The issue of buying medicines online has exercised the pharmacy and wider healthcare community over the last decade. The Internet offers another choice to people who seek medicines, with or without a prescription, and many commentators have listed associated risks and benefits. In this review article, peer-reviewed literature and associated commentary are examined to illustrate the evolution of online pharmacy. Whilst it is recognised that the issues of counterfeit medicines and wider use of consumer medicines information on the internet are closely associated with this issue, these topics are beyond the scope of this paper. The material considered here reveals differing perspectives about consumer motivations and experience when buying medicines online. Negative perceptions of online medicines supply are reflected, such as the procurement of restricted medicines without a prescription, and the lack of information offered to complement the product. There is also a strong seam that documents good practice within online pharmacy, even from the earliest anarchic pre-regulation phase. Whilst the benefits of 24/7 access and privacy seem to be well substantiated, cost benefits are more contested. Despite evidence that some illicit medicine procurement occurs online, research contends that the main sources of diversion remain dealers, family/friends and legitimate medical prescriptions. Moreover, regulatory strategies – despite cynicism that the Internet could ever be regulated – seem to have had a positive impact for illicit controlled substances. Adequate consumer ‘ehealth literacy’ is necessary, alongside effective regulation, to minimise harm, but even the most recent research shows serious expertise deficits within the general population. Online pharmacy has a place in future medicines provision, and could explore its potential to provide cognitive services alongside medicines. Bricks-and-mortar pharmacies should reflect upon the value that they add to the transaction in order to avoid losing a younger ‘wired’ generation of future parents and carers.
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