A revolution in healthcare: The growing importance of e-commerce as part of the digital transformation of the healthcare system

Pharmaceutical e-commerce is a key element of the digital transformation of the healthcare system, a process that has accelerated in recent years. In 2023, the value of sales in the Polish e-pharmacy market reached PLN 1.892 billion (at retail prices) and was PLN 291 million higher than in 2022. Moreover, 333 on-site pharmacies reported their intention to also sell medicines by mail order.

Increasing numbers of people with chronic illnesses, an ageing population, and a growing awareness in the area of health and wellbeing mean that consumers are looking for more effective options than those available through traditional treatment regimens, and want convenient, accessible and personalised shopping experiences. The ability to easily compare prices, the discretion and privacy of online shopping, and the development of telemedicine further drive the use of online pharmacies. Taking into account the dynamic development of pharmaceutical e-commerce, IQVIA, a leading global provider of clinical trials, commercial analysis and health information for the life sciences industry and healthcare entities, in cooperation with the law firm Rymarz Zdort Maruta, has created the “Report: E-commerce in the pharmaceutical market 2024”, which analyses current phenomena and trends in this market as observed in Poland.

An online pharmacy (also called an e-pharmacy) is a standard community pharmacy that, in addition to its on-site activities, conducts mail order sales of over-the-counter (OTC) medicinal products (excluding products the dispensing of which is restricted as regards the age of the patient). In addition to medicines, customers can also purchase nutritional supplements, wellness products, personal care products and medical devices from an online pharmacy. Online pharmacies offer a larger number of pharmaceutical brands and international products than on-site pharmacies. Due to lower overhead compared to traditional pharmacies, they also tend to offer competitive prices.

“At IQVIA, we continuously monitor and analyse the pharmaceutical market. Over the past few years, our data has shown the growing importance of the e-commerce market for the Consumer Health segment, which includes OTC medicines, dietary supplements, medical devices and cosmetics. Sales in online pharmacies grew at double-digit rates during this period, with 2020 being a record year when the sales value growth rate reached 45%. In the following years, the sales growth rate slowed down, but was still double that of on-site pharmacies. Pharmaceutical e-commerce is part of a larger digital transformation in healthcare that is driving changes in consumer behaviour and expectations. We believe this trend will continue in the coming years and we will see further dynamic growth in this segment of the market”, said Daniel Flis, General Manager for IQVIA Poland.

Online pharmacies most often sell products for which purchases can be planned and that are not immediately needed by customers (patients), such as vitamins and minerals, cosmetics for women and other beauty-related items. Products in the baby food category, hair and skin care products and intimate hygiene products are also more popular with customers shopping online. The largest category in terms of sales value in traditional pharmacies, which is “cold and flu” products, only ranks sixth by sales value in online pharmacies.

The e-commerce market, thanks to its specific features, offers pharmacies unlimited geographical opportunities and scale of operation. Individual pharmacies can achieve several times higher sales in this segment than traditional establishments, and pharmacy chains can also reach regions where they do not have a physical presence. The number of pharmacies in Poland is steadily declining which results in worsening patient access to pharmacies and medicines. The largest players in the e-pharmacy market are gemini.pl and apteka-melissa.pl, which have maintained their positions for years. Other online pharmacies experience frequent changes and fluctuations in terms of their ranking. The increase in competition in the online pharmacy market slowed down in 2023, with fewer new players entering the market, which has led to a more concentrated market and shares: the five largest online pharmacies have a combined 64% market share, with the next five pharmacies accounting for an additional 20% share of the market.

Pharmaceutical e-commerce in Europe is diverse and depends on factors such as the regulatory environment, market maturity, digital infrastructure, cultural attitudes, level of e-prescription usage, reimbursement policies and cross-border sales. The online pharmacy market exhibits most of the trends observed in the entire pharmaceutical market in the area of OTC products, but their intensity may differ from that in the traditional pharmacy market.

“The online pharmacy market differs from the traditional pharmacy model. Legal restrictions, the conservative approach of supervisory authorities and the specific nature of trading in medicinal products mean that the launch of e-commerce sales of pharmaceuticals should be preceded by the introduction of measures to ensure the legal soundness of the business. As a leader in life sciences consultancy, we understand how complex and sensitive this segment is. We continuously monitor all trends and legal issues, on the Polish market and beyond, in order to best respond to emerging regulatory challenges and propose appropriate paths of action for those who plan to start or further develop their business”, said Tomasz Kaczyński, partner and co-head of the Life Sciences practice at Rymarz Zdort Maruta.

In 2018, the Supreme Administrative Court held that the sale of medicines by an online pharmacy through an auction portal violates the rules stipulated by the Pharmaceutical Law. In the opinion of the court, the legislature, by allowing community pharmacies to conduct mail order sales of OTC medicinal products, precluded the possibility of intermediation in the conclusion of contracts for the sale of medicines. Consequently, online sales models in which pharmacies sell medicines via auction/marketplace portals were held to be incompliant with the law. There was a shift in the approach of the courts in 2022, brought about by a ruling of the Regional Administrative Court in Warsaw. The court noted a change in Allegro.pl’s business model and held that the requirement to sell medicines directly via a pharmacy’s website is also met if it is a website provided by a marketplace/auction portal, as long as it serves as a standalone website (i.e. it has a unique URL). The judgment is not yet final and non-appealable.

In Poland, the sale of prescription-only medicines (marked as “Rx”) over the internet is currently prohibited by law. However, the authors of the report believe that a change in the law could improve the availability of medicines for patients, especially those who take medicines continuously or for long periods of time or who have mobility issues.

Patrick Wodecki, a senior associate at Rymarz Zdort Maruta, noted that “Poland has already implemented key solutions with regard to the delivery of prescription-only medicines, i.e. it has launched the e-prescription system and developed the Patient Online Account (IKP) programme, so the infrastructure necessary for the remote purchase of “Rx” medicines is largely in place. On the other hand, the delivery of these medicines raises concerns among some in the healthcare community, especially in the context of ensuring the quality of delivery of such products”.