Online pharmacies have been warned that they can no longer prescribe high-risk medications or weight loss drugs solely based on information provided in online questionnaires. This updated guidance, issued by the General Pharmaceutical Council (GPhC), is aimed at improving patient safety.
The Royal Pharmaceutical Society (RPS) and the National Pharmacy Association (NPA) have both praised the new rules. The RPS emphasized that questionnaire-based prescribing should not become standard practice, especially for prescription-only medications or drugs with additional risk factors. The NPA pointed out that most pharmacies, including online services, already follow good practices in this area.
The GPhC, which released the guidance on February 4, highlighted the need for stronger safety measures after several cases of unsafe prescribing. This follows a recent coroner’s report in Sussex, which linked an online questionnaire to a woman accessing a fatal dose of medication.
The new rules state that, when a person requests a high-risk medication—such as drugs that could cause harm or even death in overdose, including weight loss medicines—the prescriber must take one of the following actions:
- Speak with the patient by phone or video call
- Review the patient’s clinical records
- Contact the patient’s GP, usual prescriber, or a third-party provider
For weight loss medications, online prescribers will now be required to independently verify a person’s weight or BMI before prescribing.
The guidance stresses that online consultations must involve direct communication between the patient and prescriber to ensure informed decisions can be made about treatment options.
Additional changes to the guidelines include:
- Making superintendent pharmacists jointly responsible with pharmacy owners to ensure compliance
- Requiring businesses to follow all relevant laws regarding the advertising and promotion of medicines
- Providing steps for companies to follow when patients do not have a regular GP or prescriber
- Clearly defining companies’ responsibilities when working with third-party prescribing services
The changes received strong support during a consultation, with 69% of sector stakeholders and 94% of patients agreeing that the measures would improve patient safety.
The GPhC has informed online pharmacy owners, superintendent pharmacists, and employed pharmacists and technicians to review the guidance and ensure they understand it.
GPhC chief Duncan Rudkin said, “The message is clear: online pharmacies should only supply medications after an appropriate consultation with the patient, ensuring that they have all necessary information to assess whether the medicine is safe and suitable.”
Rudkin added that online pharmacies must implement additional safeguards when prescribing high-risk medications, including verifying the information provided by patients. He also stressed that GPhC inspectors will continue to monitor online pharmacies to ensure they meet the new standards.
The RPS expressed support for the updated guidance. Professor Claire Anderson, RPS president, stated, “We fully support these safeguards to ensure safe prescribing practices and reduce risks associated with online medicines supply. The inclusion of weight loss medicines in the high-risk category is an important step toward protecting patient safety.”
Nick Kaye, chair of the NPA, also welcomed the changes, adding that many pharmacies already follow best practices. He urged patients to avoid unregulated sellers, such as beauty salons, which pose a significant health risk.
