Why is it so prudent to "untie" prescription drugs sold online?

　　On April 8, the National Development and Reform Commission and the Ministry of Commerce issued the "Opinions on Several Special Measures Supporting the Construction of Hainan Free Trade Port and Relaxing Market Access", taking the lead in launching prescription drug online sales in Hainan, and establishing Hainan in the Boao Lecheng International Medical Tourism Pilot Zone Electronic Prescription Center; On April 15, the General Office of the State Council made it clear that on the premise of ensuring the authenticity and reliability of the source of electronic prescriptions, online sales of prescription drugs other than those under special state management are allowed; on April 29, the State Drug Administration Shanghai held a symposium on the supervision of drug online sales, and discussed the management of drug online sales...

　　Why is it so prudent to "untie" prescription drugs sold online?

With this question, the reporter conducted an interview.

Tortuous and prudent exploration

　　In fact, as early as 2013, the former State Food and Drug Administration conducted pilot projects in Hebei, Shanghai and Guangdong to carry out drug retailing on third-party Internet platforms.

In 2014, the Measures for the Supervision and Administration of Internet Food and Drug Operations (Draft for Solicitation of Comments) proposed that Internet operators can sell prescription drugs with prescriptions.

In 2016, due to reasons such as unclear main responsibility and difficulty in ensuring drug safety, the pause button for online prescription drugs was pressed.

　　In November 2017 and February 2018, the "Measures for the Supervision and Administration of Online Drug Sales" solicited opinions from the outside world twice, and finally clarified that "prescription drugs must not be sold through the Internet, and prescription drug information must not be displayed through the Internet."

Until September 2019, the new version of the "Drug Administration Law" was released, allowing "prescription drugs to be sold online under certain conditions."

　　Why is the policy so prudent?

On the one hand, public data shows that the size of my country's prescription drug market is about 1 trillion yuan, accounting for more than 85% of the drug terminal consumer market, and about 80% of prescription drugs are sold through hospital channels.

　　On the other hand, the crazy expansion of the Internet pharmaceutical industry has brought difficulties to supervision.

Data show that in 2019, the sales scale of online pharmacies in my country was 125.1 billion yuan, a year-on-year increase of 38.2%, accounting for 18.9%, while this indicator was only 1.2% in 2013.

　　Tu Honggang, chairman of the medical library software, pointed out that in order to meet the needs of medical treatment during the epidemic, the Hubei Medical Insurance Bureau opened the Internet medical insurance online payment, and more than 10 provinces and cities promoted the third-party distribution of prescription drugs.

"After the epidemic prevention and control has become normalized, the Internet pharmaceutical industry has exploded, which has a great impact on the loosening of policies."

　　Fu Hongqiao, an associate researcher at the School of Public Health of Peking University, believes that the recent introduction of a series of policies means that after years of market practice and exploration, the supervision of online prescription drugs is gradually improved, and relevant market behaviors will be included in the compliance system.

Restructuring the pattern of the pharmaceutical industry

　　Tu Honggang believes that policy liberalization has double benefits for the people.

First, it is more convenient to purchase drugs, especially for chronic patients with “long prescriptions”, without frequent “seeing doctors for drugs”; second, in the e-commerce model, the intermediate links are shortened and the streamlined sales process effectively reduces costs.

This will also make the situation of some secondary hospitals difficult.

　　For the pharmaceutical industry chain, policy adjustments will trigger a chain reaction, and all stakeholders will make new choices.

Fu Hongqiao believes that if online pharmacies obtain equal market opportunities, public hospitals will be forced to squeeze out the falsely high drug prices and improve service quality.

　　Pharmacies and online sales platforms have been in a long-term competitive relationship, and their living space may be squeezed.

According to Tu Honggang, the number of pharmacies in China reached a high point in 2019, and then began to decrease, moving towards scale integration and chaining.

Under the "crushing" of e-commerce giants, the survival of small and medium pharmacies is worrying.

　　Fu Hongqiao pointed out: “Some pharmacies may be directly acquired by third-party platforms, or they may enter into cooperation with them. Under the online order store pickup and online order delivery mode, the bargaining power of pharmacies will increase. Will pharmacies suffer losses? Whether it is truly online or not depends on the upcoming regulatory rules and the relationship between online platforms and pharmacies in the future."

Security problems to be solved

　　When buying prescription drugs online, medication safety is the biggest risk point.

The reporter logged on to a pharmaceutical e-commerce platform and asked the customer service about the process of purchasing prescription drugs. The answer was: first add the user information, choose the offline diagnosis of the disease, and the platform doctor will prescribe the prescription after the payment is successful.

The entire operation process takes less than 5 minutes, and you don’t even need to provide a complete prescription. The payment page only prompts "Please confirm that you have completed the treatment at the offline hospital."

　　On the display page of a certain antibiotic prescription drug, the promotional logo of "Free shipping over 68, save 9.9 when buying 5 boxes" is very eye-catching, with a few sentences of contraindications and side effects below, when the reporter asked "Is the drug purchase process safe? "Hidden danger", the customer service said, "A professional general practitioner will conduct an audit before shipment."

　　"Ensuring the authenticity and reliability of the circulation of prescriptions is a key concern. As the Internet leaves traces throughout the process, supervision is not too difficult. But the more risk lies in the fact that you can buy drugs without a prescription." Fu Hongqiao said.

　　He revealed that regulators are working to manage chaos in the industry.

"At the symposium on the supervision of drug online sales, many measures have been included on the agenda. For example, online drug purchases must issue first-diagnostic prescriptions, and platform supplements after drug purchases are prohibited." In addition, as a core part of the drug purchase process, prescriptions The flow of circulation has not yet been fully completed.

But at present, there have been many attempts to establish a unified prescription circulation platform.

　　Reporter: Chen Xi