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Online pharmacies are more than twice as likely than their high street counterparts to not meet regulatory standards, an analysis by The Pharmaceutical Journal has revealed.
The analysis of inspection reports published between 1 April 2024 and 14 January 2025 found that distance-selling pharmacies failed General Pharmaceutical Council (GPhC) inspections at a rate of 10%, while high street pharmacies failed at a rate of less than 5%.
Of the 230 distance-selling pharmacies included in the latest Pharmaceutical Journal analysis, 24 (10%) pharmacies failed to meet all standards.
However, of the 2,002 bricks-and-mortar businesses in the sample, only 91 (4.5%) pharmacies did not meet all standards.
The inspections assess pharmacies across five standards: managing the pharmacy safely and effectively (governance); employing competent and empowered staff; providing appropriate premises; providing services safely and effectively; and using safe and effective equipment and facilities.
According to the analysis, governance was by far the most commonly failed standard in the online pharmacy sector.
Of the 24 distance-selling pharmacies to fail their inspections, 22 (92%) pharmacies did not meet the governance standard, while 16 (67%) pharmacies did not meet the service standard.
In addition, nine distance-selling pharmacies (38%) failed their inspections on staff and eight distance-selling pharmacies failed inspections (33%) on premises.
None of the distance-selling pharmacies failed their inspections on equipment and facilities.
The gap between online and high street pharmacies has narrowed since 2022, when The Pharmaceutical Journal found distance-selling pharmacies were eight times more likely to fail inspections than their bricks-and-mortar counterparts.
The findings of the analysis came before the GPhC issued new guidance for online pharmacies in February 2025, which stipulated that prescribers should not be relying on online questionnaires alone for high-risk medicines.
Instead, the guidance called on prescribers to independently verify the information the person provides by conducting “timely two-way communication”, accessing the person’s clinical records or contacting a third party with knowledge of their history.
Wing Tang, head of professional standards at the Royal Pharmaceutical Society, said: “We’re concerned by the higher failure rate of online pharmacies in comparison to bricks-and-mortar pharmacies, particularly in governance and services as these areas are critical for patient safety.
“Many online pharmacies comply with regulatory standards, and those that fall short must take immediate action to address these gaps. Robust governance and high-quality services are vital to maintain public trust in pharmacy.”
Jay Badenhorst, director of pharmacy at the Pharmacists’ Defence Association (PDA), said: “The failures suggest some online pharmacies are not putting in place the necessary checks and balances to ensure medicines are being supplied safely and appropriately. This raises serious questions about whether patient safety is being compromised in favour of commercial interests or ‘convenience’.
“There have already been too many cases where patients have been able to obtain medicines inappropriately due to weak controls, inadequate professional oversight or business models that prioritise sales over safe supply.
“The PDA believes that there must be real consequences for those who put patients at risk.”
Commenting on the regulator’s ongoing work to drive compliance with standards, a spokesperson for the GPhC said: “We continue to carry out routine inspections, as well as intelligence-led inspections.
“We are also applying and checking for adherence to our updated guidance for online pharmacies when carrying out inspections.”
In December 2024, the GPhC said it would prioritise first inspections of online pharmacies within six months of registration, while extending this target to within 12 months for bricks-and-mortar pharmacies.
Read more: The big online pharmacy clampdown
