Online Pharmacy Usage in India Before, During, and After the COVID-19Pandemic: A Systematic Review

Abstract

Online pharmacies have emerged as an important component of healthcare delivery, offering convenient access to prescription and
over-the-counter medications while transforming pharmaceutical services in India. This systematic review aimed to evaluate patterns of online pharmacy utilization in India across the pre-pandemic, pandemic, and post-pandemic periods and to identify factors influencing consumer adoption, associated benefits, challenges, and regulatory implications. A comprehensive literature search was conducted in PubMed, Scopus, Google Scholar, and ScienceDirect for studies published between January 2018 and March 2025. Following screening and application of predefined eligibility criteria, 16 studies were included for qualitative synthesis. Findings demonstrated that online pharmacy usage increased progressively over time, with the COVID-19 pandemic acting as a major catalyst for rapid adoption due to lockdown restrictions, fear of infection, and the need for uninterrupted access to medications. Convenience, home delivery, competitive pricing, and continuity of therapy emerged as the principal drivers of utilization, while integration with telemedicine services contributed to sustained post-pandemic use. Despite these advantages, concerns regarding counterfeit medicines, self-medication, inadequate pharmacist interaction, data privacy, and gaps in regulatory oversight remained significant challenges. The review indicates that the behavioral changes initiated during the pandemic have persisted beyond the public health crisis, establishing online pharmacies as an integral component of India's evolving digital healthcare ecosystem. Strengthening regulatory frameworks, improving pharmacist involvement, and promoting digital health literacy are essential to ensure the safe, effective, and sustainable growth of e-pharmacy services in the country.