A qualitative exploration of regulatory landscape and stakeholder insights on the online sale of medicines in Pakistan

Objective This study aimed to gather insights into the perceptions and experiences of the general public and community pharmacists regarding E-pharmacies. Additionally, data from healthcare regulators were used to explore the current regulatory framework for E-pharmacies in Pakistan, outline the challenges and provide future recommendations for the monitoring and regulation of these online platforms. Methods This was a qualitative study that involved three key stakeholders’ groups, including general public, community pharmacists, and healthcare regulators. The participants were selected using purposive and convenience sampling methods. In-depth interviews were conducted using semi-structured interview schemas. The sample size was determined based on the data saturation criteria. Thematic analysis was employed to analyze the data. Results A total of 44 interviews were conducted, including 16 from general public, 16 from community pharmacists and 12 from healthcare regulators. Five themes were extracted from the data obtained from the general public, while, another five themes were identified from data collected from community pharmacists and healthcare regulators. With regard to the general public, E-pharmacies were well accepted for their promptness, simplicity, ease of access, convenience and the added advantage of discounts. However, concerns were raised regarding the prevalence of counterfeit and expired medicines. Among community pharmacists, increased sales of medicines were the main motivating factor for providing online services. Community pharmacists suggested that the government should provide an online platform where all online pharmacies can register and provide services according to standard protocols. Healthcare regulators suggested that government bodies such as the Drug Regulatory Authority of Pakistan, Chief Drug Controller offices, Pakistan Electronic Media Regulatory Authority and Federal Investigation Agency should work together to have a better control on the online sale of medicines. Conclusion Some pharmacies that were licensed for onsite sale of medicines also operated online platforms to sell medicines. Regulations governing the sale of medicines in Pakistan should be revised to explicitly incorporate and regulate E-pharmacy services.