THE CMG VOICE

A la carte medicine may be in your future

We have generally become accustomed to depending on a doctor’s prescription to acquire medications, but what if we can just order these medications online? That is the model being applied by several websites that distribute certain medications after a few clicks of the mouse. Instead of relying on a doctor’s prescription, the sites depend on something more akin to a doctor’s endorsement of a patient’s request. These platforms promise to treat, or purport to treat, things like erectile dysfunction, libido, hair loss, or anxiety. Sometimes they promote off-label (non FDA-approved) uses along the way. As with any advances in technology and medicine, they have inspired curiosity from consumers, investors, and reporters.

While these platforms tout, in part, claims of convenience for consumers, the model seems fit for exploitation. New York Times reporters navigated websites to quickly acquire medications with bare minimum interaction with medical professionals, and in some cases no counseling whatsoever about drug interactions. And on the one hand the model may seem consistent with efforts towards highly individualized medical care, but the arrangement begs questions of appropriate levels of oversight both from medical professionals and regulators. These sites distribute medications dependent on patient self-reporting and without any physical examination. It is often unclear where in the process the physician decision-making takes place.

The interaction between customer/patient and physician raises questions of whether the platforms are providing health care or simply delivering products to consumers. As health care providers, they would be subject to closer scrutiny by, for example, the FDA, and state medical commissions. While they contend they are not health-care providers, the reporters’ research demonstrated that several of the sites appear intertwined with health providers.

As the healthcare landscape continues to evolve, we can expect to see more of these types of sites. And the amount of investment being made into the sites indicates that many see a future in this model.

There are risks however. What if a consumer orders a medication that a reviewing doctor would see is clearly unsafe for one reason or another, and that consumer is harmed? Who is responsible? Would that constitute practicing medicine without a license?

To be clear, our intention is not to promote scrutiny for scrutiny’s sake; instead, close attention should continue to be paid to the societal cost and benefit of expediting segments of consumer medical care.

You can read the New York Times article [here](https://www.nytimes.com/2019/04/02/technology/for-him-for-hers-get-roman.html)