PDA: GPhC consultation ‘watering down’ online pharmacy guidance

The Pharmacists’ Defence Association (PDA) has raised concerns that proposed changes to online pharmacy regulations would embed “potentially poor practice” and allow pharmacies to “circumvent” guidance.

Online pharmacy
“Poor wording and ambiguity will create risk for practitioners” • Source: Shutterstock

The General Pharmaceutical Council’s (GPhC) proposed raft of “extra safeguards” for online pharmacies risks “watering down” existing guidance, the PDA last week (November 17) said.

In September, the GPhC launched a consultation into new guidance “requiring online pharmacies to put extra safeguards in place when prescribing or supplying” high-risk medicines like weight loss drugs.

Responding to the regulator’s proposals, the PDA said that it “welcomes the strengthening of certain aspects of the guidance” and its move to make superintendent pharmacists “responsible” for stricter Wegovy safeguards.

Read more: Make superintendents ‘responsible’ for stricter Wegovy safeguards, says GPhC

But it warned that “other proposals are likely to weaken the guidance and some of the proposals are not clear and may cause confusion”, adding that there are “a number of areas” where the guidance “is embedding what is potentially poor practice”.

“While there have been positive steps to include drugs that can be harmful if misused, the watering down of content from the 2022 guidance and inclusion of certain practices are a significant cause for concern and may increase patient risk,” it added.

Questionnaire guidance must “be clearer”

The PDA said that wording around questionnaire consultations “needs to be clearer”, adding that “poor wording and ambiguity will create risk for practitioners”.

It recommended that the GPhC change its proposed guidance from saying that a prescription-issuing system that is “based on a questionnaire…is unlikely to meet” regulations to clarifying that such systems “will not” meet its standards.

Read more: New GPhC weight loss regs: Online patient forms must be ‘supplemented’

Guidance “must also detail medicines that must never be supplied by a questionnaire model”, it said.

It added that wording around verifying information provided by patients and patient monitoring “will lead to confusion” and “will not prevent future harm”.

And it urged the GPhC to “reinstate [a] crucial safeguard” prohibiting patients from choosing a medicine prior to a consultation with a prescriber, which it said had been removed from the new guidance.

Influencer marketing

The PDA highlighted that while GPhC guidance from 2022 said that prescribers “must not prescribe controlled drugs” without “access to relevant information from the patient’s medical records”, the proposed guidance only says that “it is essential” that access to medical records “is sought prior to supplies being made”.

It stressed that it is “unclear what will happen if access is denied (when sought) to the medical records”.

“We urge the GPhC to revert to and reinstate the clear wording of the 2022 guidance especially around the issue of controlled drugs and medicines that are liable to abuse,” the PDA said.

Read more: Repeat offender online pharmacy warned over weight loss POM ads

It added that “if an online pharmacy is accessed via a third party then the same [advertising] obligations” applicable to online pharmacy websites “should apply”.

“Online pharmacies must ensure that promoters and agents, many who now mainly operate via online social media websites – and who may get a commission for every referral – are not directing their ‘followers’ to the online pharmacy on the basis of false or misleading information,” it said.

“Third parties must not be used to circumvent the guidance,” it stressed.

Read more: Mum landed in hospital after taking Facebook ad Mounjaro

It also said that “significant patient safety concerns have been raised that enabling an opt-out - by way of a tick-box - for the patient’s GP to be informed of the prescription/supply has allowed online pharmacies to circumvent GPhC guidance that is not mandatory”.

A GPhC spokesperson told C+D that the regulator is “currently considering all of the responses [it] received during [its] engagement”.

They added that the regulator expects “to publish the updated guidance in the New Year”.

Regulation crackdown

Last week, C+D reported that a mum of three was landed in hospital shortly after taking weight loss jab Mounjaro, having “bought into” an online pharmacy’s ad for the drug on social media.

Meanwhile, the Medicines and Healthcare products Regulatory Agency (MHRA) ordered an online pharmacy to change its advertising for weight loss prescription-only medicines (POMs) earlier this month after it breached its rules for the second time.

And in May, the regulator hit three pharmacists with warnings after they provided “high-risk” medicine using “unsafe” online patient questionnaires.

In September, the Advertising Standards Authority (ASA) told C+D that it is “removing around 100 posts” advertising prescription-only medicines (POMs) on social media “a day”.

Read more: ‘I’m terrified someone is going to die’ - Wes Streeting demands tighter regs around Wegovy after C+D story

The ASA said at the time that it is “proactively finding and removing ads for POMs, including for weight loss products, using [its] artificial intelligence (AI) based active ad monitoring system”.

The stats came as health minister Karin Smyth said that the Department of Health and Social Care (DH) is “concerned…about some online prescribing, including the prescribing of weight loss medicines by online businesses”.

Read more: Wegovy: ‘I really hope the NHS crack down on this. I am forever traumatised by what happened’

And in June, health secretary Wes Streeting revealed plans for “much closer clinical oversight and regulation” around accessing weight loss drugs from online pharmacies, after C+D revealed that increasing numbers of people were turning up at A&E needing treatment after taking weight loss drugs.

At the time, C+D exclusively reported that a “young girl” was rushed to A&E for urgent treatment after presenting with life threatening symptoms after taking weight loss drug Wegovy that she had obtained through Boots Online Doctor.

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Kate Bowie

Read more by Kate Bowie

Kate Bowie joined C+D as a digital reporter in August 2023 after graduating from a master’s in journalism at City, University of London. She began covering the primary care beat at the end of 2022, when she carried out several health investigations focused on staffing issues, NHS funding and health inequalities.

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