New Delhi: The Union health ministry has decided to regulate online sale of medicines across India, setting rules for a channel that health officials say will improve patients' access to medicines but faces opposition from brick-and-mortar retail chemists.

A ministry notification released this week specifies the registration requirements for e-pharmacy outlets. It stipulates the rules governing adherence to and the preservation of prescriptions while allowing online sale of all medicines except narcotics, psychotropic drugs, tranquillisers and other drugs classified under Schedule X.

An e-pharmacy portal will need to keep information about customers and prescriptions confidential but could be called on to furnish such data to the central or state governments for public health objectives. The data generated or mirrored through e-pharmacy portals must not be sent or stored outside India.

"Online sales are expected to improve patients' access to medicines. Stocks of specific medicines may not always be available with neighbourhood chemists, and aged people may find it difficult to go to chemists' shops," said Eshwara Reddy, Drug Controller General of India, who heads the Central Drugs Standard Control Organisation, the apex regulatory agency for medicines. "Online transactions will also be easier to track and monitor."

Some health officials believe that competition through online sales may also help lower the retail costs of medicines if the competitors decide to give up slices of their own margins.

The proposed e-pharmacy rules - open for public comments for 45 days - will require e-pharmacy portals that receive prescriptions to verify the details of patients and doctors, and dispense drugs as instructed on the prescriptions. The portals will need to preserve the prescriptions.

India's pharmaceutical market is expected to grow annually at nearly 16 per cent to reach $55 billion by 2020 from $30 billion in 2015, a report from the Federation of the Indian Chamber of Commerce and Industry and Frost and Sullivan has predicted.

The report also predicted that the e-pharmacy model could account for 5 to 15 per cent of total pharmaceutical sales in India, largely by "enhancing adherence and access to medicines" for underserved populations.

However, the All India Organisation of Chemists and Druggists (AIOCD), an association representing over 600,000 brick-and-mortar retail pharmacy shops and drugstores across the country, says it is opposed to online sales of prescription medicines.

"How will e-pharmacy portals be able to verify the authenticity of either patients, medical practitioners, or prescriptions?" asked Suresh Gupta, former general secretary of the AIOCD, which says online sales without reliable verification mechanisms may facilitate the illegal sale of prescription drugs.

Sections of pharmacology experts have also worried about interactions between two or more drugs. "About 8 per cent of all adverse effects result from interactions between drugs taken at the same time," said Supriya Malhotra, a professor of pharmacology at the NHL Municipal Medical College, Ahmedabad.

"Drug interactions are something that doctors themselves should keep in mind before prescribing drugs - the need to ask patients what else they are taking," Malhotra said. "There is commercial software available today that can quickly caution doctors about potential interactions. Online pharmacy outlets should also ask patients about other drugs they might be taking."