E-Pharmacy: A must towards making healthcare accessible

The Dialogue on November 5 organised a webinar titled E-Pharmacy: The Road Ahead which talked about the exemplary role performed by e-pharmacies during the pandemic by offering delivery services to people. The webinar was moderated by Kazim Rizvi, Founding Director, The Dialogue with Dr. Sasmit Patra, Member of Parliament as the Chief Guest. He was joined by a diverse panel on the issue – Mr. Prashant Reddy, Advocate, Mr. Ujjwal Kumar, Policy Analyst, Consumer Unity & Trust Society (CUTS) International, Mr. Rajat Garg, Co-Founder, MyUpchar and Dr. Vikram A. Munshi, Founder, White Space Consulting and Capacity Building. 

The speakers broached on key issues around the lack of regulatory certainty in the market with respect to e-pharmacy and how it has impacted the growth and investments in the sector. They also touched upon the imprecise rules introduced to the Drugs and Cosmetics Rules, 1945 (DCR) in 2018 which failed to define its position on platforms or marketplaces, that act as intermediaries between sellers and buyers of medicines.

The COVID-19 pandemic gave way to e-pharmacies to provide people with a convenient method of purchasing medicines without disrupting the lockdown and social distancing norms by offering door-to-door delivery services. According to a report published by Frost and Sullivan, the e-pharma sector in India is estimated to reach Rs. 25000 crore by 2022. The industry is an asset for healthcare advancement because of a number of deliverables like proper stock availability, cost efficiency, greater reliability and convenience, large-scale distribution network and flexibility of price comparison. All these factors not only make the process of procuring medicines easier but also complement the National Digital Health Mission by increasing people’s accessibility to medication by leveraging  technology. 

However, the lack of regulatory thrust and constant opposition by brick and mortar retailers has heavily impacted foreign investments in the sector and forced many businesses to operate in the grey area. The drug regulations in India require retailers to get a license to dispense medicines from the respective state but no such guiding mechanism is specified for online pharmacy retailers which has forced them to comply with the existing norms of obtaining a license from every state thus pertaining to a separate set of orders each time. This has deprived the sector of the potential growth, competition and digitisation – and most importantly an opportunity to further serve the needs of patients under the current pandemic context. 

Dr. Sasmit Patra, Member of Parliament observed that “The absence of proper regulations and policies in this sector has hampered its growth and investments. Further, there is a lack of parliamentary scrutiny on these issues even though it is such an important sector. Personal Data Protection Bill, 2019, and Non Personal Data Framework has the notion of one size fits all and must take the nuances of this intricate sector. The government and academia should work together in order to ensure that this sector grows and has robust regulations in place that cater to the needs of consumers as well as the industry.”

Mr. Kazim Rizvi spoke on similar lines and said, “Under the current circumstances, e-pharmacy has emerged as one of the important sectors in the country. By providing digital healthcare and doorstep deliveries of pharmaceuticals, they have ensured the welfare of citizens. However, owing to the regulatory uncertainty and lack of concrete plans for this sector, the growth and innovation has been halted and has kept foreing investments at bay. Going forward, this sector will be one of the crucial elements of the National Digital Health Mission and therefore, there is a need for certainty in the market.”

Mr. Prashant Reddy noted that “E-pharmacy has been operating in the grey space for quite some time now. There is a need to convince policy makers and people as to why e-pharmacy in India is needed. Cartelisation has been a major problem among the brick and mortar businesses and as a result citizens have to pay a really high price for generic drugs. E-pharmacy would help in increasing the competition among the businesses and help the cause of healthcare while driving down the prices and margins to a reasonable figure. Moreover, the current regulatory uncertainty will affect the investments and growth of this sector. 

Dr. Vikram A. Munshi noted, “Government should focus on building a broader healthcare infrastructure which is just more than storage of medicines. There is a need for a draft policy and I strongly believe that it is not ‘either or or’ when it comes to both online and traditional pharmacies. They must work harmoniously. However, the e-pharmacies have to add value to their existing models and provide a diverse set of services.  

He further said, “For e-pharmacy to sustain it is important that they go beyond just home delivering medicines and offering discounts. They can explore tele-consultation and other services which will add more value to their business. 

Mr. Ujjwal Kumar observed that there are different models for e-pharmacy businesses such as platform based or inventory based which require different regulatory scenarios. For example, platform based models where they are only acting as intermediaries between retailers and end users should not be subject to pharmacy rules but on the other hand businesses operating on hybrid models should be subject to pharmacy laws. Further, there is a need for increased competition in this sector which could help its growth. 

He also suggested that the traditional traders and associaciations can leverage the technology by building their platforms given their umbrella ecosystem and help the phased out retailers rather than discouraging the online players.

Mr Kumar urged the policy makers to first identify the objectives of regulation which can be identified based on the models and other factors. However, the regulation should not be too restrictive to curb the development of the industry. Moreover, the judiciary should be trained to understand the rapidly emerging digital ecosystem in all sectors.

On data, Mr Kumar felt that before introducing digital health data regulation framework, the Personal Data protection Bill should come into effect so that the gaps can be addressed by these parallel bills. Further he said, “the localisation of data should be revisited to understand it’s objective. India should not act protectionist but multilateralist.” 

Mr. Rajat Garg noted,“Online and offline businesses have to work together towards providing services to the citizens.” On regulation, he said that the government should not be a regulatory and the service provider at the same time. Rather the government should  be focused on creating the infrastructure and regulation.

In healthtech, Mr Garg said, that the reality is that the patient is not the customer but the doctors are who are fairly cautious in adopting tele-consultation. “Thus, healthtech is a slow moving industry and the investors too need to understand this.”

The panelists emphasised the contributions made by e-pharmacies in the current times which has sequentially revolutionized the pharmaceutical industry. It also countered how the efforts made in the last 5 years to regulate the sector were never properly executed to begin with. The panel accentuated the need to give regulatory support to the sector which is not too restrictive to reap better results and increase competition in the market for the benefit of citizens.