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'It's too late for regulators to ban online prescribing - but we can make it safer'

Linda Scammell, senior policy advisor at the MHRA

We don’t have the power to ban online prescribing yet, but we are working hard to monitor the issue and work with appropriate bodies to make sure that will change. Patient safety is our absolute priority.

The MHRA does not regulate prescribing - we are responsible for the sale of medicines – but we are concerned about patient safety and are working with partner regulators to map the regulatory landscape in UK and identify gaps.

All the main UK regulators got together to have to have serious interagency conversations after the death of a man in Brighton. He was already addicted to dihydrocodeine and his GP was restricting his prescription, and when the police did their enquiries his GP said I didn’t prescribe them and questions started to be asked. He had bought them online. He was prescribed dihydrocodeine by a doctor not in the UK, the doctor was in Eastern Europe.

This isn’t the only one but they are not put in the public domain until the coroner has received the answer from the relevant organisation. There are two cases in the public domain but we have seen more.

By law, a doctor registered in the EEA can prescribe to patients in the UK. Subsequently, British registered pharmacies can then dispense these drugs to patients with a valid prescription. The mutual recognition of healthcare providers was something we all decided back when making decisions about EU member states.

What was not envisaged was the internet would come along and people would be able to consult with a doctor in Bulgaria or anywhere but that’s about prescribing and that is not something we regulate. Nobody does. The CQC are restricted to regulating providers where some part of the activity is in England and the GMC regulate GMC registered doctors. But the pharmacy who dispense the prescription would have to do certain checks and the GPhC has guidelines about checking the ID of the patient etc.

We have GPs writing to us saying it’s your fault, because you allow medicines to be traded online but that’s only a small part of the picture. It is helpful that doctors voice their concerns about it. It adds influence if GPs themselves are saying ‘is that right that someone can prescribe opioids to someone they have never met?’.

All medicines no matter what category are available online in the UK but this is not widespread [in Europe]. Only six member states allow prescription medicines to be traded in this way and 22 do not. If you’re in France you cannot buy prescription medicines online but you could buy them from the UK. The patient is buying something from a country that allows it when they are in a country that does not

If we don’t allow it, like in France and Spain, citizens will buy it elsewhere. I think it’s too late, that train left the station many years ago and it is in no-one’s interest to pull that back but it is all about making it a safer environment.

Lynda Scammell is senior policy advisor at the MHRA and she was speaking to Emma Wilkinson. This article was updated at 11am on 5 April 2018

Readers' comments (5)

  • pathetic lack of grip, sack them and install me as 'Grand Inquisitor'
    oops, time to take the on-line risperidone again

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  • 'the train has left the station'! What nonsense. On-line prescribing and trading in Britain CAN be banned. We have as much sovereignty over this in Britain as the French do in France!
    And, er, buying over the internet from another country, well that requires a Controlled Drugs Import Licence, annual inspection costing thousands of pounds, and all sorts of burocracy. (yes, I can, but I can't be bothered).
    Here is somewhere where government can reduce the death toll of unregulated supply, and the GMC could actually do something useful regarding prescribing.
    And what's that about it not being in Britain? if the patient is in Britain, then the doctor and company are prescribing/selling in britain, and are subject to British Law, and the GMC has links to other European Countries' Registration bodies.
    It's simples really.

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  • AlanAlmond

    Absolutely pathetic. How convenient you believe there’s nothing you can do! Put your feet up and blame someone else. There’s always something that can be done, if you don’t think so you shouldn’t be in your job, really you shouldn’t. Use your brain, get creative, think of something you CAN do! I’m gobsmacked by the shoulder shrugging passivity of this article. With this sort of attitude coming from medicine regulators no wonder people are dying from inappropriate use of medicines. Limp beyond belief.

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  • Idiotic. Of course it can be banned. Unless it is a physical impossibility then we are choosing not to ban it. An organisation may not have the power to ban it, in which case we need to go above them. And make sure the online doctor is extradited and charged with manslaughter, actually appropriate in this situation unlike poor dr BG

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  • On-line prescribing makes a mockery of everything we do. Antibiotics, CDs ...if this is the attitude we may as well all pack up and go home.

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