There are online pharmacies whose websites create a “consumer-driven” user experience, General Pharmaceutical Council (GPhC) chief executive Duncan Rudkin claimed at a Westminster Health Forum event in London last month.

These websites see their role as responding to “consumer requests” rather than “starting with a request for support, advice and potentially medicine as part of a healthcare intervention”, he added.

It is important for online pharmacies to be configured as “healthcare environments”, Mr Rudkin stressed, explaining that the GPhC is “challenging the design of some websites” as part of its investigation into pharmacies offering services at a distance.

The websites of some online pharmacies are “designed in ways which appear to be either accidentally or deliberately set up [to] enable patients to coach themselves in how to answer questions to procure the product they want and that, of course, creates additional risk”, he said.

“It is not really a professional and healthcare environment if your service encourages patients to regard themselves as purchasing a medicine as if purchasing shampoo,” he added.

“Range of issues”

It is not a case of “the regulator saying that online is bad and offline is good”, Mr Rudkin stressed, as both on and offline services can be “done well or done badly”.

However, the GPhC has “identified a range of safety issues, particularly concerning medicines that are liable to misuse, abuse or overuse and where there is a risk of addiction”, he explained.

This includes cases of “medicines being [supplied] without appropriate – or in some cases any – steps being taken to check that [they were] prescribed and dispensed in a way that was clinically appropriate for that patient”.

The GPhC has also “seen inadequate identity checks, putting children and vulnerable adults at risk” and has encountered instances where “prescribers – including pharmacist prescribers – are relying too much on the information provided by patients, without making intelligent follow-up queries to interrogate that”, he added.

“We have seen prescribers based overseas who are not familiar with legal and regulatory requirements in the UK and not necessarily working to UK-recognised prescribing guidelines,” Mr Rudkin said.

In its latest guidance for pharmacist prescribers, issued last month, the GPhC highlights the need for “proper professional responsibility, both on the part of the prescriber and the professional service overseeing the dispensing, to ensure medicines are clinically appropriate for patients”, when pharmacy services are offered online, Mr Rudkin said.

This includes “basic things like robust identity checks…to identify requests for medicines that are inappropriate by, for example, [noticing] multiple orders to the same address [or the use of] the same payment details”, he added.

The GPhC has restricted the practice of 12 online pharmacies since August, after raising concerns about their supply of controlled drugs and high-risk medicines.