Vending machine offers access to controlled drugs

The Pharmacy Department at Changi General Hospital (CGH) in Singapore is always coming up with technological solutions to automate medication management, drug safety and patient guidance. CGH’s latest innovation is called Pharmacy Smart Interface System (PharmaSIS), a smart vending machine in Singapore that offers access to drugs sold exclusively by pharmacies and also provides teleconsultation to a pharmacist.

“CGH’s strong dedication to innovation is rooted in our pharmacy team. We continuously explore and implement smart solutions to connect with patients and enhance health and medication care and guidance measures, with the goal of optimising health outcomes for patients and helping them stay healthy,” says Dr Jonathan Seah, director of pharmacy at CGH.

According to Singapore regulatory requirements, controlled drugs can only be purchased under the supervision of a pharmacist. CGH’s solution facilitates the purchase of medicines in this particular class by having a pharmacist available between 9am and 6pm on weekdays who can guide the consumer through teleconsultation. The professional will evaluate the patient before making recommendations on the appropriate medicines.

CGH is also exploring the possibility of extending teleconsultation hours. PharmaSIS also offers a variety of over-the-counter medicines that will be available 24 hours a day. In addition, products such as hearing aid batteries and other audiology items will also be sold

According to CGH, as part of the development process, the hospital’s pharmacists rigorously tested each step, considering the safety of medicines and the confidentiality of consumer data. PharmaSIS received approval from the country’s Health Sciences Authority in April 2023.

To ensure the safety and quality of the medicines, PharmaSIS is installed with due care. For example, they are stored in a controlled environment that automates temperature and humidity control. Real-time videos allow the pharmacist to monitor the process to ensure that the correct type and quantity of drugs are dispensed from the vending machine. Key information about over-the-counter medicines is also displayed on an interactive screen to assist consumers in drug selection.

CGH plans to deploy PharmaSIS machines in community centres in Simei City and in CGH’s community nursing posts to support nurses in their tasks.

Digital evolution of pharmacies

For Nadeem Sarwar, who founded Phlo Technologies in 2017 in his home city of Glasgow and is now one of the UK’s leading providers of B2B pharmaceutical services and direct drug delivery, the much-needed digital transformation needs to take place in this sector that is one of the most essential to people but has lagged behind in the digital health revolution. According to the executive, the main challenge is to demonstrate that the traditional pharmaceutical experience consolidated decades ago can be successfully digitized, as is the case with other parts of the healthcare and consumer sector.

When asked how he sees the future of technology in healthcare, Sarwar said that in order to survive in an increasingly competitive market, health technology companies will need to meet the demands for personalized, on-demand services. Patients, on the other hand, will always seek ease of use at all points of contact with service providers and sales centres.

In the specific case of pharmacies, paper prescriptions, inefficient drug release processes and long queues need to become a thing of the past. Phlo Technologies addresses two problematic points in this scenario. With Phlo Digital Pharmacy, it acts in delivering prescription drugs on the same day as the request. The second product, Phlo Connect, provides infrastructure for digital pharmacies.

Dark pharmacy

One model that has been gaining space in Brazil is that of the dark pharmacy. Similar to what happens with dark stores or dark kitchens, the idea is to be a fully digital business that only manages distribution centers for purchases made online to accelerate deliveries and reduce operating expenses and, consequently, the price of products.

Also in this segment, the challenge has to do with the consolidated culture of physical pharmacies, especially in large chains. To overcome this barrier, it is necessary to show the advantages of digital processes. Another obstacle is the regulatory issue. In Brazil, it is the National Health Surveillance Agency (Anvisa) that has the competence to supervise the distribution and sale of medicines and cosmetics by pharmacies, among other health products. The dark pharmacy model is not currently regulated, however the pandemic paved the way for flexibilization initiatives such as digital prescriptions, telemedicine and online sales of controlled drugs. Since then, Anvisa has been discussing good pharmaceutical practices for sanitary control and marketing of products, among other topics. The discussion is not directly linked to the dark pharmacy model, but about the remote marketing of medicines and the operation of e-commerce sites.