The implications of e-commerce for pharmacy were discussed at a plenary session held on September 10, before Lord Hunt (Parliamentary Under-Secretary of State for Health) revealed the Government’s support for electronic prescription transfer and e-pharmacy. Mr Peter Curphey (member of the Royal Pharmaceutical Society’s Council) was in the chair
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| Will e-commerce replace face-to-face sales in pharmacies? |
The United Kingdom represented a large potential market for online pharmacy
services, Mr ANDREW TUCKER (business development manager, Pharmacy2u) told the
Conference. The level of use of the internet among the UK population was of
a similar proportion to that in the United States, he said, but British consumers
had shown a greater inclination to buy online.
So, who was buying pharmaceutical products through the Pharmacy2u website (www.pharmacy2u.com)?
The four main groups that the company had identified so far were busy executives,
mothers at home, the elderly or disabled and those making embarrassing purchases.
The common theme was that they either did not have the time to visit a conventional
high street pharmacy or they wanted home delivery for reasons of convenience
or privacy.
Pharmacy2u worked on a wholesale model, with central dispatch of products. Speed
was of the essence and the company aimed to dispatch orders within six hours
of receipt. At present, delivery was made using couriers but Mr Tucker said
that he believed that in future the Royal Mail could be used for making deliveries.
A number of future models for e-commerce involving pharmaceuticals were emerging,
he said. At present there were four steps in the supply chain: manufacturers
delivered to wholesalers which delivered to pharmacies which supplied patients.
However, e-commerce and the internet offered the possibility of removing either
or both of the intermediate steps between manufacturers and the consumers of
their products — the patients.
Europe and e-commerce
The European Commission had decided that e-commerce sales of pharmaceutical
products were possible within the European Union and that current regulations
covering such sales applied to the internet, Mr MARK CLOUGH (partner, Ashurst
Morris Crisp) said.
A report for the commission, prepared by Ashurst Morris Crisp, had been presented
to a round table meeting chaired by former EU Commissioner Martin Bangemann
in December, 1998. Among the obstacles to expanding e-commerce identified in
the report were the need to gain marketing authorisation in each member state,
while the internet allowed global sales from a single base. There were also
strict rules covering the advertising of medicinal products and bans on distance
sales or “teleshopping”. The commission had subsequently tried to
interpret its rules on advertising medicinal products to allow key information,
such as that contained in the summaries of product characteristics, to be included
on websites.
In addition, there were moral and ethical considerations. These were “the
other side of the story” and needed to be given due consideration. Pharmaceuticals
were different from other items of commerce, particularly in that they should
only be used as and when they were required.
The UK was at the forefront of internet pharmacy within Europe, Mr Clough said.
As well as companies such as Pharmacy2u, there was the online version of NHS
Direct, which the Government had said it wanted to see available through kiosks
in pharmacies.
E-pharmacy or mail order
Going behind the “whizzy” front-end of online pharmacies, there was
still the problem of getting products to patients, Mr JOHN D’ARCY (director,
National Pharmaceutical Association) said. In this respect, e-pharmacy was no
different to mail order, something the profession had resisted for over 150
years.
Since the backbone of a typical community pharmacy was its dispensing business,
with a standard fee of less than one pound, the only viable e-commerce model
was a warehouse one, handling large numbers of prescriptions from a central
site. Such a model would seriously undermine the pharmacy network. A more preferable
solution was the so called “clicks-and-mortar” solution, linking online
sales to existing pharmacies. This was the only model which had so far proved
successful in the US.
There was also the problem of whether patients actually wanted to use online
pharmacy systems. This did not seem to be the case in general at present, although
use would grow as the population became more used to using the internet. There
would always be a need for immediate-use sales too, for which the internet was
not ideally suited. Face-to-face sales were preferred for this.
Electronic prescriptions
The introduction of electronic prescriptions would bring benefits to all those
involved, Mr D’Arcy said, particularly as information would not have to
be rekeyed into different systems.
General medical practitioners would benefit from a decreased administrative
workload as the responsibility for managing repeat prescriptions was transferred
to community pharmacy. They would also receive better information on prescribing
and compliance.
For the National Health Service, there would be the opportunity to develop a
consolidated electronic health record. A more transparent and controlled system
would give greater opportunity to control fraud.
Direct links between the PPA and pharmacies would lead to a huge improvement
on the current system of reimbursement. The paper-based system was “state
of the Ark” and viewed with incredulity by European pharmacists, who saw
pharmacists dispatching 4,000 or more invoices per month to the PPA in brown
paper bags without any records being kept in the pharmacy.