Large online POM orders should only be permitted following consultation, says RPS

Patients should not be able to place online orders for large amounts of prescription-only medicines unless an appropriate consultation has taken place, the Royal Pharmaceutical Society (RPS) has said.

“High risk medicines, such as opioid painkillers, have particular patient safety issues with potential for fatal overdosing,” said a spokesperson for the Society.

“Websites should not enable patients to order large quantities of prescription only painkillers without having an appropriate consultation to gather all the necessary safety information. This is an unacceptable risk to the public.

“Any online consultation should meet the same standard as a face-to-face consultation.” 

The RPS’s statement comes in response to a BBC Panorama investigation due to be broadcast on 6 August 2018 at 20:30. In
Online Doctors Uncovered
, the BBC reports that some online clinics have avoided Care Quality Commission (CQC) inspections by employing doctors from contractors based in Romania. The CQC can only inspect online medical services if the GPs working for them are hired by companies based in England.

The Panorama investigation uncovered cases of opioid-based painkillers and slimming tablets being delivered through these sites to potentially vulnerable patients. In response, the RPS said that pharmacists and doctors are seeing an increasing number of patients with long-term conditions, with pain as a significant symptom.

“With advances in technology it is understandable that people may want to access pain relief online, but medicines are not normal retail products,” a spokesperson from the RPS said.

“They carry risks as well as benefits, and the best option is always to speak a pharmacist for direct personal advice.”

The CQC does not inspect pharmacies: in Great Britain, pharmacy inspection is the remit of the General Pharmaceutical Council (GPhC).

Duncan Rudkin, chief executive of the GPhC, said the BBC Panorama programme highlighted “some significant concerns that we share about potential risks for people obtaining medicines online”.

“We want to play our part in strengthening the safeguards in place for patients and the public through our regulation of pharmacies and pharmacy professionals in Great Britain,” he said. 

The GPhC is proposing that online pharmacies put in place new safeguards to protect people who want to obtain medicines online, and is currently consulting on those proposals.

The RPS said it was pleased to see the GPhC consultation, and urged pharmacists and other interested bodies to submit their views by the deadline of 21 August 2018.

While expressing concern about online breaches of regulatory standards, the RPS also said there is work to do to improve access to care across the board.

“As well as improving the standards of healthcare provided online, it is vital that access to services for people with chronic pain and addiction are also improved dramatically so they can get the help they need, when they need it.

“Pharmacists have an important role to play in this.”