The Bioethics and Law Observatory of the UB warns about the risks of online access to medicines and food

Made with the support of “la Caixa”, the report is coordinated by members of the OBD-UB M. José Plana, lawyer and co-director of the masterʼs degree in Food Ethics and Law of the UB; professor Manuel López Baroni from the University Pablo de Olavide (Sevilla), and Lluís Cabré, doctor and member of the Deontological Commission of the School of Doctors of Barcelona, as well as president of the Bioethics and Law Association. 

Online distribution of medicines and food, a public health issue

The report states that at the moment, it is easy to get medicines and food online, which can put individual and collective health at risk. The offer is usually canalized by a parallel market that allows the users to access illegal low-quality products, which involve risks for our health.

The report provides some examples, such as products with unauthorized substances, created in places without public control and made without sanitary guarantees; fresh food products that are sent by mail without any guarantee on fresh cold chain; food supplements made with protected plant varieties; vaccines and other products that are not abundant in traditional pharmacies (such as the vaccine for meningitis); and even fake products or stolen merchandise.

Regarding medicines, the report notes that “the lack of sanitary coverage or payment by Social Security encourages certain sectors of the population to access low cost channels”. It also says that “the illegal offering does not only cause damage to the users but also to public health, the health system, the owners of the brand and the usersʼ trust”.

Moreover, the report highlights the economic importance of the illegal food market, and notes that Europol affirmed that part of the groups that have been dedicated to sell medicines online illegally are leaving these products aside and opting now for the food market, which is bigger and less risky and in many cases the customer is not aware of the products being illegal”.

However, a significant contribution of this report is noting that these risky exchanges are not only done through a clandestine market but also via popular online platforms, although the rules of the platform do not allow selling medicines and they restrict the conditions of food sale too.

In some way, this happens because for the medical control authorities, “the online market is hard to control compared to the traditional one: the protocols designed by authorities and training of control staff and their teams are not adapted to the online market”. The authors defend that “the Internet cannot be a place for irresponsibility and impunity” and this requires “to extreme and diversify supervision initiatives for the online market to make it safer, while promoting responsible behavior for the consumers and economic operators”.

The authors identified that, in order to improve the security of the online market, it is necessary for the pharmacy offices and new online food companies to collaborate. In particular, they emphasize the fact that legal pharmacies do not always make a proper use of the European logo that identifies legal dispensation of medicines. OBC states that “medicines are not mere consumer goods and therefore, pharmacy offices are not just selling them, they are administering them”. The report highlights that medicines and their distribution “require safety, reliability and credibility standards. Their supply through pharmacies is part of the catalogue of guarantees”. These guarantees do not exist when the medicines are obtained outside the legal pharmacy.

Online paramedicine

The report also notes that “different types of alternative medicines, which are already a public health problem, find a fertile area in the online distribution”. Therefore, it notes that “We are supporting a phenomenon that sometimes is mixed with the offering of legal medicines with food supplements or homeopathic products, which makes the user believe all these products are scientifically tested”. The authors ask the legal online pharmacies to separate “the offer of health medicines and products from the parapharmacy ones and alternative medicine, to avoid putting alternative medicine and medicine products at the same level”.

Self-medication

In this sense, the report warns on the fact that the Internet favours the risk of self-medication, since “the existing information (…) suggest the users that they can self-diagnose their disease”, and regarding the chance of buying their products online, “the user not only self-diagnoses the disease but is encouraged to self-medicate”.

Unprotected personal data

There is a part dedicated to the usersʼ personal data for online pharmacies, to warn about “personal data that can be taken from the online dispensation can affect privacy more than any other online service”. The report notes that it is an essential step to present normative changes to allow online access to medicines with prescription.

Digitalization of retail food sale

Regarding food, the document talks about several initiatives in Europe that note these products have higher rates regarding the unfulfilling of food regulation when distributed online by 100 % online operators (which can reach 90 % in some sectors), and it suggests building a dialogue with the new operators of the food industry, platforms and authorities to guarantee online market safety on the fulfilment of the current regulation of manipulation, production and distribution of food products”.

As for food sale, the authors defend that the online food offer can be a potential dynamic of local and sustainable food systems, “to make the food system more universal, resilient and sustainable”, since it allows new operators to directly connect with consumers with no intermediaries

However, it also warns about its perverse effects, such as feeding monopolies (buying Whole Foods via Amazon, in the United States, is a good example), and affecting the environment (plastics are multiplied) and negative social and labour consequences (precariousness regarding warehouse workers and deliverers). Therefore, it suggests informing the users on the external aspects of buying online in this sense, the authors recommend to be aware “of the collateral effects of online shopping models on the food production and distribution system (…), and taking responsibility”.

Collaborative economy, medicines and food

The document also recommends “prosumer” citizens (according to the OBC, citizens who make products available for other citizens without being a professional of its distribution) to be aware of the legal and social responsibilities involved in putting food products in circulation.

Last, the authors note that in order to offer food products online -which cannot be used in time so that others can get them can limit food waste but doing so without the proper safety guarantees can put at risk the health of those who receive the food at home. They highlight the need to understand that offering medicines and health products through online platforms violates the applicable regulation and can bring important public health problems.