Online prescription drugs are facing a policy vacuum, who will protect consumers' drug safety?

In this era of "everything on the Internet", more and more people choose to buy drugs online, including some prescription drugs that require a doctor's prescription
.
However, after investigating, the reporter found that the current online drug sales platform is very "convenient" to buy prescription drugs-even if there is no prescription from a doctor, the platform will "help" prescribe prescriptions and "help" consumers buy drugs
.
Zhao Peng, dean of the Institute of Rule of Law and Government of China University of Political Science and Law, said in an interview with a reporter from the Rule of Law Daily that the revised Drug Administration Law has clarified the attitude of liberalizing online sales of prescription drugs.
Relevant regulations and implementation rules for medicine and Internet diagnosis and treatment to ensure the safety of people's medication
.
You can buy prescription drugs online without a prescription.
In order to get rid of an advertisement, Jane Allie stayed up all night for several days, causing dry and itchy eyes.
She decided to buy a bottle of eye drops to relieve it
.
During the rush period, online shopping is naturally the best choice.
On a certain online drug platform, Jane Allie selected a "sodium hyaluronate eye drops" after a simple screening, but only found out that it was a prescription drug after submitting the order.
Need to fill in specific information for consultation
.
I have never been to the hospital due to eye diseases, and I will never have a prescription from a doctor.
With the mentality of giving it a try, Jane Allie chose "Dry Eye Syndrome" in the confirmed diseases of this medication after filling in her personal information.
"And "Used this medicine" options
.
After ticking the "Internet diagnosis and treatment risk notification and informed consent", the platform automatically jumped to the consultation interface for them, and the platform "doctors" asked them for consultation
.
A physician surnamed Lin did not even ask about the basic symptoms, so he sent multiple messages in the dialog box, including the two needs of "whether the user purchased the drug himself" and "are there any allergies or adverse reactions during use" The information filled in by the purchaser, but Jane Allie has not had time to fill it in.
The physician has "issued" an electronic prescription form, which not only contains the prescription number, but also the patient information, the name of the drug, the usage and dosage, and the physician's signature There are special chapters for hospitals and hospitals
.
In this way, Jane Allie, who has never been to the hospital to see the ophthalmology department, easily bought a bottle of prescription eye drops online
.
It's not uncommon for Jane Airy to be in this situation
.
Many consumers reported to reporters that online shopping for prescription drugs is very convenient, and the platform is also designed to fill in the information section very "intimately".
It will default to a certain common disease in the diagnosed disease.
Whether or not the drug has been taken and there is no contraindication The most "appropriate" answer is also automatically selected in the options such as symptom, presence or absence of allergic reaction
.
After that, the "doctor" will issue electronic prescriptions online, and the drugs will be shipped and distributed
.
In order to verify the actual situation, a reporter from the Rule of Law Daily bought the prescription drug Youjiale for the treatment of thyroid diseases on two online drug sales platforms
.
There is no obvious difference between one of the platforms and the process of purchasing ordinary drugs.
The difference is that when the order is submitted, it will prompt that the drug is a prescription drug and need to fill in the drug purchaser information registration.
After filling in the personal information and checking the confirmed disease, the platform will enter the physician During the review stage, no physician contacted the reporter.
One minute later, an electronic prescription signed by the physician and stamped with the official seal of an Internet hospital was "released," and the reporter successfully purchased the medicine
.
Another platform will jump to the interface for issuing electronic prescriptions after purchasing drugs, and online doctors will ask patients for consultation and prescribe prescriptions
.
However, the doctor’s question is limited to the most basic content such as whether the drug has been used, whether there is any adverse reaction, etc.
, and then an electronic prescription will be issued
.
The electronic prescriptions issued by the two platforms are also different in the filling of doctor information
.
On the electronic prescription issued by one platform, the signatures of the prescribing, reviewing, dispensing and distributing physicians are relatively complete; for the electronic prescription issued by the other platform, in addition to the signatures of the physician and the reviewer, the three columns of dispensing, verification and distributing are all Blank
.
It is worth noting that in the interface for filling in the consultation information, except for personal information that needs to be filled in manually, both platforms automatically list specific confirmed diseases based on the drugs purchased for purchasers to check
.
For example, when a reporter buys Youjiale, the list of diagnosed diseases includes options such as attenuation of thyroid function and thyroid cancer.
When purchasing "Angelsa Mesalamine Enteric-coated Tablets", the diagnosed diseases include colon ulcer, colitis, etc.

.
In the option of whether this drug has been used, the platform defaults to "Yes"
.
There are hidden safety hazards in online prescription drugs.
“In fact, sometimes even if you don’t have a doctor’s prescription, you know what you should take
.
” In the eyes of some consumers, the “relaxation” of prescription drugs on online drug platforms has brought convenience to drug purchase
.
But behind the hasty treatment of prescription drugs, the cost of life may be paid
.
In November 2018, a 22-year-old woman in Shanghai was poisoned by taking 200 capsules of colchicine at home and died
.
Colchicine is a drug mainly used to treat acute attacks of gouty arthritis and other diseases.
Because of its strong toxicity, it is listed as a prescription drug
.
Afterwards, it was found that women in the drug department purchased from 4 online pharmacies, and none of the 4 platforms required doctors’ prescriptions
.
Colchicine has been removed from the online drug sales platform.
The reporter searched for the keyword "colchicine" on many online drug sales platforms and found that it was out of stock
.
"Prescription drugs are drugs that can be dispensed, purchased, and used only with the prescription of a licensed physician
.
Such drugs usually have certain toxicity and other potential effects.
The method and time of medication have special requirements and must be used under the guidance of a doctor
.
" In Beijing According to Jia Renjie, a pharmacist in a tertiary hospital, prescription drugs must be treated equally, and no special attention should be paid to accidents caused by colchicine, and some prescription drugs that seem to have little side effects should be ignored
.
During the online drug purchase period, the reporter noticed that many platforms have launched promotional activities for prescription drugs
.
For example, a certain platform launched a prescription drug coupon discount activity, the higher the purchase amount, the more discounts
.
Jia Renjie believes that medicines are different from foods, and such promotion orientation may bury hidden dangers such as overdose or expired medicines
.
Zhizhi Law.
net supervises online sales of drugs.
In view of the particularity of prescription drugs, whether prescription drugs can be sold online has always been the focus of debate in the industry
.
In 2017 and 2018, the former State Food and Drug Administration successively issued two versions of the Measures for the Supervision and Administration of Online Drug Operation (Draft for Comment), both of which clarified that prescription drugs cannot be sold online
.
The revised Drug Administration Law, which came into effect on December 1, 2019, delineates the scope of drugs that are banned on the Internet, and prescription drugs that have been more controversial before are not included in the ban
.
"The promulgation of the law means that the country has gradually liberalized the online sales of prescription drugs
.
" Zhao Peng pointed out that the sales of prescription drugs have been concentrated in hospitals.
To some extent, it can improve this situation and promote transparency in drug prices
.
The Drug Administration Law also puts forward some principled requirements for online sales of prescription drugs
.
For example, the drug sales network must be interconnected with the information system of medical institutions, and information must be shared to ensure the authenticity of the source of prescriptions and ensure the safety of patients' medication
.
In November 2020, the National Medical Products Administration issued the "Measures for the Supervision and Administration of Drug Online Sales (Draft for Solicitation of Comments)".
Compared with the previous two versions of the draft for solicitation of comments, the draft for this consultation set forth the conditions for the opening of online sales of prescription drugs
.
As stipulated in Article 9, pharmaceutical retail companies that sell prescription drugs through the Internet shall ensure that the source of electronic prescriptions is authentic and reliable, conduct prescription dispensing reviews in accordance with relevant requirements, and electronically mark used prescriptions
.
However, for various reasons, measures for the supervision and management of drug online sales have not yet been issued
.
In the opinion of medical expert Shi Lichen, after the release of online sales of prescription drugs, detailed operation and supervision policies have not been introduced, resulting in the current field still in a policy "vacuum period".
Brings difficulty
.
"The main reason for the current problems is that the regulatory capacity has not kept up with the regulatory needs in the Internet environment, and the corresponding system should be introduced as soon as possible to regulate
.
"In Zhao Peng's view, the supervision of online prescription drugs is not a matter of the Food and Drug Administration alone.
Among them, doctors receiving and prescribing prescriptions involve Internet diagnosis and treatment.
The Health Commission should also issue corresponding operating regulations as soon as possible to strengthen Internet diagnosis and treatment standards
.
10 this year On the 26th, the National Health Commission issued the "Internet Diagnosis and Treatment Regulations (Draft for Comment)".
One of the important regulations is that doctors need to be authenticated by their real names before receiving consultations to ensure that they are received by themselves, other personnel, artificial intelligence software, etc.
No fraudulent use or substitution of doctors to
receive medical treatments.
Shi Lichen has conducted investigations on some online drug sales platform doctors, and found that in the dialogue window, apart from the doctor’s name and profile picture, there is no other information displayed, such as a practicing doctor’s qualification certificate, etc.
This makes consumers lack the ability to distinguish these online doctors, and from the response speed of some doctors and their response skills, most of them are replaced by artificial intelligence systems
.
Inquiry, such as existing symptoms, time of medication, etc.
, rather than replacing them with fixed questions
.
These measures can guarantee to a certain extent that'real people' doctors receive consultations and prescribe prescriptions
.
Shi Lichen believes that the online drug sales supervision and management measures and the Internet diagnosis and treatment supervision rules should be promulgated as soon as possible to tighten the "legal network" and regulate the online sales of prescription drugs from the system level
.