ArticlePLOS global public health2025
The good, the bad, and the ugly: Compliance of e-pharmacies serving India and Kenya with regulatory requirements and best practices.
Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The trial behind it
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Who cites it
2 citing papers in PubMed.
- Variation and gaps in online pharmacy regulation: a comparative review of regulations across 12 countries.BMJ public health · 2026Article
- The effect of electronic prescription systems on pharmacy performance through evaluation of existing infrastructure in Kerman Iran.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
As with most technology-driven change, e-pharmacy markets have expanded faster than the pace of regulation, particularly in low- and middle-income countries. We developed and applied a checklist to assess compliance with best practices and regulations by e-pharmacies serving clients in India and Kenya, two countries with contrasting regulatory environments. We defined e-pharmacies as businesses selling prescription-only medicines directly to consumers through websites or apps. We identified the universe of e-pharmacies through online searches, and captured data using a structured questionnaire (Jan-May 2023). We then assessed e-pharmacies against a set of global 'best practice' standards, as well as national regulations (for Kenya) and 'proposed requirements' from local guidelines and draft bills (for India, which had no e-pharmacy-specific regulations). We identified 61 websites and 37 apps serving India, and 26 websites and 3 apps serving Kenya. Regarding best practices, a facility to upload prescriptions was provided by 90% of websites serving India and 58% serving Kenya. Only 16% (India) and 42% (Kenya) provided complete drug information. On average, websites serving Kenya met 8.9 of the 12 (74%) Kenyan regulatory requirements, while those serving India met 7.5 of the 14 (54%) 'proposed requirements'. Only 31% serving Kenya and none serving India displayed required registration numbers. Contrary to regulations/guidelines, many e-pharmacies serving Kenya (62%) and India (34%) listed narcotic/controlled drugs for sale. In both countries, high-traffic websites and e-pharmacies located within the study country had higher mean compliance to regulation and best practices compared to the others. These findings can be leveraged to strengthen enforcement in Kenya and inform the development of a comprehensive regulatory framework in India. We recommend a risk-based regulatory approach, where regulators work with the largely compliant ("good") e-pharmacies, improve enforcement among the partially compliant ("bad"), and eliminate the largely non-compliant ("ugly") from the market.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.