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