The PDA yesterday (February 5) said the new General Pharmaceutical Council (GPhC) guidance for online pharmacies “is a missed opportunity and needed to go further in the interests of patient safety”.
This week (February 4), the GPhC published new rules banning online pharmacies from prescribing high-risk medicine based on online questionnaires alone. It stressed they must “independently verify” patients’ weight and height before prescribing weight loss drugs.
Read more: New online pharmacy regs ‘effective immediately’ amid weight loss risks
But now, the PDA has said that the updated rules do “not go far enough to protect patients”.
The body said it welcomed the new inclusion of weight management medication into the category of “high-risk treatments which should not be supplied based on an online questionnaire alone”.
But it said that rules around independently verifying patient information “could still introduce significant risk”.
“Contradictory”
The new guidance states that prescribers could verify patient information “through a video consultation, in person, from the person’s clinical records or by contacting another healthcare provider such as the person’s GP,” the PDA said
“However, where there might not be access to the NHS GP patient record, or where consent is not given by the patient for their GP to be contacted, there is scope for a medication to be prescribed without those vital checks being made,” it warned.
The PDA’s head of policy Alima Batchelor added “it is disappointing to see that there is still ambiguity and room for manoeuvre where words such as ‘should’ remain, instead of a more robust ‘must’”.
Read more: PDA: GPhC consultation ‘watering down’ online pharmacy guidance
She also claimed that there are “areas where the guidance is contradictory”.
“While there are some changes that are welcome, the GPhC had an opportunity to strengthen guidance to remove any doubt about what is required from providers in this space,” she added.
“Our view is that the new guidance does not satisfactorily address this,” she said.
Read more: Wegovy: Ten deaths linked to weight loss injections, says MHRA
“There are sadly too many cases of patient harm where medicines have been purchased online without the level of checks that should be in place to ensure patient safety,” she added.
The PDA said that it “will continue to work with the GPhC to see how these areas can be addressed”.
Share “all relevant info” with GPs
Responding to the concerns, GPhC chief strategy officer Louise Edwards today (February 6) told C+D that the regulator welcomes “the PDA’s contribution to the discussion on safe prescribing online”.
“We’ve made clear in the guidance that online pharmacies have to identify which method of consultation is best suited to get the information needed to deliver safe and effective care, and two-way communication should always be available,” she added.
“For ‘high-risk’ medicines, the prescriber would have to have timely two-way communication with the person - such as a video call - access the person’s clinical records, or contact the person’s GP,” she said.
Read more: Coroner: Patient dead after ‘tick-box’ online pharmacy prescription
“All relevant information about the prescription then needs to be shared with the GP,” she stressed.
“If the person doesn’t give consent for their GP to be contacted, the prescriber would have to consider whether supplying treatment outweighs the risks and to make a record justifying their decision,” she said.
The added that the GPhC is “meeting with [the PDA] to talk through our updated guidance.”
“Track record of safety”
Meanwhile, the body presenting pharmacy multiples told C+D that its pharmacies had already been providing weight loss drugs safely.
The Company Chemists’ Association (CCA) said that its members “have been remotely providing weight loss medicines to patients for many years with a proven track record of safety”.
Read more: Draft GPhC rules ‘leave door open’ for unsafe weight loss scripts
“We fully support GPhC’s principal of ensuring that the provision of online pharmacy and other healthcare services is safe, effective, and person-centred,” it added
“Our members will continue to comply with the guidance from all relevant regulators,” it said.
Prior the new guidance, the CCA said that said that it did “not see the need for any additional regulation”.
“Watering down”
This is not the first time that the PDA has warned that the GPhC guidance is not strong enough.
During the regulator’s consultation on the updated rules, it warned that the proposed raft of “extra safeguards” risked “watering down” existing guidance.
It added that the changes would embed “potentially poor practice” and allow online pharmacies to “circumvent” guidance.
Read more: Make superintendents ‘responsible’ for stricter Wegovy safeguards, says GPhC
Meanwhile earlier this week, National Pharmacy Association (NPA) chair Nick Kaye said that the pharmacy body was “pleased” with the new guidelines.
“It is important to note that the vast majority of pharmacies, including online sellers, already adhere to good practice in this area and do all they can to support patients,” he added.
The NPA had previously warned that that the draft GPhC guidance allows patients to “inappropriately access weight loss injections”.
