Earlier this month, Amazon Pharmacy became a registered trademark in the UK – raising the prospect of a UK online pharmacy launch, as we have seen in India and the US. But just how worried should community pharmacists be by the tech giant’s move into the pharmaceutical sector?

From his viewpoint, Darrin Baines, professor of Health Economics at Bournemouth University, first employs an analogy to describe the difficult situation that community pharmacy may be facing.

Amazon Pharmacy is a bit like a car and community pharmacy is like a horse-drawn cart. People are trying to compare them as if they are the same thing - but they are not. They are very different vehicles serving very different purposes. The main problem lies here: if the car works well, understandably no one is going to want to use a horse-drawn cart anymore.

But, if you truly believe - as many pharmacy professionals do - that pharmacy is more than a dispensing service, then you should not worry about people choosing the car over the horse-drawn cart.

Over the last few years, the community pharmacy sector has been promoting the clinical aspect of pharmacy through an ever-growing variety of pharmaceutical services and clinical training of pharmacists.

Face-to-face clinical services are not something that Amazon Pharmacy is likely to want or be able to provide.

General practice online

The biggest concern for community pharmacists is general practice moving online - which we can already see happening.

Logistically, if people are not visiting their GP surgery they will not be walking past their local pharmacy and so won’t be nipping in for that prescription or OTC medicine - footfall will drastically drop. This is when Amazon comes in - to fill a void like it always does.

People will not want to make the journey to their local pharmacy if they can see their GP online. Instead, they will order their medicine online too and get it delivered to their door within hours. This suggests that when all the surgeries go, pharmacies, as we know them, will go too.

This model of Amazon Pharmacy does not affect the clinical aspirations of community pharmacy. However, as of yet, pharmaceutical care hasn’t proven itself.

'Surviving the online revolution'

We are in a lazy economy, which is only getting lazier. It is now uneconomical for people to wait for customers and patients to turn up to their shops in person, and it's just as uneconomical for people to visit shops.

Picture this: someone is sitting on their sofa, watching Netflix having ordered their food off Deliveroo. They have an Apple health monitor attached to their wrist when Alexa suddenly notices they sound depressed. In response, a virtual pharmacist pops up on their phone to say: ‘We’re just about to send you a tablet to try, this should help with your low mood.’ This is potentially where we are heading: a world which requires minimal effort.

The pharmacy profession believes that pharmacists must always be part of the dispensing process – that it’s unsafe to provide medicines unless there is a pharmacist around to oversee. My argument would be – could artificial intelligence do that job?

Pharmacies are like community drug storehouses. But we have to think, where are drugs best stored? Companies like Amazon may be better equipped to supply large loads of medicines, which can then be quickly distributed to patients around the country in a matter of hours.

Banks are shutting down many of their high street shops, they’re moving everything online because it makes more economic sense.

Perhaps another way of looking at this modernisation is to work out how community pharmacy can work in conjunction with Amazon Pharmacy.

It is likely that Amazon will be able to collect data that they could provide to organisations with lots of patients. So pharmacies could potentially go to Amazon, set up a deal where Amazon dispenses medicines to their patients and in return the organisation provides the pharmacy with the data necessary to then provide relevant clinical treatments to patients.

If you truly believe pharmaceutical care is the future of pharmacy, pharmacy needs a big organisation like Amazon behind it to do all the non-clinical work so that pharmacists have the time to provide the services they so desperately want to and need to, in order to survive the online revolution.

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