From “Prohibition” to “conditional release”, will prescription medicine boots be sold online?


Hangzhou, November 21, Xinhua News Agency: from “Prohibition” to “conditional liberalization”, will online prescription medicine boots be sold?
Huang Xiao, reporter of “China Internet Affairs” of Xinhua News Agency
The State Drug Administration (SDA) has officially released the measures for the supervision and administration of online drug sales (Draft for Soliciting Opinions), in which it plans to release the contents of prescription drugs for online sales under certain conditions, causing heated discussions. Pharmaceutical e-commerce platforms are jubilant and look forward to the dawn of policy, while some people are worried about regulatory norms, medical insurance payment, drug safety and other issues.
On the supervision of “letting go” and “not letting go”
After more than two years, the regulations on online drug sales have again sought public opinions. From November 12 to November 30, the State Food and Drug Administration of the people’s Republic of China (SFDA) solicited public opinions on the measures for supervision and administration of drug online sales (Draft). The provisions on prescription drug sales mentioned that drug retail enterprises should ensure the authenticity and reliability of electronic prescription sources, and carry out prescription dispensing audit according to relevant requirements, and carry out prescription dispensing audit on the used prescriptions Electronic marking.
This makes the practitioners of pharmaceutical e-commerce platform rub their hands and hope to win a place in the market. “Since 2014, the” gate “of online sales of prescription drugs has been” opened and closed several times “. Once opened, it has been” disorderly “, and once closed, it has been” dead “. All the enterprises that can achieve today are enterprises that want to do things in the industry. This draft has enhanced our confidence. In the new round of industry standard reshuffle, we certainly have development opportunities.” A person in charge of online drug sales platform said.
As early as 2014, the former State Food and Drug Administration issued the “Internet food and drug management measures (Draft)” proposed that Internet operators can sell prescription drugs by prescription. However, as soon as the draft was issued, it was opposed by more than ten industry associations and well-known drug retail chain enterprises in the pharmaceutical field.
Just two years later, the former State Food and Drug Administration officially ended the relevant pilot work in 2016 due to unclear main responsibility and illegal sales of prescription drugs.
In November 2017 and February 2018, the former State Food and Drug Administration issued the measures for the supervision and administration of online drug trade (Draft for comments) and the measures for supervision and administration of drug online sales (Draft for comments), specifying that online drug sellers are not allowed to sell prescription drugs to individual consumers online, nor to display prescription drug information through the Internet. This has brought great impact to the pharmaceutical e-commerce business.
After that, the “Internet plus medical health” documents issued by the intensive industry have brought about a favorable turn for the industry. Among them, the “general public office” issued the “opinions on promoting the development of” Internet plus medical health “, and the” Internet diagnosis and treatment management method “(Trial Implementation) issued by China Health Protection Committee, all of which allow medical institutions to conduct online referral of some common diseases and chronic diseases. After mastering the patient’s medical records, doctors can prescribe prescriptions online for some patients with common diseases and chronic diseases. After the online prescription is approved by pharmacists, medical institutions and drug distribution enterprises can entrust qualified third-party institutions to deliver.
In the “window period” of lack of constraints, there are loopholes in the pharmaceutical e-commerce platform
In the era of “all things touching the Internet”, online sales of prescription drugs may be the general trend. However, in the “window period” of lack of constraints and lack of unified standards for platform management, it is not uncommon for e-commerce platforms to illegally sell prescription drugs.
Some media have carried out an evaluation survey on 18 online drug shopping apps, and found that 16 of them did not display or sell prescription drugs in compliance with the regulations, and even caused a tragedy. In 2018, two girls successively purchased prescription drugs for colchicine tablets online, and all of them died due to overdose.
At present, the relatively standard platform is not “foolproof”. The reporter tried to purchase the prescription drug amoxicillin on an e-commerce platform. The platform marked “prescription drug” on the drug display page. After placing an order, there was also an option requirement to confirm that the drug in the order had been taken and there was no adverse reaction. Next to the “submit booking” button, the words “need to supplement the consultation information immediately after the prescription drug is placed” is marked.
After confirming the payment, fill in the information of the user, and then enter the waiting for the doctor to prescribe. Half a minute later, the reporter received a phone call from the platform doctor asking whether to prescribe a prescription for the doctor. When the reporter replied that the doctor did not prescribe the prescription, but bought antibiotics online according to the past medication habits, the platform doctor refused to prescribe, and the order was automatically cancelled, and the system automatically refunded.
When the reporter placed the order for the second time, a platform doctor was changed in the inquiry link. The doctor only asked “whether the drug has been used before and whether there is any allergic history”. After answering “used, no allergy”, the platform doctor will issue an online prescription. The three links of doctor’s prescription, hospital pharmacist’s prescription and pharmacy pharmacist’s prescription are completed within eight seconds. The online pharmacy begins to enter the delivery process The process did not require reporters to upload offline hospital information, prescriptions of doctors in physical hospitals and other relevant information.
There are still three barriers for prescription drug safety
There are also controversies about the “release” and “non release” of prescription drugs sold online. The supporters believe that for the elderly patients with chronic diseases, it is more convenient to not frequently prescribe medicine in the hospital, but also reduce the pressure of hospital outpatient overcrowding and poor medical experience. Netizens “a cup of warm tea” said, “I support it. It’s very convenient for patients like us who have to take medicine every day. We just need to upload medical records to buy prescription drugs. We don’t need to register and queue up all the way.”
The skeptics said that the safety of prescription drugs is far more important than their convenience. Once the online prescription drugs are released, they may lead to the proliferation of fake prescriptions, and the abuse of prescription drugs will seriously threaten the health of patients. Netizen “crazy Feng Feng Feng” said that the relative risk of prescription drugs is high. Nowadays, there are still illegal sales of prescription drugs in offline pharmacies. If online sales are allowed, the risk will be more difficult to control.
The trade-off between convenience and safety is testing the wisdom of policy makers and managers. Industry insiders say that there are still three hurdles to be overcome in the safety of prescription drugs.

One is the circulation of electronic prescription. At present, the reliability and authenticity of prescriptions is a big problem. Prescriptions issued by doctors in physical hospitals are mainly used for hospital circulation. Some e-commerce platform practitioners said that the circulation of e-prescription in the platform can be monitored through the e-prescription platform, which can effectively supervise the e-prescription and ensure the authenticity and reliability of prescription sources to a great extent.
The second is the connection with medical insurance payment. Chen MINMING, a Hangzhou citizen, said that even though prescription drugs can be sold online, people (69.400, 2.30, 3.43%) may still be willing to buy drugs in hospitals or pharmacies, “medical insurance payment is the key factor.”. Xu Jing, manager of the strategic planning department of Huadong Pharmaceutical (30.850, -0.33, -1.06%) (Commerce), said that opening up the online sales of prescription drugs was more to solve the problem of legalization in the grey area, with limited impact on the stock market. At present, the budget of medical insurance fund is linked with designated medical institutions, and a large number of prescription drugs are in the medical insurance directory. If the online shopping platform of prescription drugs can not realize online medical insurance payment, it will affect the enthusiasm of patients.
Third, the regulatory rules need to be implemented. According to the relevant person in charge of Zhejiang provincial drug administration, the conditional liberalization of online prescription drugs can be regarded as the beginning of new drug retail. Both electronic prescription sharing and prescription audit should be strictly supervised by regulators. We should not leave room for the platform through perfect system design, but also make full use of big data and other technical means to monitor the whole process.