Is Amazon about to move your pharmacy cheese?

 

As a society, we are moving towards ways of buying products that have the potential to save us time. For many people, online pharmacies have become a convenient option.

 

Over the years we have seen a rise in the number of prescriptions that are being fulfilled by distant selling pharmacies (DSPs).

 

And COVID-19 has accelerated this shift – as it has in so many sectors of the economy. Since January, DSPs have seen a dramatic increase in the total number of items sold.

 

Unsurprisingly, Amazon has recently entered the US pharmacy market and have trademarked key terms to prime themselves to follow a similar path in the UK.

 

Does the traditional bricks and mortar community pharmacy still have a place?

 

In a word?

 

Yes.

 

Despite the convenience online pharmacies bring, they are not for everyone. I think we can all relate to the frustration felt when we see a ‘Sorry, we missed you’ card in our letterbox because we were not at home to sign for our delivery. We all live busy lives and convenience comes in different forms for each of us.

 

Depending on your situation or routine, dropping into a local pharmacy might not take away value from your day. For some, a short stop on the way to or from work will be preferable to waiting for a delivery. For others, the face-to-face contact with their local pharmacist could be of particular importance, especially now when so many patients are stuck inside deprived of human interaction.

 

Furthermore, community pharmacies are able to offer vital services that cannot be outsourced or replaced online; including but not limited to flu vaccines, travel clinics, weight loss assistance, and micro-suction earwax removal.

 

Rather than competitors, online and community pharmacies are complementary, providing convenience in different ways to different customers.

 

A good example of that can be found with Lloydspharmacy, which is pushing the convenience that online pharmacies can offer whilst simultaneously using the physical presence of their stores to offer choice to their patients.

 

Lloydspharmacy is actively encouraging patients to register for their app-based online service Echo, the revenue from which has increased 300% since the start of the coronavirus pandemic. Patients using the app have the choice of having their medication delivered to a selected address, most likely at home or work, or collecting at one of Lloydspharmacy’s 1000-plus branches. The medication is dispensed at Echo’s centrally-located pharmacy and, if the patient prefers click-and-collect to home delivery, taken to the branch pre-packed and ready to pick up.

 

Boots and Co-op have also introduced pick-up lockers, an idea borrowed from retailers like Amazon. These lockers allow patients to go to a pick-up point in a pharmacy or, in the case of the Co-op, a food store, with a unique code that grants them access to a locker containing their order.

 

For pharmacists and community pharmacies, the overlap between online and face-to-face can be hugely beneficial. Though not everyone will want to take their medication needs online – meaning that in-store pharmacists will still spend time dispensing medication – an increase in the number of people who order for delivery or collection does indicate that community pharmacists will have more time on their hands.

 

Consequently, they will have more time to invest in the provision of services. For Lloydspharmacy, the company’s in-store pharmacists can now dedicate themselves to providing services like their £260-a-month private weight loss scheme, stop smoking help plan, or six-step health check-ups. Companies like PharmaDoctor also provide innovative services in across community pharmacy.

 

Even though smaller groups or independent community pharmacies may not have the resources to found their own online service or buy out a company like Echo, the shift in Lloydspharmacy’s business model could give us a window into the future for them, too.

 

By partnering with a service like the Healthera app and Patient Access, independents can take advantage of this move to online ordering. Healthera provides a repeat prescription service personalised to each pharmacy that allows patients to collect their medication without needing to visit their GP again and again or wait in line.

 

This also provides pharmacists with an opening to offer relevant services to patients. When a patient drops by to collect, the pharmacist can take the time they would have previously spent dispensing the medication to inquire about the patent’s wellbeing and, if appropriate, suggest services or additional products that could be of benefit. With the margins on NHS prescriptions slimmer than the margins on many services, that could help community pharmacies boost profitability.

 

Compared to retail, pharmacy is relatively late to the party in terms of moving towards an online model of sales – a tiny fraction of prescriptions are currently fulfilled online.

 

But change is afoot. The cheese is already moving.

 

According to statistics from ResearchAndMarkets.com, the global online pharmacy market is expected to grow at over 20% annually between 2019 and 2025, with the UK cited as one of many key growth potential markets.

 

Rather than pushing community pharmacies under, new developments in online ordering should be seen as an opportunity.

 

The rise of online pharmacies and can be of benefit to local high-street pharmacists, who, using the extra time through a reduced dispensing workload, can provide valuable services that make them uniquely useful to patients.

 

The market is changing, and those changes can benefit us all.

 

Reece Samani is a pharmacist. He is also the founder of Signature Pharmacy and The Locum App.

 

 

Online pharmacy crowdfunds over £1.7 million in 48 hours

 

Phlo, an online pharmacy operating in England, has crowdfunded £1,728,820 from 249 investors less than two days after launching a crowdfunding campaign.

 

Launched in late 2019, the team at Phlo have said they are ‘on a mission to become the UK’s leading on-demand digital pharmacy’.

 

They say they ’empower patients to better manage their healthcare by helping them to easily order and track their prescriptions in real-time’.

 

Phlo claims to be the UK’s first on-demand, same-day delivery digital pharmacy. They say that they have achieved an average monthly patient growth of 43% in 2020 and served 4079 ‘users’ in September 2020.

 

Earlier this year they secured a contract with Babylon, to deliver telehealth services.

 

Nadeem Sarwar, Founder and CEO of Phlo commented:

 

“A few years ago I was diagnosed with diabetes, and as a result, I had to go on a repeat prescription. Far too often I was having to chase my prescriptions, wait too long in pharmacy queues, or receive incomplete medication, meaning multiple trips to my local pharmacy. My experience made me realise, that I wasn’t alone and that most people trying to access medication struggled with what I think is an archaic pharmacy system.

 

“As a busy professional with limited time, I thought there must be an easier way, and more convenient way for me to manage and access my medication, than this. So that’s when I decided to launch Phlo. Phlo is a patient-first digital pharmacy service that puts patients back in control of their healthcare.

 

“We’ve laid the foundations for the future of healthcare by building the most technologically advanced pharmacy ever launched in the UK. But we are not finished yet. Today’s world is different. The pressure on healthcare now and into the future will be unprecedented. We want everyone to benefit from the pharmacy service they deserve.

 

“In terms of our revenue numbers, we’ve grown our total patient numbers by 1,064% since the start of the year with monthly revenue growth of at least at 73%, every month, and we continue to do that.

 

“Our aim is to deploy this investment into helping scale our real-time same-day delivery service across other cities in the UK and implement new product features to ensure whatever happens our patients will always be in control.”

 

Chief Commercial Officer at Phlo commented:

 

“Monday 12th October 2020 was a huge day for Phlo as we launched the UK’s first crowding funding campaign in the pharmacy sector. Phlo represents a step-change in the online pharmacy space. No-one is currently doing what we do. We are a generational business and this is a great opportunity to be part of our story.

 

“Our mission is to make health care flow around your day. And we achieve that by providing a digital pharmacy and medication delivery service that is unparalleled in terms of convenience, accessibility and ease of use, close for everybody. As long as someone is registered with a GP in England, we can provide them with a first in class pharmacy service and deliver their medication across the UK.

 

“We deliver repeat and acute NHS and private prescriptions in London. We offer a real-time same-day delivery service that ensures that patients can order and receive their medication within four hours, all while easily tracking their medication on the light map as it travels from our pharmacy to their doorstep. Our handy reminder notification system also means our patients never forget to order their medication. Our patients can get in touch with our pharmacist via text, phone call or email.

 

“At Phlo, we take phenomenal pride in our patient care. Our team of qualified pharmacists are on hand to answer any patient queries through telephone, email, or live chat, whenever they need to. We’ve helped patients as young as five and as old as 84 to access to medication, and the excellent feedback we’ve received so far has validated the success of our patient-centric approach.

 

“COVID-19 has created a huge surge in demand for digital pharmacy services. We are proud to be helping those who are most vulnerable access to medication with confidence, and peace of mind, we’ve laid the foundation.”

 

Do you feel online pharmacies are the future for pharmacy in the UK? How will this type of venture impact on traditional bricks and mortar pharmacies? Share your thoughts on this story and others by writing to the editor. 

 

 

 

 

Well double online pharmacy capacity during COVID-19

 

In response to patient demand during the COVID-19 pandemic, Well have now doubled the capacity at their online pharmacy, based in their Healthcare Service Centre in Stoke-on-Trent.

 

Before the pandemic took hold in the UK, Well were seeing approximately 3,000 patients signing up to their online pharmacy each week. In late March, as lockdown was announced, this jumped to a peak of nearly 6,000 patients signing up in just one day.

 

“It was clear that patient behaviour changed almost overnight,” comments Gill Stone MRPharmS, Regulatory and NHS Standards Lead, Digital Pharmacy. “You just need to look at the numbers. Back in January, we dispensed 42,000 items and had around 400 customer queries a day… but in April the volume of items nearly doubled to 80,000 with up to 2,000 customer queries in a day. This wasn’t just a busy time, it was like nothing we, or the profession, had ever seen before.

 

“So that we were able to manage the expectations of those people who wanted to use the service, we took the responsible decision to pause sign ups and introduce a waiting list for patients wanting to register. We responded to this massive surge in demand, with additional resource in our Customer Service Team to provide support for our patients and by introducing an additional shift to deal with patients’ orders – effectively doubling our capacity.” Gill continues, “With so many patients still shielding and in isolation, we’re not expecting this demand to drop off anytime soon as we all adapt to the new world we find ourselves in.”

 

 

 

Amazon files for pharmacy related trademark in the UK

 

The online technology company Amazon has submitted an application register a trademark against the term ‘Amazon Pharmacy’.

 

The move follows their acquisition of the pharmacy company PillPack in 2017.

 

The UK application was filed on 9th January 2020 and can be viewed on the UK intellectual property office website.

 

Trademarks are registered under one or more classes. These classes describe the nature of the trademarked entity. The ‘Amazon pharmacy’ trademark has been registered under the following classes:

 

5, 9, 10, 20, 21, 35, 36, 39, 42 and 44.

 

We have highlighted the classes most relevant to pharmacy below.

 

Class 10

 

“Surgical, medical, dental and veterinary apparatus and instruments; medical apparatus and instruments; medical apparatus for facilitating the inhalation of pharmaceutical preparations; inhalers for medical use; cups for dispensing medicine; testing apparatus for medical purposes.”

 

Class 20

 

“Containers, not of metal, for storage or transport; commercial dispensers for pills or capsules, sold empty; plastic medication containers; medical storage apparatus, namely, plastic pill dispensers, plastic pill containers, medication cases, and non-metal plastic boxes for storing pills and medication.”

 

Class 21

 

“Personal dispensers for pills or capsules for domestic use; personal medical storage apparatus, namely, plastic pill dispensers, plastic containers for storing and organizing medications and vitamins, and non-metal boxes for storing pills; lotion containers sold empty for domestic use.”

 

Class 39

 

“Transport; packaging and storage of goods; travel arrangement; delivery of goods; delivery of goods by mail order; distribution services, namely, delivery of prescription medication; packaging of medication; pharmacy packaging service that aligns, sorts and packages a patient’s medications by date and time into individual packets.”

 

PIP has approached a range of stakeholders in UK pharmacy for comment.

 

You can search for trademark applications and/or registered trademarks on the Government intellectual property office website by clicking here.

 

 

Crackdown on online pharmacy supply of high risk medicines

 

 

The General Pharmaceutical Council (GPhC) has identified that some online pharmacies have supplied high-risk medicines including opiates and sedatives to patients without appropriate steps being taken by the pharmacy owner, prescriber, responsible pharmacist or other members of the team. It has been found that check to ensure that the medicine being prescribed and dispensed was clinically appropriate for the patient were not made.

 

These patient safety concerns were identified during recent pharmacy inspections which looked at whether online pharmacies were meeting the standards for registered pharmacies and following updated guidance published in April this year.

 

The updated guidance on providing pharmacy services at a distance made clear that some categories of medicines are not suitable to be supplied online unless further safeguards have been put in place to make sure they are clinically appropriate for patients. This includes medicines liable to abuse, overuse or misuse, or when there is a risk of addiction and ongoing monitoring is important, such as opiates and sedatives.

 

In response, the GPhC is taking enforcement and regulatory action where appropriate against the owners of these registered pharmacies, as well as individual pharmacy professionals involved in both the prescribing and supply of medicines where their conduct may have fallen short of professional standards. The GPhC are also taking forward Fitness to Practise investigations against a number of superintendent pharmacists, pharmacist independent prescribers and responsible pharmacists.

 

Improvement notices and conditions on a pharmacy’s registration have been imposed; for example, conditions restricting the supply of controlled drugs by the pharmacy.

 

The chief executive of the GPhC, Duncan Rudkin, has this week written to the owners of online pharmacies and asked them to provide information on the actions they have taken to follow the new guidance and make sure patients access pharmacy services online safely. This information will be used to proactively prioritise the GPhC’s inspection programme.

 

Duncan Rudkin, Chief Executive of the GPhC said:

 

“I want to reassure patients and the public that we are taking robust action against the small number of online pharmacies and pharmacy professionals who through their actions have put the safety of patients at risk. I have also written to online pharmacy owners to obtain details of how they are keeping patients safe online and following our guidance.

 

“I have made clear that pharmacy owners need to make sure that they have the right safeguards in place to make sure all medicines they supply are clinically appropriate for their patients.

 

“When prescribing and supplying high-risk medicines such as opioids, it is not acceptable to rely solely on information provided by the patient via an online questionnaire; the prescriber needs to take other steps such as consulting with the patient, reviewing medical records and contacting the patient’s GP, as outlined in regulatory standards and guidance. (1)

 

“Patient safety is our central focus, and we are continuing to work closely with other regulators involved in regulating online primary care services, governments and other stakeholders across Great Britain to improve the quality of care for patients online.”

 

(1) Prescribers are expected to follow relevant regulatory standards and guidance such as the GMC’s Good Medical Practice and the GMC’s guidance on prescribing. The GPhC is currently developing prescribing guidance for pharmacist independent prescribers.

 

 

Tighter regulations on selling medicines online announced

 

Online pharmacies in Great Britain will have to follow updated guidance from the pharmacy regulator to protect people from getting medicines online.

 

The General Pharmaceutical Council (GPhC) has strengthened its guidance (1) for pharmacy owners to help make sure that people can only obtain medicines from online pharmacies that are safe and clinically appropriate for them.

 

Online research by YouGov commissioned by the GPhC (2) found that 25% of people say they are likely to use online pharmacies in the future, but 50% of those unlikely to do so have concerns about the safety of online pharmacies. After considering feedback from the sector, patients and the public to proposals published last year (3), the GPhC has introduced further safeguards for patients and the public in the following key areas:

 

Making sure medicines are clinically appropriate for patients – online pharmacies will have to make sure:

 

  • Antimicrobials (antibiotics).
  • Medicines liable to abuse, overuse or misuse, or where there is a risk of addiction and ongoing monitoring is important. For example, opiates, sedatives, laxatives, pregabalin and gabapentin.
  • Medicines that require ongoing monitoring or management. For example, those used to treat diabetes, asthma, epilepsy and mental health conditions.
  • Non-surgical cosmetic medicinal products, such as Botox.

 

These safeguards include making sure the prescriber proactively shares all relevant information about the prescription with the patient’s GP after seeking the patient’s consent.

 

In the case of medicines liable to abuse, overuse or misuse, or when there is a risk of addiction and ongoing monitoring is important, the online pharmacy should have checked that the GP has confirmed to the prescriber that the prescription is appropriate and that monitoring is in place. In cases where a patient does not have a GP or a regular prescriber, or if there is no consent to share information and the prescriber has still issued a prescription, the online pharmacy should make sure the prescriber has made a clear record setting out their justification for issuing the prescription.

 

  • Transparency and patient choice – pharmacy owners will have to supply more details about where the service and health professionals involved in prescribing and supplying the medicine are based and how they are regulated, so people have enough information to make an informed decision about using the service and can raise concerns about the service if they need to.
  • Regulatory oversight – pharmacy owners working with prescribers or prescribing services operating outside the UK must take steps to successfully manage the additional risks that this may create, including assuring themselves that the prescriber is working within national prescribing guidelines for the UK.

 

These new safeguards received strong support overall from more than 800 individuals and organisations responding to a discussion paper published last year.

 

Duncan Rudkin, Chief Executive of the General Pharmaceutical Council said:

 

“We support pharmacy services being provided in innovative ways, including online, as long as the services are safe and effective for people. But providing pharmacy services online carries particular risks which need to be successfully managed. People can be put at serious risk if they are able to obtain medicines that are not appropriate for them. We are now putting in place this updated guidance with further safeguards to protect people.

 

“I would strongly urge patients and the public wanting to obtain medicines online to only use online pharmacies registered with us, to protect their health. These pharmacies have to meet our standards and follow this guidance, so they provide safe and effective services, and we will be inspecting pharmacies to make sure this is the case. We are also continuing to work closely with other regulators involved in regulating online primary care services, governments and other stakeholders across Great Britain to improve the quality of care for patients online.”

 

RPS President Ash Soni said:

 

“The RPS welcome this updated guidance from GPhC to improve the protection of patients seeking medicines at a distance, including online.

 

“We are particularly pleased to see that the requirement for additional safeguards for certain categories of prescription only medicines – which include antibiotics, medicines liable for abuse and medicines that require ongoing monitoring or management – have been strengthened in the guidance document. Patient safety in relation to medicines is central to any pharmaceutical service.

 

“Furthermore, we welcome the fact that the GPhC has addressed our long held concerns that some websites have enabled patients to select which medicines they want rather than taking a consultation-based approach. An online consultation should meet the same standards as a face-to-face consultation.”

 

References

 

(1) The guidance for registered pharmacies providing pharmacy services at a distance including on the internet can be read here.
(2)  All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 2040 adults. Fieldwork was undertaken between 8th – 9th August 2018.  The survey was carried out online. The figures have been weighted and are representative of all GB adults (aged 18+).
(3) The consultation report can be found here.