Though it is hugely convenient and economical for consumers, the online market place throws up puzzling governance issues. If earlier there was confusion on how to tax online players, a serious public health issue is the new headache.

With e-pharmacies on the rise, authorities are clueless about what should be done to regulate prescription drug sales through online platforms. Kerala, which consumes more than 10 per cent of the drugs marketed in the country, is especially vulnerable. Health minister K K Shylaja made a general statement of on March 1 that online sale of medicines would be controlled. 

But the minister knows that mere intent is not enough. “This requires the Centre's intervention, too,” the minister said.

Last year, the Kerala Drugs Control Department had revoked the licence of leading online pharmacy store Medlife International. This but has not stopped Medlife from continuing to serve Kerala. “We have reports that Medlife International is carrying on with its operations in Kerala. Action will be taken after a probe is initiated,” the minister said.

In fact, in 2018 the Delhi High Court had clamped a ban on the operations of e-pharmacies across the country. The High Court had then termed the sale of prescription drugs as “illegal”. “Unlike common items, drugs are highly potent and its misuse or abuse can have serious consequences on human health, not just for the one person consuming it but for humanity at large as some drugs can be addictive, habit-forming and harmful to the body. A large number of children/minor or people from uneducated rural background use the internet and can be victims of wrong medication while ordering medicines online,” the Court said in its order.

E-pharmacies but have not been deterred. They secured a stay order from the Madras High Court and sustained their smooth run. Leading stores continue to sell prescription drugs without a doctor's prescription. Even Schedule X  drugs prescribed for depression and pain are sold like clothing or footwear, without even checking the age of the buyer.

As for these online medicine stores, it helps that archaic law still regulate pharmacy business in India. These laws were made long before the virtual business revolution was even considered a possibility. The country's major drug laws are the Drugs and Cosmetics Act, 1940, Drugs and Cosmetics Rule, 1945, and the Pharmacy Act, 1948.

At the moment, at least till some regulation is clamped, a bit of self-discipline will be in order. “Everyone should realise that it is extremely dangerous to consume allopathy medicines, especially antibiotics, anti-depressants and sexual performance-boosting drugs, without the doctor's prescription,” Shylaja said. The State Drug Control Department had also done an extensive investigation into the e-pharmacy business and has found that most sell medicines without insisting on prescription.

“And virtually all of them operate from outside Kerala. On the basis of our findings, we had alerted the drugs controllers of the states from where these online stores function. We are yet to see any action taken. It was in this context we had banned the operations of Medlife International, which had Kerala also as its base,” Shylaja said.

However, certain e-pharmacy stores, say for instance Netmeds, insist on prescription. These platforms provide the buyer with the facility to upload their prescription, which is then accessed by a licenced pharmacist in a brick-and-mortar store that operates under the Drugs and Cosmetics Act. But the charge is, the prescription needs to be uploaded only once to buy the same medicine multiple times.

The Centre, rather than shutting down e-pharmacies, wants the business to be put under stricter control. The Centre had issued draft rules on “sale of drugs by e-pharmacy” in 2018. It says that e-pharmacy portal can function provided they are registered with the Drug Controller General of India.

“Any person who intends to conduct the business of e-pharmacy shall apply for the grant of registration to the Central Licensing Authority in Form 18AA through the online portal of the Central Government,” the draft notification said. The licence will be valid only for three years and would prohibit these stores, like in America, from selling narcotic drugs, tranquilisers, and Schedule X drugs.

And like in the case of cigarettes and liquor, they will not be able to advertise either.