Super specialities in India include oncology, nephrology, organ transplant, rheumatology, gastroenterology, amongst others. Super specialist doctors primarily receive a Doctorate of Medicine degree (DM) which is completed after post-graduation in medicine (MD) and are experts in their speciality. Super speciality hospitals typically have DMs in multiple specialities that can work independently or in teams to treat complex cases.
Medicines for critical illnesses include chemotherapy and targeted therapy infusions for cancer, antiviral tablets for HIV and hepatitis, immunosuppressive medications for post-transplant rare, epoetin injections for severe chronic kidney disease, and a host of other medications to treat relatively rare but extremely complex conditions. The supply chain for these medications, till recently, was centered around hospitals and large medical institutions. General neighbourhood pharmacists and chemists often are not even aware of these medications, let alone have access to the supply.
The healthcare industry has undergone a renaissance with the emergence of online pharmacy, which is one of the revolutionary technological advances in recent years. Online pharmacies have made it easier for people to access medicines, especially for those living in remote areas where access to medical stores is limited.
Gaps and issues in access to critical illness medicines
Access to super specialty networks is still limited to metros and has recently expanded to tier-1 cities. The larger government-run hospitals that provide care for critical illnesses are primarily located in state capitals and are often overburdened beyond their capacity. As a result, only approximately 15-20% of India’s population has access to super specialty hospitals. The remaining patients from semi-urban and rural areas must make the journey to cities for diagnosis and therapy protocols from treating doctors. However, it is almost imperative for patients and caregivers to procure medicines from the city before they head back to their hometowns. Therefore, patients are left with two choices – buy all medicines till the next consultation or keep coming back often to the city to procure these medications. Both are expensive options.
The COVID-19 pandemic exacerbated this problem, leading to a drastic decline in the sale of super specialty medications for conditions like cancer and chronic kidney disease during the first total lockdown from March to May 2020. Limited access to large hospitals due to travel restrictions and the fear of entering potential “COVID hotspots” to procure medications led to a further decline in sales. The lack of availability of these critical medications during the pandemic highlighted the need for alternative methods of procurement and delivery to ensure patients have continued access to their medications, even in times of crisis.
Expanding access to super specialists in smaller towns and the supply of super specialty medications is a slow process due to high capital costs and as well as the preference of DMs to stay in the larger cities is delaying this transition. Carrying an inventory of super specialty medicines by all pharmacists is not practical due to the complexity of pricing, the rarity of diseases, and special storage requirements.
Emergence of online pharmacies
Enter online super speciality pharmacies! The problem faced by local chemists of finding patients in their catchment area is not one faced by online pharmacies, wherein the entire country is their potential catchment area.
Online super specialty pharmacies like MrMed started during the pandemic and have since then solved a problem faced by several patients across the country. At a time when Indian families were looted by agents for the drug remdesivir, MrMed provided the few vials they had at over 50% discount to genuine patients.
Through networks of supply chain distributors of these medications combined with efficient air and ground logistics, online pharmacies can provide lifesaving medications to patients across the country at the right time. Whether it be delivery of crucial antivirals to an Indian Army jawan in Srinagar, to providing guidance of the availability of patient assistance programs sponsored by a large pharmaceutical company to a cancer patient in Imphal to delivering cancer tablets by India SpeedPost to a patient in rural Andhra Pradesh – online pharmacies have provided an invaluable service in ensuring the accessibility to these medications are adhered to.
Another critical point to factor in when it comes to critical illness medications is the extremely high cost of therapy. By aggregating supply chains alongside direct procurement, online super specialty pharmacies can provide massive discounts (up to 85%) on these medications. Further, reliability in the transport of temperature-sensitive medications, easy refunds, easy payment options, and door delivery are the benefits that online pharmacies provide that are often not available to patients.
Online pharmacies can be a viable solution to address the problem of limited access to super specialty medicines in remote areas. They provide patients with a safe and convenient way to access their prescribed medications without leaving their homes. Overall, online pharmacies can help bridge the gap in access to critical medications.
Author is Co-founder of MrMed Online Pharmacy.
