Buying drugs online? Check for PCN licence or risk counterfeit medicines — Ahmed, PCN boss

In this interview by Sade Oguntola, the Registrar and Chief Executive Officer of the Pharmacy Council of Nigeria (PCN), Pharmacist Ibrahim Ahmed explains what Nigerians need to know about online pharmacy and its importance in expanding access to quality medicines and strengthening Nigeria’s healthcare system.

Is online pharmacy legitimate or a scam?

An online pharmacy is legitimate if it is operated under the regulatory purview of the Pharmacy Council of Nigeria (PCN). The law establishing the PCN clearly recognises the fact that medicines can be accessed from different PCN-registered outlets (sources), one of which is the online pharmacy. The rise of online purchasing during COVID-19 significantly transformed various sectors, including the pharmaceutical industry.  Consumers began to access medicines through online pharmacies and e-commerce sites.  In fact, shortly after the COVID-19 pandemic, PCN engaged key stakeholders to develop the draft Online Pharmacy Regulation, 2021, which was approved by the Honourable Minister of Health and later gazetted by the Attorney General of the Federation and Minister of Justice as a key instrument for regulation of this practice. 

 PCN has since commenced inspection of facilities that engage in online sales of medicines to ascertain their compliance with the provisions of the regulations.  Such platforms must have a physical facility from which they are conducting their operations. During inspections, we take time to check the back end of their system to ensure that there are no unauthorised activities taking place in the background. So far, PCN has licensed a few facilities for online pharmacy, with others underway.

What are the main benefits of online pharmacy for Nigerians?

One of the benefits of online pharmacy is that it improves access to medicines. Through the online pharmacy platform, medicines can be made accessible to people where and when needed. This way, Universal Health Coverage (UHC) is guaranteed. However, those platforms working outside the regulatory oversight of PCN are most likely prone to the sale of falsified and counterfeit medicines. This certainly poses harm to public health.

How do you identify approved online pharmacies?

Very simple. We have the PCN license with the Federal Government Coat of Arms on each online pharmacy platform that is duly registered. The license must be displayed on the platform. The license is a clear indication that the site is duly registered by the PCN.

What type of medicines can you buy from an online pharmacy?

It ranges from over-the-counter (OTC) medicines to prescription-only medicines (POM), but excluding controlled medicines. Controlled medicines, such as tramadol, codeine preparations, etc., are not permitted to be sold online.

Do individuals need a prescription and/or online consultation to be able to order medications on these online platforms?

Yes, part of the documentation required for the supply of POM includes information like the name of the prescriber, the registration number of the prescriber and so on. 

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But is it possible to order discreetly without revealing the individual’s ailment?

Medication is not like any other commodity.  Definitely the prescriber must ask you questions and establish a diagnosis before writing out appropriate medicines for treatment.  It is only after that that the medication can be dispensed through the e-pharmacy platform.

Will the personal medical information of people patronising online pharmacies be kept confidential?

 Yes, we are currently developing a robust electronic pharmacy platform that would serve as a gateway for every online pharmacy to deliver medicines to a patient. That is what is obtainable in other climes, such as Ghana. The regulation recognises the regulatory oversight functions of different IT regulatory bodies such as the Nigerian Communications Commission (NCC), the Nigerian Data Protection Commission (NDPC), and the National Information Technology Development Agency (NITDA). They all have a role to play as regards confidentiality of patient data and safety of same.

Will buying drugs online make the medication cheaper compared to buying in local pharmacies?

Medications sold through the online pharmacy may not necessarily be cheaper.  After placing the order online, the patient could have the option of picking up the medication from the physical pharmacy or rely on the pharmacy to arrange for delivery through its logistic services.  It is expected that logistic arrangements could attract additional cost. 

Is there any way of getting complaints solved? Maybe the medicine is delayed, lost or seized after its purchase online?

 That is why you have the Pharmacy Council of Nigeria.  The PCN has the responsibility to investigate complaints and put in place appropriate sanctions if it is established that there is a breach of the regulations. We are also partnering with Interpol in the handling and processing of complaints.

Where a wrong medicine or generic brand is supplied, is there any way of getting one’s money back?

 There are ethical issues around the prescribing, dispensing and sale of medicines. Where such complaints exist, the client/patient should formally report to PCN.

What role, therefore, should licensed pharmacists play in ensuring patient safety with regard to online pharmacy services?

The pharmacist is expected to provide pharmaceutical care: counselling, documentation, medication therapy management, educating the patient on possible side effects, a mechanism for feedback, and so on.

At times, some prescription drugs become scarce, and getting to know the few pharmacies with their stock may be difficult. Do you see online pharmacies helping to ensure that this is no longer a challenge?

Yes, it is expected that if you log onto the PCN electronic pharmacy site platform to check for a particular product or brand, all the registered facilities online with that product will pop up. From there, you will be able to decide which facility you can buy from.

Once something is scarce in Nigeria, marketers increase the selling price to make more profit. Will these platforms not extort the people because the medicine is a bit scarce?

 No, it should not.

So, how do you see this sanitising the drug market to ensure Nigerians access quality and safe drugs?

 You are referring to the problem of open drug markets. I can put it to you that there is no country in the world where you walk into a market and see people selling medicines in the open market next to textile shops, groceries and so on. It is an unfortunate situation that has happened in Nigeria. However, I can attribute it to system failure. Those errors of the past have now been corrected, and we are now on the path of eliminating those challenges completely from our system.

 How did we get here? We got here because before now, the licensing of Patent and Proprietary Medicines Vendors (PPMVs) was undertaken through a delegated mechanism. The PPMVs are non-pharmacists who are authorised to sell over-the-counter medicines, especially in underserved and hard-to-reach communities.  The reason is because we have an inadequate number of pharmacists and healthcare facilities. Also, even the few healthcare facilities available are skewly distributed in favour of urban areas.

In the past, there was a time that the authority to issue licenses to these non-pharmacists was delegated to the local governments, while at other times, the authority was delegated to the state governments and later even the Federal Ministry of Health. Meanwhile, we have a Pharmacy Council that was established in 1936, which from inception has had the responsibility of regulating the profession of pharmacy and premises involved in the manufacture, importation, distribution and sale of medicines.  There were times, of course, that the authority was also delegated to PCN, but such times were characterised by resistance and several litigations by PPMVs.

In the course of these litigations, there were times that PPMVs secured injunctions against regulation by PCN, which sometimes lasted over a decade.  This provided an opportunity for the PPMV associations to transform themselves to become regulators and use such opportunities to grant approvals to their members to operate anywhere and anyhow without control.

Now, what is the good news? It is that, one, the new PCN Law has consolidated the regulation of PPMVs. That is number one. This implies that the regulation of this group is now exclusively going to be handled by the PCN.

Number two, the Presidential Committee on Pharmaceutical Sectors Reform (PCPSR) recommended the need for the Federal Government to develop the National Drug Distribution Guideline (NDDG) guidelines. These guidelines, which were developed by the Federal Ministry of Health through effective engagement with key stakeholders in the pharmaceutical sector, have clearly spelt out four levels of drug distribution in this country. The first level involves the manufacturers and importers; the second level are the distributors/wholesalers; the third level are the retailers; and the last level are the clients, the patients or the consumers. The NDDG has also provided a concept called Coordinated Wholesale Centres (CWC).

The Coordinated Wholesale Centres (CWC) are facilities where those operating in the open drug market would be relocated to. You may be aware that last year, in February, PCN and NAFDAC successfully closed down the Sabon gari market in Kano.

Those stakeholders who were operating in the Sabon gari market and adjoining plazas were successfully relocated to the Coordinated Wholesale Centre in Dangoro, in Kano. No drug is now sold in the open market in Kano. At Idumota, we are working assiduously with the stakeholders to relocate them to the CWC at Ijora, Lagos, which is actively under construction.

Similarly, a facility is currently being developed in a village called Ogba in Anambra State for the relocation of the Onitsha Head Bridge open drug market. The one in Ariaria would be relocated to Aba, Abia State. Meanwhile, the Imo stakeholders would be relocated to the CWC located in a village called Mgbidi. Our next target would be Agbeni Market in Ibadan, Kaduna/Zaria markets and Gombe open drug markets.

Mind you, in those locations called Coordinated Wholesale Centres, there is provision of offices for regulatory agencies, PCN & NAFDAC. There will also be a police station there. The facility will be duly inspected and registered by the PCN.  The operation of each CWC will be under the direct control of a superintendent pharmacist.

Is there anything else about online pharmacy practice in Nigeria that you feel is important but we have not discussed?

We have not touched the aspect of online consultation. Consultation is supposed to be by a registered medical practitioner. So, there is going to be a handshake between the platform for prescription and that for the sale and dispensing of medicines.

A word of caution for Nigerians, including pharmacy practitioners, on ensuring online pharmacy is not bastardised.

 The FMOH recently launched a National Electronic Pharmacy Policy (NEPP), which provides strategic direction for the regulation of online pharmacy. Also, to strengthen the regulation of online pharmacy operations, the 2021 regulations have now been updated and are now titled the Online Pharmacy Regulations, 2025.

 The public should not see the online pharmacy as just another platform to buy medicines. Currently, we have more unregistered than registered ones. So, it is only appropriate to first establish that the platform being patronised is duly registered and licensed by the PCN.