British pharmacies face tighter restrictions over online sales

The new restrictions, set out in updated guidance published by the General Pharmaceutical Council (GPhC), applies to certain medicines sold online, including weight management drugs which have grown in popularity in recent times. Other medicines impacted by the change include medicines which have a higher risk of fatality or serious harm if taken in overdose, such as amitriptyline, propranolol, colchicine and carbamazepine; medicines used for diabetes, asthma, epilepsy, heart conditions and mental health conditions; and medicines liable to misuse, such as opioids, sedatives, laxatives, gabapentinoids, stimulants and nootropics.

The sale of those medicines is now prohibited by “questionnaire model alone”, the GPhC said. Instead, online pharmacies must undertake additional identify verification and authentication, as well as further checks that the information provided online is accurate. This could, according to the guidance, entail “timely two-way communication with the person, accessing the person’s clinical records, or contacting the person’s GP, their regular prescriber, or a third-party provider”. Stronger duties have been imposed on superintendent pharmacists and pharmacy owners to ensure the new requirements are adhered to.

“If the prescriber cannot independently verify the information the person provides or get the information they need, the person should be directed to an appropriate care provider so that they can be appropriately assessed,” the GPhC added. “Examples include, but are not limited to, an out-of-hours service, a local walk-in centre, or urgent care.”

Louise Fullwood, healthcare specialist at Pinsent Masons, said tighter restrictions on the sale of medicines online has been under consideration for some time, reflecting the popularity of both online pharmacies and weight loss drugs. 

“There have been cases of serious illness and even death as a result of buying these drugs online, and media outlets have demonstrated that a number of online pharmacies would supply weight loss drugs to people of a healthy or even low weight, for whom such drugs could be dangerous,” Fullwood said. “The issue is not with weight loss drugs themselves, which have been shown to be highly beneficial for a number of conditions, but the fact that there are suppliers who are at worst unscrupulous and at best simply not taking all necessary safeguarding factors into consideration.”

“Many organisations that supply these drugs carefully set up their processes and consultations to be as safe as possible and act in the best interests of patients. Good practice in this could include requiring independent identity verification, video consultations, and making sure legal requirements are adhered to. However, there has been growing frustration in the industry at other providers who seem to flout such practice,” she said.

“A significant move by the GPhC includes making superintendent pharmacists and pharmacy owners jointly responsible for compliance with the guidance. As a superintendent pharmacist is personally regulated by the GPhC and breaches of guidance could have serious impacts on their professional standing and ability to practice, the seriousness of the risks of non-compliance may often be far more pronounced than that of pharmacy owners,” she said.

“As well and establishing more robust safeguards to ensure the right care and advice is being given, this requirement for independent verification is also an opportunity for businesses looking to do more in the primary care sector. We have seen a greater interest in provision of healthcare services via pharmacy, retail or sports settings. Such premises could use their existing facilities to offer an accessible initial consultation for patients across a number of medicines, before then verified by the online prescriber,” Fullwood added.