known as National Association of Boards of Pharmacy (NABP) runs a department called Verified Internet Pharmacy Practice Sites OR VIPPS accreditation program. This acts as strong indicator of an Internet pharmacy’s compliance with state and federal laws and regulations and NABP’s criteria. The organization recently analyzed ~10,000 websites, and found that 97% did not fully comply with state and federal regulations, while 88% did not require a valid prescription. Also worth noting was the finding that almost half sold medicines, lacking FDA approval.
The ‘how’ and ‘why’ of it is easy to understand. Firstly, website building is almost a child’s play nowadays. Secondly, attractive low prices and freebies offered on online orders makes the patient fall for such thousands of rogue websites pretending to be legitimate online pharmacies. More than 50% of Internet drug outlets, which conceal an actual address, have counterfeit drugs, according to theWorld Health Organization. Counterfeit drug sales are increasing at nearly twice the rate of legitimate drug sales and were estimated to expand to a $75 billion industry globally by 2010 only. The European Alliance for Access to Safe Medicines (EAASM) stated in their report, the counterfeiting superhighway, that 62% of medications purchased online are fake or substandard. Anyhow, as a useful measure to tackle it, NABP has applied for and successfully passed the initial evaluation by the Internet Corporation for Assigned Names and Numbers (ICANN) for a .PHARMACY as a community-based generic top-level domain (gTLD) representing legitimate online pharmacies and prescription drug-related organizations worldwide. Moreover, as a rescue measure, few portals like Legitscript,ASOP, Rxrights provide functionality to check the validity of such websites.
Given the findings from US and Europe, clearly, there are no wrong sides to this debate of to-have-or-not-to-have the online pharmacies in India. Rather it’s just about watching this concept evolve from its infancy stage within the Indian scenario where variables like affordability, healthcare burden, education, healthcare insurance (or the lack of it); loose drug policies and being a hub of generic supplies come into play. How such initiatives in Indian Market will eventually pay, and how it will measure up against the comprehensive programs of its developed country counterparts, well, we need to watch closely in future.
Anyways, moving on, other things got me busy and I only got to catch up with the topic again quite lately (June 2013). And then, SURPRISE! Here comes a website called HealthKartPlus.Com. I’ll save some effort on explaining what it is and rather quote the company’s own words: “HealthKartPlus is India’s first and only Generic Drug Search Engine which enables you to find the best medicine for your treatment. It includes most of the brands as well as their generic equivalents which are cost effective”. Now may be, you will agree to what I said in the beginning about technology and its fast pace, at least in the world of healthcare.
So yes, it is for real and has started happening in India. There is now an online website (read ‘database’), where it is actually possible to do a search for generic versions (substitutes) of branded drugs for their active ingredients (the component which is responsible for its therapeutic activity), compare prices, choose pocket-friendly equivalent substitutes, as well as order them online and get it delivered to our doorsteps right away.
And guess what! There is even a free Smartphone App across various mobile platforms which does the job seamlessly (Android,Apple, Windows). The company’s initiative is highly visible in its digital marketing efforts. There is off course an Official Website,Smartphone Apps, apart from presence on Facebook, Twitter and even the facility of SMS-based services for drug information.
But why do this as a customer? Consider this scene.
You are a professional who is at work from morning 9 A.M. to 6 P.M. Off course you need to travel to and from office which could take nearly 3-4 hours in a busy place like New Delhi, India. Unfortunately, a chronic ailment affected you for which doctor prescribed you a couple of medicines to be taken three time a day. You do try to manage this within all your capacity, still sometimes it’s easy to forget amongst many other things, that you need to refill your prescriptions. This leads to gap in dosing and lack of adherence. What follows is return of symptoms, suffering and anguish. To top it up, there are other members of family who also need to pop up pills and injections for their specific health conditions (often multiple co-morbid conditions that affect seniors concomitantly). Then there is stuff to care like banking, groceries, and bills, electrical that need repairs/service, attending guests and everything else one can think of in their routine. (Oh, I forgot to mention….You have only ONE Sunday).
Now, personally speaking, if there is a tool which makes my life a bit easier to order prescription drugs online, choose the cost-effective generic version, which I get delivered at home, same day, quite frankly I don’t mind going for it. No surprise the application platform has been awarded with the title of South Asia’s Best Mobile Innovation in the Health Category a week ago. It’s interesting to note that although currently, the service is available only in Delhi-NCR; the company also plans to expand its operations to Bangalore and Chennai. Great Innovation!
A couple of wish list though I would still like it to have in its offerings to address some of the limitations for more advanced users. For example, there can be an advanced search function where one is able to search substitutes by adding generic names of fixed dose combinations. Another limitation that can be worked upon is to add a facility for the consumer to do their payments online as the company is doing Cash-on-delivery business only. A minimum order of Rs. 250 also seems a bit on the high end (This could be due to the logistic costs incurred in processing the order, but still I would like to see it a bit lower). Then, considering the ever-increasing numbers of generic manufacturers flooding the market daily with new brand names of a drug, it will also be interesting to see if the company can stay up-to-speed in updating its information database.
Summarizing, no doubts there are risks associated given the experience in developed countries where rogue websites often duped patients causing harm; however, the benefit can’t be underestimated given that the concept has seen success with the US based big Rx stores like Aetna, Caremark, CIGNA, Walgreens, and Medicines2U in the UK. To protect the patients from harm, what is required is a legislation and watchdog like VIPPS in place in India as well.
Going forward: The post will be frequently updated with various viewpoints and touch upon the Pros and Cons of such concepts, the story of a startup, mHealth initiatives, Analysis on eHealth websites, digital-marketing efforts, Global environment surrounding online pharmacies, Counterfeit issues, Regulatory challenges, Affordability, Cost-effectiveness through generic versions and more.
Hence, Explore and Always Look Out for More!
Disclaimer: While I work at Value Edge, this blog entry reflects my own thoughts and not necessarily those of my employer.