Are Pharmacies Ready for the Rollout of Electronic Prescriptions?
Calls for the liberalization of e-prescriptions have been persistent. On one hand, there is a demand-driven need to facilitate medication access for residents; on the other, regulating e-prescriptions poses significant challenges. Striking a balance between these two aspects has become key to loosening restrictions on e-prescriptions. In recent years, many local health and drug regulatory authorities have made proactive efforts, leading to a continuous rollout of new policies in the pharmaceutical circulation sector.
VCBeat (WeChat ID: vcbeat) has learned that the Chengdu Municipal Drug Administration has recently launched a pilot program for electronic prescriptions among chain pharmacies across the city. Over 3,000 pharmacies have enabled online consultation services, and more than 1,800 have joined the e-prescription pilot. Participating pharmacies will provide consumers with health consultations, e-prescription issuance, and prescription review services.
The prescribing and distribution of prescription drugs have long been a key focus of regulation by health and drug supervision authorities. According to the "Measures for the Classified Administration of Prescription and Non-Prescription Drugs (Trial)," which came into effect in January 2000, "prescription drugs may only be dispensed, purchased, and used with a prescription from a licensed physician or licensed assistant physician." The aim is to ensure the safe and rational use of medications by the public. However, such rigid regulations can sometimes create inconveniences in medication access. For instance, patients with chronic conditions or those requiring long-term medication may need only a limited variety of drugs, yet they must obtain a prescription from a qualified pharmacist each time they make a purchase, making the process cumbersome.
Is it possible to relax prescription regulations or implement electronic prescriptions for specific categories of drugs and specific medications? As a leading province in healthcare reform in southwest China, Sichuan Province’s Notice on the Pilot Program for Deepening Comprehensive Reform of the Healthcare System (Chuan Fu Fa [2016] No. 32) proposed “actively developing internet-based health management services for chronic and common diseases.” The pilot program for electronic prescription services in retail pharmacy chains, currently being implemented by the Chengdu Food and Drug Administration, represents a refinement and practical application of this earlier initiative. The rationale for advancing this program is to further promote the separation of prescribing from dispensing and to enhance healthcare informatization.
Notably, a key component of Chengdu’s current pilot program is the PC-based micro-consultation terminal. According to VCBeat (WeChat ID: vcbeat), patients visiting pharmacies equipped with these terminals can select a medical specialty and consult with corresponding backend physicians. Services available through the terminal include health consultations, prescription issuance, prescription review, and medication purchase. While many regions and hospitals have previously attempted to leverage internet-based solutions to improve physicians’ consultation efficiency and meet residents’ healthcare needs, large-scale deployment of remote consultation devices, as seen in Chengdu, remains rare. With continued observation, if operated effectively, this model has the potential for widespread adoption.
As a pilot program, the diagnosis and treatment provided by Weiwenzhen terminals are relatively simple and standardized. Consequently, electronic prescriptions issued through this platform are limited to common and chronic diseases—such as upper respiratory tract infections, hypertension, and diabetes—that require fixed-dose medication. Nevertheless, it is foreseeable that the integration of remote consultations with pharmacies will offer substantial room for growth, approaching the requirements for an “Internet Hospital.”
Previously, the concept of internet hospitals made a high-profile debut at the Wuzhen World Internet Conference. Data from initial implementations show that WeDoctor, in partnership with the Second People's Hospital of Gansu Province, and AliHealth, in collaboration with Wuhan Central Hospital, have already taken tentative steps. If medication-related issues can also be resolved, this future-oriented healthcare model—internet hospitals—will become more widespread and convenient.
Therefore, this also poses new requirements for brick-and-mortar pharmacies. The influx of prescription drugs will have a profound impact on the business models of retail pharmacies, and one of the most significant challenges is how to meet the medical treatment and medication needs of patients with chronic diseases, minor illnesses, and serious conditions.
The domestic prescription drug market exceeds RMB 1 trillion, with an average annual growth rate of over 6%. In terms of sales channels, approximately 60% of this volume, amounting to more than RMB 700 billion, originates from urban tiered hospitals. Should a portion of prescription drug sales from these hospitals shift to retail pharmacies, the resulting market scale would be substantial.
Moreover, in addition to the favorable impact of electronic prescriptions, two other key focuses of healthcare reform—“not prohibiting the outflow of prescriptions” and “drug price negotiation mechanisms”—also have a profound influence on the business models of retail pharmacies.
The “Plan for the Division of Key Tasks among Departments to Implement the Guiding Opinions on Promoting the Healthy Development of the Pharmaceutical Industry,” recently issued by the National Development and Reform Commission (NDRC) and widely discussed within the pharmaceutical sector, explicitly prohibits medical institutions from restricting the outflow of prescriptions. It further requires medical institutions to issue prescriptions using the generic names of drugs, proactively provide prescriptions to patients, and safeguard patients’ right to choose where to purchase their medications.
With the implementation of prescription drug outflow from hospitals, offline pharmacies are the primary beneficiaries. Pharmacies will directly capture patient demand from those who no longer wish to purchase medications through hospital channels. Coupled with electronic prescriptions, this will generate a vast amount of data on medical services and medication usage, providing pharmacies with significant leverage in their negotiations with pharmaceutical manufacturers and substantially enhancing their bargaining power. If prescription drug pricing can be effectively guided, end consumers will also stand to benefit in the long run.
Meanwhile, this also revitalizes the internet-based layout of pharmacies. We have observed that many pharmacies are intensifying their efforts in O2O medicine delivery services, while numerous pharmaceutical companies are investing in pharmacies. These represent two of the most direct industry indicators: one demonstrates the diversification of pharmacy operations, and the other shows that pharmaceutical companies have recognized the impact of electronic prescriptions and prescription outflow on their businesses. The rationale behind proactively establishing a presence in pharmacies is to secure a direct-to-consumer channel.
From the broader context of deepening healthcare reform, both medical services and pharmaceuticals must be directly patient-centric, addressing patients’ needs for convenient access to care and rapid medication acquisition. The pathways to achieve this include deploying micro-consultation terminals in pharmacies and expanding the channels for obtaining prescription drugs. The former can supplement the scarce medical resources in public hospitals and better utilize the underutilized physician capacity in non-public hospitals, while the latter simplifies the distribution process for prescription drugs, thereby curbing intermediate costs.
In summary, pharmacies will play an increasingly vital role in the healthcare landscape. Urban pharmacies will serve as a robust supplement to medical care, while also providing consumers with convenient and affordable prescription medications. The only concern is whether pharmacies are adequately prepared to expand their service capabilities.