Debra O'Connor, Consumer Representative, General Practice Computing Group; and Matthew Blackmore, Executive Director, Consumers' Health Forum
Joel Lexchin's article highlights two of the many risks for consumers in obtaining prescription medicines or drug information from the internet. The first risk is the blurring of promotional information with balanced objective information on suppliers' web sites. This can mislead consumers and expose them to the second major risk, internet supply of prescription medicines with no or limited 'virtual' medical advice.
If advertising is not seen for what it is, consumers will be hard pressed to distinguish it from balanced information. It is always difficult to know if information on the internet is balanced. Given recent Australian experience in other arenas (Crimenet, internet gambling) regulation of the internet is unlikely.
Consumers need to know how to minimise the potential problems of obtaining information and medicines from the internet. Some consumer groups and other researchers have begun developing criteria to assist consumers to evaluate the health information they obtain from the internet. For many consumers, discussing the information they find on the internet with their doctor will be an important check.
The development and promotion of 'authoritative' web sites is equally important. At a national level, the development of 'HealthInsite'1 as an internet 'portal' by the Department of Health and Aged Care, is a welcome development. HealthInsite 'endorses' sites so that consumers can be certain of the quality of the information. However, more resources will be needed to ensure that valuable information from the consumer movement is available through HealthInsite.
The article does not mention alternative therapies. This is an area where there is less stringent regulation. Misleading or insufficient information from suppliers may therefore present even greater challenges for consumers, particularly where health care providers may be unable to act as informed advisers.
Obtaining prescription medicines through the internet without the need to see a doctor can be a risk for consumers. However, doctors are not necessarily excluded from helping consumers to benefit from electronic commerce and may be able to assist consumers to minimise the risks. In Australia general practitioners are already using electronic prescribing and there are trials of electronically transferring prescriptions to a pharmacy. This could lead to 'virtual' pharmacies in future with potential benefits for consumers. People isolated by their age, illness or distance would not have to take their prescriptions to a pharmacy; the doctor could e-mail the prescription and the medicine could be delivered to the patient's home.
Purchasing medicines through the internet could also make it easier for consumers to shop around for cheaper medicines. This would be a welcome development for people with high medication costs due to chronic and complex conditions. Internet prescribing can also inform doctors and patients about medicines that are not available in Australia and allow them to consider all the options.
Consumers value effective face-to-face communications with trusted health professionals about treatment options and how to use their medicines appropriately. The reluctance of some health professionals to provide advice and consumer medicine information may have undermined consumers' perceptions of the value of that interaction. However, the internet is only a supplement to personal communications with health care providers and not a replacement.
