The platform in question promotes online consultations to deliver treatment options and prescriptions. However, investigations by this newspaper uncovered a troubling process: customers pay for medication upfront, followed by a "free text diagnosis" by a doctor. This sequence undermines standard medical protocols of diagnosis preceding prescription. The text-based assessment lasts barely a minute, with video consultations requiring an additional payment of several hundred dollars. Worryingly, the platform collects personal information without verifying identities, enabling drug purchase with falsified information.
Medications should neither be taken nor prescribed casually. Rigorous regulation of medication access, particularly access to psychiatric drugs and cough syrups, prevents risks of abuse and large-scale circulation. Current laws in Hong Kong stipulate penalties of up to $100,000 and two years' imprisonment for the illegal possession or sale of prescription drugs. While the platform claims its operations are conducted entirely within safety parameters, the Medical Council's telemedicine guidelines clearly state that a doctor must have adequate knowledge of the patient's health before prescribing medication. It is warranted for the authorities to thoroughly investigate whether the drugs provided by the platform are prescribed by qualified doctors; if so, the involved doctors must be held accountable for any professional misconduct.
At the root of the issue is the inconvenience of obtaining prescriptions in Hong Kong. Public hospitals are plagued by lengthy consultation and dispensing procedures, while the high fees charged by private clinics deter many patients. Those with minor illnesses or chronic conditions requiring regular refills are understandably keen on more cost-effective and time-efficient options. The authorities must address these legitimate public concerns.
Many advanced economies have implemented systems that separate prescribing from dispensing, placing registered pharmacists at the centre of medication distribution. In the UK, for example, patients with common ailments can obtain prescription drugs directly from community pharmacies without a general practitioner's diagnosis. This model balances healthcare roles and prevents over-reliance on doctors. Yet, after more than three decades of discussion in Hong Kong, the separation of prescribing and dispensing has made no progress, facing resistance from private practitioners concerned about income loss and community pharmacists hesitant to expand their roles.
The SAR government has identified primary healthcare reform as a priority to alleviate pressure on the public system in the long run. Over two years ago, the Primary Healthcare Blueprint proposed leveraging community pharmacists for medication consultations and prescription refills, as well as drug dispensing by community pharmacies for public hospital patients. A pilot programme for community pharmacies is planned for late next year, with an initial goal of establishing five to six pharmacies in each district.
Driving progress in primary healthcare is critical. Building a robust network of community pharmacies and elevating the status and role of pharmacists require not only a well-conceived reform strategy but also the resolve to dismantle entrenched interests.
明報社評 2025.01.14：防止網上濫售處方藥 發展社區藥房便市民
有網上平台聲稱由醫生提供「線上文字診斷」，售賣處方藥物，但所謂的「診斷」極其簡化，反映法例有「漏招」之處，當局有必要跟進處理。由社區藥房為醫管局病人配藥，既可方便市民取得處方藥物，亦可減輕公院壓力，期待改革可以早日落實。
涉事平台聲稱透過線上問診服務，為患者提供治療方法及處方藥品。但記者實測，整個流程是先購藥付款，再由醫生提供「免費文字診斷」，顛倒了「先診症後配藥」的正常做法。其次，「文字診症」短短一分鐘，視像診症須加收數百元。另外，平台雖然要求提供個人資料卻沒核實身分，恐怕虛報資料也能成功購藥。
藥不能亂服，更不能濫開，精神科藥物和咳藥水等，更必須嚴格把關，以防濫用及大量流出市面。現行法例規定，非法管有或售賣處方藥物最高可被判罰款10萬元及監禁兩年。儘管涉事平台強調其處理完全在安全範圍內進行，但醫委會的遠程醫療指引明確提到，醫生必須充分了解病人狀況才可處方藥物。當局有必要徹查，涉事平台提供的藥物是否由合資格醫生處方；如屬實則須追究涉事醫生有否專業失德。
問題的根源在於現時病人取藥配藥過程不便。公立醫院診症及取藥程序冗長，私家診所則因診金和藥費昂貴讓患者卻步；如果只是小病，又或為長期慢性病配藥，病人希望有省錢省時間的「捷徑」可走，當局須回應市民的合理期望。
不少發達國家奉行「醫藥分家」，配藥和賣藥由註冊藥劑師負責。例如英國，一些常見病症的患者，毋須家庭醫生診斷，可直接從社區藥房獲取處方藥物。「醫藥分家」可收利益制衡之效，避免醫療系統過度偏重醫生，然而，香港醫藥分家談了30年，卻未見進展。有私家醫生認為禁止配藥會影響收入，亦有社區藥劑師不願跳出舒適圈。
特區政府推動基層醫療，盼可長遠減輕公營醫療系統負荷。《基層醫療健康藍圖》兩年多前出爐，建議探討社區藥劑師在藥物諮詢和覆診配藥方面的角色，以及社區藥房為醫管局病人配藥。當局希望於明年底推出社區藥房計劃，初步目標是全港每區有5至6間。
發展基層醫療事在必行。建設社區藥房網絡、提升藥劑師地位和角色，當局要有周全的改革計劃，更要有破除固化利益藩籬的決心。
/ Glossary生字 /
cursory：done quickly and without giving enough attention to details
preceding：happening before sth
deter：to make sb decide not to do sth or continue doing sth, especially by making them understand the difficulties and unpleasant results of their actions
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