Indian pharmacists go on strike over e-sites

Around 850,000 pharmacies in India have shut up shop in a one-day nation-wide protest against government plans to introduce e-portals and allow online stores to sell drugs.

The strike follows unheeded calls by the All India Organisation of Chemists and Druggists (AIOCD) trade group to reconsider the new legislation, which will make e-portal registration for pharmacists mandatory and will involve the collection of data around medicine sales. The government is also deliberating on e-pharmacy regulations to support the sale of drugs online.

Despite grey areas in the current law, online pharmacies have already started to pop up in India – around a dozen in the past three years, according to The Indian Express – where patients can upload their prescription and receive their drugs without having to leave home. In some cases, online discounts have also been offered, which opponents say raises questions about drug quality.

Yet online pharmacies are proving popular. According to a consumer survey last year, 61 per cent of Indians prefer to purchase medicines online because they perceive better accessibility and choice compared with their brick and mortar counterparts and 90 per cent said they would consider e-pharmacies in the future.

The AIOCD, which has called the new regulations "stringent", is concerned the competition with online pharmacies will lead to reduced profits for brick and mortar stores and a scarcity of medicines, as well as the possibility that counterfeit medicines will further infiltrate the market and pose a risk to public health.

While the prescriptions received online are said to be verified by a certified pharmacist, high street chemists claim quality, credibility of the supply chain and safety checks can't be guaranteed and they fear the over prescribing of some classes of drugs, such as antidepressants and anti-anxiety meds, might occur.

"The online pharmacy will encourage irrational usage of medicines and sale of fake drugs," an AIOCD member said in a statement.

The trade body also claims that the infrastructure is insufficient in India to support the e-pharmacy.

"This is an absolutely wrong idea in a country like India where is will have long-term repercussions," AN Mohanan, national vice-president of AIOCD, told The Hindu. "Though online purchase of medicine is legal in advanced countries, in our country with low computer literacy and extremely weak regulation of the drug industry, the initiative will have serious consequences for public health."

The threat to business is also very real, Jagannath Shinde, the trade body's president, told India's independent newswire IANS. He believes more than 40 per cent of the chemists in rural India would have to close down.

In response to the regulation's opposition, the Indian Internet Pharmacy Association (IIPA) said the AIOCD claims were unfounded and argued that the distribution of medicines would be transparent with tracking and monitoring, and pledged to be accountable. It alleges a digital pharmacy is more fit for purpose in achieving transparency, reducing diversion and ensuring the safe access to medicines than high street stores.

"We are happy that the government is committed to reform the healthcare sector in India and not just in the online space. Having said that, the strike will be very inconvenient or patients and can even cause serious repercussions. As an online healthcare company, we can work with the government on healthcare data and patient reforms," Prashant Tandon, president of the IIPA and founder of PharmEasy website, told The Indian Express.

The AIOCD has previously warned the Health Ministry and Prime Minister of its concerns in several representations opposing the legislation but the AIOCD said that these have been disregarded.

In February, the AIOCD petitioned that the new rules allowing the online sale of medicines be delayed to allow time for further review and around 80,000 objection letters have been sent to the government. Several localised groups of pharmacies have also taken strike action before now.

The Times of India reported that last minute intervention by the Health Ministry failed to call off the strike.

Further strikes in the future may be considered if the government fails to respond and address concerns. "If our demands are not met, we will go on an indefinite strike," Shinde told PTI News.