Researchers from The George Institute for Global Health, with collaborators from Strathmore Business School in Kenya and the London School of Hygiene & Tropical Medicine, are researching the rapidly growing e-pharmacy sector in India and Kenya. Findings of their research, recently published in the PLOS Global Public Health, highlights opportunities to enhance consumer safety in the digital healthcare ecosystem and underscores the need for robust regulatory framework to ensure safety and quality of care in these rapidly growing markets.
E-pharmacies, which enable consumers to buy prescription medicines via websites and mobile apps, are becoming more prominent in low- and middle-income countries. In India and Kenya, the sector has grown, with businesses adapting to local market needs and regulatory environments. The research team identified the e-pharmacies operating in India and Kenya and reviewed their websites and apps and mapped them against existing regulatory requirements and international best practices. The research identifies strengths and areas for enhancement to promote better consumer and industry outcomes.
The research shows significant strengths among e-pharmacies, with 90% of e-pharmacy websites in India and 58% in Kenya providing an option to upload prescriptions. This feature prevents the sale of prescription medicines without proper authorization, as a means to ensure safe and responsible pharmacy practices. The study highlights opportunities for improvements, such as enhancing the provision of drug information to boost consumer safety and confidence. As of now, only 16% of Indian e-pharmacies and 42% of Kenyan ones providing complete drug information (such as on side effects, drug interactions, and contraindications).
India currently does not have a regulatory framework specific to e-pharmacy, but regulations have been proposed in the past. The research indicates that e-pharmacies with more website visitors tend to exhibit better compliance with best practices or ‘proposed regulations’ in India. The most visited websites met 8.7 out of 14 (62%) ‘best practices/proposed regulations, compared to other websites that met 51% of them. In Kenya, which has established specific regulations for e-pharmacy, websites met an average of 8.9 out of 12 (74%) regulatory requirements.
To build on these strengths and address the gaps, the researchers advocate for a ‘risk-based’ regulatory framework that encourages regulators to engage constructively with compliant e-pharmacies, creating opportunities that support best practices, while helping the partially compliant to improve compliance. The researchers suggest that regulators and e-pharmacy businesses can work together to create rules that promote safety and quality and improve the accessibility and affordability of medicines.
” E-pharmacies can be great tools for improving access to medicines. However, the lack of regulation governing e-pharmacies poses risks. There is a need to create a trustworthy e-pharmacy environment in which patients can confidently access the medications they require,” said Dr. Mohammad Abdul Salam, a Senior Researcher, who co-led this research.
The research highlighted that many e-pharmacy platforms also offer teleconsultations with doctors and diagnostic services, reflecting the trend toward integrated digital healthcare. The researchers note that as digital healthcare services expand, regulatory frameworks need to evolve to address new models of care. The role of technology in this sector was another focus of the study. Mobile apps are becoming an increasingly important channel for accessing e-pharmacies, particularly in India, where digital adoption is high.
The global e-pharmacy market is projected to grow from USD 92 billion in 2023 to over USD 350 billion by 2033, with emerging markets like India and Kenya playing a pivotal role.
A follow-up assessment a year later found that India’s e-pharmacy market had grown from 61 to 76 websites, while Kenya’s market expanded from 26 to 28. The increase was largely driven by local businesses, with some international platforms exiting the market.
Dr. Gautam Satheesh, Research Fellow at The George Institute for Global Health, said, “E-pharmacies have enormous scope for improvement to become a trusted source for patients to access prescribed medicines for a healthier future for communities, especially in countries such as India and Kenya, where ensuring continuous access to high quality and affordable medicines remains a challenge for many. Our research provides a foundation for policymakers to develop regulations to govern the growth of e-pharmacies and safeguard consumers.”
Access the full study here – https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0004202
DOI – https://doi.org/10.1371/journal.pgph.0004202
