INTRODUCTION:

The annual Indian pharmaceutical market is measured at rate of 20% and 79,000 Crore. India ranks 2^nd in top 6 pharmaceutical global producers. Indian vaccines are exported nearly to 150 other countries. 40-70percent of the World Health Organization (WHO) demand for Diphtheria-Pertussis-Tetanus and Bacille Calmette-Guérin vaccine (DPT and BCG) and also 90% of measles vaccine is manufactured by India¹. The Internet has evolved into a source of consumer products that were historically only available in “brick-and-mortar” establishments^2,3,4.

In this 21^st century there has been growth in use of internet in medical practice mostly used in online pharmacies to fulfill prescriptions and mail the drug directly to the patient^5,6. This system is more useful for patients who have limited mobility or accessibility needs^5,7. In past, the best communication method for physicians to have communication was hand prescription. Now it is being replaced by electronic prescription network commonly known as e-pharmacy/online pharmacy⁸.With the discovery of modern technology, offline shopping has been turned to online mode. Online shopping has become latest fashion among Young citizen. The reason behind increasing online shopping is peoples turning towards online mode rather than offline mode. E-pharmacies are expanding like “mushrooms”. There are several major factors which fuel the gearing up of e-pharmacies like increased number of netizens, long term illness patients and increased chronic diseases⁹. As there are many commercial activities that are now wandering in the environment, One of the component is e-Pharmacy, which supplies a variety of products i.e. health and beauty products. Some pharmacies only dispense drugs with a valid prescription, some provide online consultations for prescribing and dispensing medicines, and some dispense medications without a prescription. There are a number of reasons that may lead patients to the use of the internet in search of medical care; it acts as a second opinion or second doctor for desperate patients. Also, it gives insight into patient problems, as well as the drugs that could cure them¹⁰.

ONLINE PHARMACY IS CLASSIFIED INTO TWO TYPES AS:

(1) Legitimate Internet pharmacy (2) Illegitimate online pharmacy⁸.

CONSUMERS ARE LIVING ONLINE IN INDIA:

In India there are total about 167.2million internet users. So India ranks nearly about10^thin the global marketing buying online material.

· There has been a great impact on offline shores.

· Be it electronics, apparels footwear, cosmetics, FMCG products, groceries, or accessories, consumers prefer online shopping for their conveience

Fig. No. 01. Online Dealing Centers in India

· More spread smart phone and jumbo offers on online sales is the reason for more online sale¹¹.

BENEFITS OF E-PHARMACY:

Internet pharmacies offer a host of benefits some of the sticky benefits are as follows:

1. Less or free shipping charges.

2. Can distinguish between Generic vs. Branded drug.

3. Additional medical information¹².

4. Saves precious time.

5. Can save money.

6. Day night service available. (24/7 service)

7. More quantity of medicine available.

8. Easily refund possible.

9. Easy access to old people and few exceptional patients.

10. Fast-track delivery possible

11. Delivery of medicines at desired place at desired time possible⁹.

12. E-Pharmacies also enable access to rural areas where there is limited presence of retail pharmacy.

13. Provides authenticity¹³.

14. Additional choice of products⁸.

15. Helps to avoid nuisances such as going out in bad weather, parking hassles, standing in line, etc.

16. Offer perks not found in traditional market^.¹¹.

17. Easy deals possible.

18. More job opportunities for modern generation pharmacists¹⁴.

19. Provides media alerts¹⁵_.

LOOPHOLES OF E-PHARMACY:

1. Greediness can lead to hidden Fees and may be added to drug Prices

2. Can’t Protect Personal and Financial Information.

3. Lead to Unlicensed illegal Pharmacies which is crime¹².

4. Inappropriate discussion physician and pharmacists.

5. Misdiagnosis and improper use of medicines.

6. Corrupt websites may lead to some serious social issue.

7. Directs towards self-medication.

8. Inadequate handling of medicine (in case of transportation).

9. The brand names may lead to cause confusion.

10. The most frightening thing is the sale of antibiotics. India is already fighting against this global issue of antibiotic resistance⁸.

11. May leads to drug resistance

12. Chances of drug interaction

13. May lead to habitually of drug.

14. Adulteration of drugs.

15. Illegal substances may be easy available.

16. Encourage direct to consumer advertising of prescription drugs which is illegal.

17. Illegal sale may lead to harmful consequences.

18. I respect to doctors prescription.

19. Doctor- Pharmacist- Patient: this tricycle may break.

20. Affect business of offline pharmacists⁹.

21. The cyber doctor’s qualifications and his experience may create worry¹⁰.

22. No proper guidance.

23. Error to access websites on net¹⁴.

LAWS TO PROHIBITS ONLINE PHARMACY IN INDIA

1. The Narcotic Drug and psychotropic Substance Act and Rules:

Chinese were famous for there known for opium addiction since time immemorial Coca leaves were chewed by natives in Peru, Bolivia and Latin American. Hemp was more popular and available mostly in Africa and Asia^16.In Present day like LSD, heroin, ‘brown sugar’, ‘Smack’ is the major highlights in habit forming list. Now a day unfortunately narcotic drugs and psychotropic substances are responsible for creating an inadequate all corners of the world. As a result this problem has having great impact on modern generations throughout the world, India being no exception. Smuggling and sale of narcotic drug and psychotropic substances is still the most lacerative business amongst anti-social elements¹⁷. This act came in force on 16^thsep. 1985^18.This act was passed to provide stringent provision to prohibit the operations related Narcotic Drugs. According to this act sale, transportation, purchase is Completely Prohibited¹⁹. It also provides licensing system for central and state government to regulate the progress²⁰. The most significant point of this act is it gives strict punishment sometime 30 years imprisonment or Fine of more than 3 lacks Rupees¹⁸.

2. Drug and Magic act, 1955:

In this 21^st century competition, advertisement has become a part of life. So this era may also be called advertisement era. Advertisement is having a great impact on our life. There are some merits and some demerits of advertisement. So in order to control the demerits of adds this act was passed in year1954¹⁷. The rules for this act came in to existence on 1^st April 1955. This act spread in whole country except JandK¹⁶. The main objectives of this act were to control unnecessary adds of drugs¹⁷. Also to prohibit some adds which are false²⁰. In this act under section 3, 4, 5, advertisements of drugs is completely illegal¹⁹.As we know that drugs are very toxic and potent in nature. Miff used directly for add will lead to self medication which is very dangerous. So drugs should rich to patient only through pharmacist. The drugs used for diagnosis, cure, mitigation, treatment or prevention of any disease, disorder are prohibited under schedules J of this act¹⁸.

3. Pharmacy Practice Regulations, 2015:

It appears that electronic prescriptions should be valid especially in the light of the Pharmacy Practice Regulations of 2015 declared by pharmacy Council of India in January 2015. In these regulations, “Prescription” is defined by regulation¹⁷. “Prescription” means a written or electronic direction from a Registered Medical Practitioner or other properly licensed practitioners such as Dentist, Veterinarian, etc. to a Pharmacist to compound and dispense a specific type and quantity of preparation or prefabricated drug to a patient. On basis of existing regulations it appears that a scanned copy of prescription will be perfectly considered as a valid prescription. However, whether such electronic prescriptions can be used to buy medicine from e-pharmacies has been questioned⁹.

4. Drug and cosmetic act 1940:

The drug and cosmetic act was passed on 10april 1940²⁰.The drugs are vital to health of a single person¹⁷also it is important that the import, manufacturing, sale of drugs should be done with a help of qualified personality¹⁶. So drugs are classified as essential commodity under the essential commodity act 1955. As now mostly allopathic drugs are used, though Ayurvedic, unaini, tibbi, etc. Are all homeopathic drugs and there need to be handled by trained person only¹⁷. The main objectives of this act are that There are some regulations over import, manufacturing, sale of drugs and cosmetic. Also enacted to control some operations related to allopathic drugs.¹⁶. To prevent substandard drugs to get high quality medical treatment¹¹. This act has amended from time to time the major amendment was done in year 1982.^(16,17) There are 2 schedule to this act and 23 schedule rule to it¹⁶. The schedules H, G were revised. The schedule E, I, L was deleted. The schedule X was introduced. Later schedule M, Y were introduced in 1988^16,17.This act is spread in all India also¹⁶. According to section18 (C) it prohibits the sale of drugs without license also there should be prescription to give medicine. According to section 27(C) there can be punishment or imprisonment for improper behavior⁹. The Drugs and Cosmetics Act, 1940 and it’s given provisions, have set rules on the offer of Schedule H and Schedule X drugs, which can be sold with a legitimate prescription only²¹.

AN CLINICAL SURVEY OF E-PHARMACY:

1. There are approximately 35,000 active online pharmacies operating worldwide.

2. 96% of online pharmacies do not comply with U.S. federal and state laws and pharmacy standards.

3. More than 12% of online pharmacies (roughly 3,400 sites) sell controlled substances like opioids.

4. 600 illegal online pharmacy websites are launched each month.

5. 100% of search results for “buy medicine online” lead consumers to illegal and unsafe websites.

6. 27% of consumers are very familiar with online pharmacies.

7. Younger, have higher incomes (above $80,000 annual income per household), and purchase other items online.

8. Less than 5% of consumers are aware of tools available to help them find safe online pharmacies.⁽²⁵⁾

9. 67% Are either not approved by the FDA or had been taken off the market because of safety concerns,

10. 5% contained no active ingredients

11. 28% contained controlled substances prohibited from being imported.⁽²²⁾

12. 5% Doctors are confident to advise patients on online medications.

13. Most of the doctors don’t know much about the online medications.

14. Some were also not sure whether buying medications is legal or illegal.⁽²³⁾

CONCLUSION:

Lawful Internet pharmacies benefit a consumer’s healthcare experience in many ways. Though e-pharmacies are more liable than local pharmacy especially in remote areas, there should be proper rules and regulation like upload of scanned prescriptions, etc. Patients should be made aware on use of prescription. New health programmers should be arranged to design and develop e-pharmacy. These pharmacies provide convenience and efficiency—two advantages coveted by people living busy lives. Consumers can take a few minutes out of their lunch break to place an order, or they can even order the prescriptions at 3 A.M., long after many conventional pharmacies have closed. Internet pharmacies can offer a degree of privacy not found at the local pharmacy, and patients can obtain prescriptions and ask questions away from the prying eyes and listening ears of neighbors, coworkers, and other parties. Internet pharmacies that perform illegal dispensing practices, however, assert a wrath of potential dangers to a consumer’s health. It is clear that patients must be protected from such dangerous dispensing practices. Physicians and pharmacists should ask themselves why their patients would rather receive medications without a prescription, a face-to-face consultation, or a visit to their local pharmacy, and what legitimate and legal practices the medical community can adopt from online pharmacies to improve the physician pharmacist-patient relationship. Patients’ safety and quality of drug should paramount whilst framing rules.

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Received on 21.03.2018 Accepted on 18.04.2018

Asian J. Pharm. Tech. 2018; 8 (2):108-111 .

DOI: 10.5958/2231-5713.2018.00017.X