The regulator has suspended two registrants, twice issued warnings and once issued advice in cases involving pharmacists working for online providers since August 2022, it confirmed to C+D this week (June 14).

In addition, one interim order has been issued since August, which was “linked to concerns around high-risk online prescribing practices using a questionnaire-based prescribing model,” the GPhC said.

Read more: Pharmacist suspended for nine months over online supply of high-risk drugs

And it confirmed that there are currently 261 open cases linked to businesses it has “classed as online pharmacies”. Of the pharmacies linked to open cases, 102 – or 39% – are “unique”, it clarified.

 

“Regulatory concerns”

 

The regulator told C+D that it “cannot comment on the specifics of cases currently under investigation”, although it was able to reveal the “regulatory concerns” that most often lead to online pharmacies or online prescribing being investigated.

These include:

• "Poor governance and oversight of prescribing high-risk medications open to abuse
• Prescribing transactionally using questionnaire-based models only, with little or no verification with patients' GPs or without access to patients' medical records
• Prescribing medication repeatedly with no monitoring or review
• Prescribing outside scope of practice
• Prescribing medication off licence without clear evidence of the skills or expertise to undertake this
• Prescribing transactionally with apparent financial incentive
• Dispensing against prescriptions issued using an online questionnaire based prescribing model without due diligence of the prescribing model being used or the skills or competence of those prescribing."

It comes after the GPhC’s director of insight, intelligence and inspection Claire Bryce-Smith revealed in March that almost a third of online pharmacies were not meeting the regulator’s standards.

Read more: GPhC takes action against 5 more pharmacists working for online providers

Some 84% of all pharmacies were meeting the regulator’s standards, according to slides Ms Bryce-Smith presented at the 2023 Sigma conference on March 6.

But this fell to 69% for online pharmacies – meaning almost a third (31%) are failing to meet regulatory standards.

Meanwhile, former GPhC chair Nigel Clarke suggested earlier this year that it was “difficult” to make money from a purely online pharmacy model.

He told delegates at a Westminster Health Forum conference on March 28 that “if you talk to anybody in the City of London, there is considerable scepticism about whether purely online pharmacy will ever be profitable”.

Read more: 'Difficult' to make money from online pharmacy, ex-GPhC chair suggests

And speaking exclusively to C+D after the conference, Mr Clarke said there are “a combination of factors” affecting the sustainability of the model.

“I suspect it’s quite difficult to make money out of online pharmacy”, he said. “If you look at the records, profitability in online pharmacy is difficult to achieve.”

 

Interim orders

 

Interim orders were imposed on the registration of five pharmacists working for online providers in June and July 2022, the GPhC revealed to C+D last August.

The regulator issued a total of seven such interim orders against pharmacists working for online providers between March and August 2022, it said at the time.

Read more: Almost a third of online pharmacies failing to meet standards, warns GPhC

Each of the pharmacists issued with interim notices – either interim suspensions or conditions on their registration – “were working as pharmacist independent prescribers for online services or were dispensing medicines prescribed online”, the GPhC said.

But the regulator warned that it could take “further action” against other pharmacists who are working for online services as there were a “number of ongoing investigations” into their practice.