We live in a world of the ‘New Normal,’ where we normalize work-from-home settings, online schooling, wearing face masks and maintaining social distancing in public. The rise in e-commerce has been rapid, especially in the post-pandemic times. Demonetization made way for a rise in digital payments and ‘the common man’ is now comfortable with UPI payments or shopping online in a prepaid order.
The need to buy medicines, sanitizers, masks and immunity boosters rose during the pandemic while trying to preferably avoid stepping out of the house. This scenario boosted a sharp rise in e-pharmacy transactions.
Currently, e-pharmacies offer you:
– Doorstep delivery to most locations around the country
– Discounted rates
– Pill reminders
– Refill reminders
– Profile creation
– Timely delivery (within a specified promised time)
What can you purchase and how?
– Hassle-free purchase of non-prescription medicines
– Ease of buying nutraceuticals, wellness products, sexual and intimate wellness products
– Easy step-by-step process to buy prescription medicines
– Add-on services such as doctor consultant (often free of cost!) in case a user wants to buy prescription medicine but does not hold a valid prescription
– Curated plans for certain conditions such as diabetes (which is a packaged offering of medicines, condition-specific lab tests and doctor/lifestyle educator consults)
The quintessential aspects of e-pharmacy apps:
– User-friendly interface
– Products categorised for ease of display
– Substitute medicines on display along with cost comparison
– Patient reading material on each pharma/nutraceutical product
– Discounts and offers available through coupon codes. These are often highlighted in banners on the app and are visible/enlisted at the time of checkout too
– Cart building and checkout
– Secure payment gateway
– Articles and blogs on relevant topics
What are the elements that are lacking?
– The prescriptions are not linked to an individual with a unique identification number
– No restrictions on issuing medicines between different apps as the process is not centralized
– User-specific vital information such as medicine allergies is not saved with any
e-pharmacies
What should we expect futuristically?
India is on the cusp of a digital revolution in the field of healthcare. With the National Digital Health Mission (NDHM), the government envisages linking all the dots in the healthcare ecosystem and associating them with a unique identifier. Each individual can create a unique health account number called Ayushman Bharat Health Account number aka ABHA number and store their key information with it.
Imagine the following scenarios for patients/users who have linked their personal health information with an ABHA number and have securely shared certain important history with e-pharmacies:
Scenario 1:
Allergy alerts
One day Swati is trying to place an order for Ciprofloxacin for her UTI using a valid prescription. The system alerts her “You could be allergic to the medicine you are trying to order. Are you sure you want to continue?”
Swati is allergic to Levofloxacin and has added that vital bit of information to her records. She had shared this information with healthcare providers and e-pharmacies.
Although she forgot to mention this history to her doctor at the time of the visit, she gets an alert for medicine from the same group of medicines.
Scenario 2:
Access to prescription history
Mahesh had a really bad cough one day, which was sudden. He gradually started developing shortness of breath. His neighbours rushed him to a nearby hospital. He was not in a position to talk much and the neighbours were oblivious to his medical history. He had a recent prescription in his pocket. A quick look at his e-prescription linked with his ABHA number showed that he recently had a fracture and was bedridden for a long time. High suspicion for pulmonary embolism (a fatal condition) was extrapolated. Tests were done and treatment was offered immediately. Turned out to be life-saving situation for Mahesh.
Scenario 3:
Refill check to ensure no duplicate purchases
Prescription medicines that are controlled drugs, (medicines that fall under the regulation of the narcotics drugs and psychotropic substance act aka NPDS Act) and the Schedule H drugs cannot be bought without a proper prescription. Also, there is a limit on refills that can be provided on each. Unethically, some people use the same prescription to stock up on controlled medicines by buying them from different pharmacies. With a linked unique identifying number and a digital network of pharmacies across the country, such duplicate purchases will not be possible.
Self-medication and taking these medicines from someone else who was prescribed the same is a huge problem in India. Such incidences can be curbed with a centralised regulatory process.
Scenario 4:
Generic medicine/substitute medicines:
Currently, e-pharmacies do not dispense “substitute, cheaper brands” or generic medicines instead of the medicine prescribed for the patient. An e-pharmacy will provide you with a cheaper alternative only if there is a footnote on your doctor’s prescription that specifically says, “Allowed to substitute in case of unavailability.”
India is a country with mostly out-of-pocket expenses on healthcare and cost is a huge limitation to quality care in India. Now, with e-pharmacies one can look for cheaper brands of reputable pharmaceutical companies and opt for those if the doctor is in agreement. Patients can insist on getting the footnote as mentioned above written on their prescription, in their in-person/online doctor consultations.
Imagine a situation when a (less aware) person looking for a life-saving medicine has to run from pillar to post for a medicine prescribed by the doctor, which is not available at the nearby stores. What is more ironic than having several other substitutes available but being denied any of the same? We definitely need more awareness around generic medicines. Ayushman Bharat Digital Mission (ABDM) will eventually normalize more and more online consultations and online orders for medicines. Insisting on the footnote will gradually gather pace.
With ABDM, the world of healthcare is more accessible than ever before. E-pharmacy is one of the key offerings of the digital health ecosystem. India will become a digital health country in the true sense only when the maximum number of people create their ABHA numbers and use all the components of the NDHM ecosystem to the fullest!
Click https://bit.ly/3IY3psW to create your ABHA now!
Picture courtesy: <a href=’https://www.freepik.com/photos/remedy’>Remedy photo created by freepik – www.freepik.com</a>
Source:
Dr. Mamta Lele- Pawara
(MD Ayurveda-Internal Medicine, CRAV-Kayachikitsa, MA Sanskrit)