The regulation of online pharmacies is becoming “potentially more complex and resource intensive” as online and distance-selling pharmacies continue to increase in number, the GPhC noted in draft council papers it published ahead of its meeting on Thursday (December 9).
It is “at an early stage of exploring differentiated fees for online pharmacies”, a GPhC spokesperson confirmed to C+D today.
“We would hold a full public consultation setting out our proposals if we did decide to propose charging differentiated fees for any type of pharmacy”, they added.
All pharmacies must register with the GPhC and and pay annual fees so they can operate in Great Britain.
Pharmacists, pharmacy technicians and pharmacy owners each pay “for the cost of regulating their own [registrant] group”, the spokesperson told C+D.
The regulator believes this is a “fair” way to set fees, but these need to be adjusted for a specific group or subdivision – such as online pharmacies – if the cost of regulating them increases.
Increased regulation of online pharmacies
In the papers, the GPhC outlined the risks associated with providing pharmacy services online and the regulatory activities it has already carried out.
Since April 2019, the GPhC has carried out 187 inspections of online pharmacies and received 839 concerns relating to online pharmacies, it wrote.
Only 63% of the 187 online pharmacies the GPhC inspected in the past year and a half met all the necessary standards, compared to the overall benchmark of 84%, the GPhC added.
It is therefore “evident” that online providers “pose a high risk in terms of professional care and professional standards” and “patient safety”, it said.
There are 170 fitness-to-practise cases related to online pharmacy, which make up a quarter of the regulator’s active caseload.
The GPhC has placed four professionals connected to online pharmacies “under interim orders” and another four have pending disqualification hearings. Two more pharmacies are subject to interim orders.
The regulator said it had taken “swift enforcement action” against 48 online pharmacies compromising patient safety by supplying “higher risk medicines for private prescriptions based on questionnaire-type consultations”, with “little or no evidence of involvement of the patient’s usual GP”.
It also took enforcement action against pharmacies using “overseas prescribers outside UK regulatory oversight”, it said.
The regulator flagged remote prescribing as one of the hazards associated with providing pharmacy services online, calling it a “lucrative but also high-risk” business model.
It also noted that online pharmacies need to be vigilant with managing patient data and payment details, obtaining appropriate consent through interactions that are not face-to-face and supplying medications “liable to abuse, overuse or misuse or [..] addiction” or that “require ongoing monitoring or management”.
Updating distance-selling guidance
The GPhC first updated its guidance for registered pharmacies providing pharmacy services at a distance in 2019, “in recognition” of the increase in popularity and use of distance-selling pharmacy business models.
In its latest council papers, it revealed that it is looking at updating this guidance once again to align with its prescribing guidance.
The regulator is also in talks with other professional and system regulators – such as the Care Quality Commission, the General Medical Council and Medicines and Healthcare products Regulatory Agency – about “how online pharmacy websites are set out” and “how products/services are advertised”, it said.
