US authorities crack down on remote prescribing of controlled drugs. Could the same happen in the UK?

According to a recent article from the Verge, the US' Drug Enforcement Administration has opened an investigation into Done Global Inc, a telemedicine start-up which provides remote diagnosis and prescription services. This follows on the heels of an investigation into Cerebral Medical Group, a similar telemedicine start-up. Both investigations relate to the prescribing of controlled drugs such as Adderall, which is an amphetamine-based combination medicine used for the treatment of ADHD.

According to the article, such start-ups are a relatively new phenomenon in the US. Before the pandemic, doctors were legally required to see a patient in person in order to prescribe a controlled drug. That restriction was relaxed during the pandemic for obvious reasons.

Such restrictions did not exist in the UK before the pandemic. Remote prescribing of medicines, including controlled drugs such as Adderall and even medical cannabis, was and still remains entirely legal, subject to regulatory controls. For instance, only certain healthcare practitioners are entitled to prescribe controlled drugs (the category of healthcare practitioners who are entitled to prescribe medical cannabis is especially limited), and all healthcare service providers (including telemedicine providers) are required to be registered with the Care Quality Commission (CQC). 

The CQC is the regulatory body which supervises healthcare service providers in England. It carries out regular audits to ensure that its activities and procedures comply with the law. 

Nonetheless, remote prescribing of all kinds did become much more prevalent in the UK during the pandemic, and the CQC and other regulatory bodies such as the General Medical Council released further guidance (some of it specific to controlled drugs) to help healthcare providers which were new to remote prescribing conduct it safely. 

Unsurprisingly, the increase in remote prescribing still led to a corresponding increase in improper access to controlled drugs. The CQC's 2021 annual report on "The safer management of controlled drugs" highlighted that there has been an increase in people taking advantage of remote prescribing services to fraudulently access controlled drugs. The same report also highlights concerns around controlled drugs going missing when dispatched by pharmacists for home delivery.

The CQC's 2021 report suggests that its focus remains on helping healthcare providers to improve the safeguards they use to prevent improper access to controlled drugs. We haven't seen any indication that it (or any other relevant regulator) is considering major investigations of the sort initiated by the Drug Enforcement Administration in the US. However, it will be interesting to see whether the investigations initiated in the US create an impact on the telemedicine sector which is felt over here in the UK.