An Evaluation of Online Pharmacies for Compliance to Regulatory Criteria and Price Variation of Listed Medicines

Objective: To evaluate Online Pharmacies (OPs) for compliance to regulatory recommendations and to assess price variations of selected medicines, sold from these pharmacies. Method: The first 100 listed websites from different countries on Google (Search terms: “e-pharmacy websites” and “online pharmacies”) were selected. Primary and secondary criteria for assessment were determined from Verified Internet Pharmacy Practice Sites (VIPPS) programme and recommendations of relevant regulatory bodies. A checklist was prepared and re-validated. The OPs were grouped according to the presence of regulatory recommendations in that country. Seven branded medicines sold in India were selected and assessed for price variations. Results: A total of 100 OPs belonging to 17 different countries were analyzed. Of these, 32 were Indian. Forty-seven OPs from countries with regulatory recommendations for OPs were included in Group- A. Of these, 24 (51%) OPs did not comply with primary criteria like Shipment within territory of the country (60%), requirement of prescription (39%), confidentiality policy (34%) and secondary criteria like providing option for communication with pharmacist (43%), toll-free number (39%) and information about contraindications and special precautions (65%). Fifty-three OPs belonged to countries without any regulatory recommendations made for OPs and were included in Group- B. Of these 16 OPs did comply with the criteria. About 40% OPs provide a facility for a prescription refill. An option for generic/lower price substitute was provided in 79% OPs. A marked price variation (14%-32%) was observed for selected brand medicines. Conclusion: Continuous monitoring for adherence to regulatory recommendations, price variations and consumer education about the appropriate use of OPs is required.