Contents

Chapter 1: Mail Order and Internet Pharmacies in Europe…….1
Table 1: Number of Internet Users Compared with total B2C e-commerce in Europe’s Main Markets…………………………………………………………………………………………1
Graph 1: What types of products US consumers buy online…………………………………..2
The position of Mail Order and Internet Pharmacy in Europe………………………………..3
Graph 2: Turnover percentage shares in the European mail order non-prescription pharmacy market in 2015 by country……………………….……………………………………………3
Graph 3: Turnover share in € millions in the European mail order non-prescription pharmacy market in 2015 by country……………………..…………………………………………….3
Mature, developing and entry-level European Mail Order Pharmacy markets………4
From ‘Pure play’ Pharmacies to Omnichannel Drugstore Chains…………………………..4
Table 2: Non-prescription and Prescription only Medicines Status for Mail Order and Internet Pharmacy in European Countries under Study………………………………….5
The Legal Status of Mail Order and Internet Pharmacies in Europe………………..6
History of the Legal Status of Mail Order and Internet Pharmacies for Medicines in Europe……………………………………………………………………………………………………………..7
European Measures against Dubious Mail Order Pharmacies……………………………….8
Different Models…………………………………………………………………………………………………10
Table 3: Key Characteristics of the different Types of Mail Order and Internet Pharmacy in Europe…………………………………………………………………………………………….11
Traditional Independent Pharmacies in Europe with Online Services…………………..11
‘Pure play’ Online Mail Order Pharmacies in Europe……………………………………………12
Top ‘Pure play’ Pharmacy e-commerce Websites in Europe…………………………………13
Graph 4: Leading ‘Pure play’ Mail Order and Internet Pharmacies in Europe – based on estimated € Turnover for 2015……………………………………………………………..13
Online Consultation Pharmacies in Europe………………………………………………………….15
Table 4: Legally Operating Online Doctor Consultation Services in Europe 2016…..16
Pharmacy Chains Multi-channel and Omnichannel retailing in Europe………………..16
Pharmacy chains with Multi-channel Strategies in Europe…………………………………..17
Online Pharmacy Portals Linking Independent Pharmacies in Europe………………….19
Online ordering for Non-pharmacy Pick-up Points in Austria and Germany…….……20
Table 5: Mass Market Retail Chain Partnerships with Mail order and Internet Pharmacy Partners………………………………………………………………………………………………21
Conclusions – The rise of the omnichannel giants and a uncertain future for‘pure p lay’ and independent operators…………………………………….…………………………22

Chapter 2: Mail Order and Internet Pharmacies in the US……24
VIPPS accreditation programme………………………………………………………………………….24
Americans Seeking Health Information Online…………………………………………………….26
Graph 1: US Consumers Seeking Information about Health Online……………………….26
Table 1: US Consumers Purchasing Healthcare…………………………………………………….27
Share of the US Pharmacy Market by Channel…………………………………………………….27
Graph 2: How the US Market for Prescription Medicines and OTC Health and Personal Care is divided between Retail and Mail Order Channels………………………28
Prescription Pharmaceutical Market in the USA………………………………………………….28
Graph 3: % Share of the US Prescription Pharmaceutical Market by Channel 2015………………………………………………………………………………………………………29
Table 2: % Value Turnover Share of the US Prescription Pharmaceutical Market by Channel 2011 to 2015……………………………………………………………………..…29
USA – Mail Order Service – Pharmacy Benefit Managers (PBMs)……..…………………..29
Graph 4: USA – % Growth of Mail Services Channel 2011 to 2015………………………..30
The Role of Pharmacy Benefit Managers and their Influence on the Development of Mail Order and Internet Pharmacy in the US…………………………….31
Figure 1: The Role of Pharmacy Benefit Managers (PBMs) in Processing and Reimbursing Prescription Medicine Claims in the US……………………………………………32
Graph 5: Market share of leading US Pharmacy Benefit Managers (PBMs)……..33
Express Scripts…………………………………………………………………………………………………….34
Graph 6: Express Scripts’ Mail Order/Speciality Pharmacy Business 2013 – 2015…………………………………………………………………………………………………………34
CVS Health………………………………………………………………………………………………………….35
Graph 7: Sales at CVS Pharmacy Services division 2013-2015………………………………36
Consumer Healthcare and Personal Care Market………………………………………………..36
Graph 8: US OTC Health and Personal Care Market % Share by Category…………….37
Graph 9: US OTC Health and Personal Care Market % Share by Retail Channel……37
Table 3: Beauty and Personal Care Top Destinations for Online Shoppers…………..38
Chain Drugstores in the USA………………………………………………………………………………38
Table 4: US Leading Drugstore Chains – Net Revenues by source………………………..38
Table 5: US Leading Drugstore Chains – % Share of USA Prescription Medicine Dollars……………………………………………………………………………………………………………….39
US Drugstores’ Omnichannel Retail Strategies……….………………………………………….39
Graph 10: US location-based signal technology – In-store use of smartphones 40
Walgreens and the evolving Omnichannel retail model……………………………………..40
Walgreens’ Omnichannel Pharmacy Experience…………………………..…………………….41
Walgreens Drugstore.com acquisition and shut down……….……………………………….42
Sam’s Club Example of using mobile apps and tablets for scanning QR Codes and receiving E-values Discounts…………………………………………………………….42
Online Consultation Pharmacies…………………………………………………………………………42
Conclusions – Mail Order and Internet Pharmacy in the USA……………………………..43

Chapter 3: Mail Order and Internet Pharmacies in Germany…………………………………………………………………………….44
Graph 1: Top e-commerce Countries in the World………………………………………………44
History of Mail order and Internet Pharmacy in Germany………………………………….44
Mail Order and Internet Pharmacy Landscape in Germany………………………………..45
Turnover of the German Mail Order Pharmacy Sector by Product Group…………..46
Internet Access in Germany……………………………………………………………………………….47
Graph 2: Germans Who Buy Goods and Services online………………………………………47
Germans Seeking Health Information on the Internet………………………………………..48
Germans Searching for Information about Non-prescription OTC Medicines on the Internet……………………………………………………………………………………………………….48
Graph 3: German Adults’ Sources of Information about Non-prescription Medicines………………………………………………………………………………………………………….48
Germans Purchasing Healthcare on the Internet……………………………………………….48
German Consumers Frequency of Shopping in Pharmacies………………………………..49
Table 1: Frequency of Consumer Visits to Pharmacies in Germany 2015……………..49
German Consumers Multi-channel Shopping for Healthcare………………………………49
Table 2: Reasons Consumers in Germany Give for Choosing a Pharmacy…………….49
Health and Personal Care Sales through Mail Order and Internet Pharmacies in Germany………………………………………………………………………………………………………..50
Table 3: Internet and Mail Order Pharmacy Share of Sales by Category 2015……..50
Non-prescription OTC Medicine Sales in retail pharmacy and through Mail Order and Internet Pharmacies in Germany………………………………………………………………….51
Graph 6: Sales of Non-prescription products through all Pharmacy channels in Germany…………………………………………………………………………………..…………………….51
Graph 7: Turnover and market share of the Non-prescription market in Germany through the Mail Order and Internet Pharmacy channel 2015-2020……52
Graph 8: % Split of Sales of Non-prescription and OTC Medicines through Mail Order Pharmacies in Germany by Category…………………………………………….………… 53
Healthcare Therapeutic Categories most frequently bought through Mail Order and Internet Pharmacies in Germany……………………………………………………….………..54
Graph 9: Germany – % Share of Pharmacy only Non-Prescription Medicines Bought through Mail Order Channels by Therapeutic Categories……………………….54
Prescription-only Medicines Purchased through Mail Order and Internet Pharmacies in Germany…………………………………………………………………………………….55
Cosmetics and other Personal care Products purchased through Mail Order and Internet Pharmacies in Germany………………………………………………………………..55
Mail Order and Internet Pharmacies Challenging Traditional Pharmacies in Germany……………………………………………………………………………………………………………55
Graph 10: The Number of Pharmacies in Germany 1990 to 2015………………………..56
Mail Order and Internet Pharmacies – Medium sized Businesses in Germany…………………………………………………………………………………………………………….57
Table 4: Number of Pharmacies in Germany with a Mail Order Licence………………57
Top Mail Order and Internet Pharmacy Brands in Germany……………………………….58
Graph 11: % Share of Internet and Market Mail Order Pharmacies in Germany 2015……………………………………………………………………………………………………58
Brand Awareness of Mail Order Pharmacy Brands in Germany…………………………..59
Table 5: Consumer Awareness of Mail Order Pharmacy Brands – Customers compared to Non-users………………………………………………………………………………………59
Share of Consumer Shopping for Mail Order Pharmacy Brands in Germany……….60
Table 6: % Consumers claiming to have Purchased from Mail Order Pharmacies..60
Consolidation of the Internet and Mail Order Pharmacy Channel in Germany…….61
Zur Rose – the Largest Mail Order Pharmacy Group in Germany as a Result of Acquisitions and Multi-channel Strategies…………………………………………………………61
Europa Apotheek Venlo (EAV) – Shop-apotheke………………………………………………63
German Druggist and Grocery Chains’ Multi-channel Healthcare Strategies through ‘Pick-up Point’ Collaboration with Mail Order Pharmacies……….…………….64
Pioneers of Multi-channel Drugstore and Pharmacy Strategies in Germany – Europe Apotheek Venlo and DM………………………………………………………………………….64
Other Mail order and Internet Pharmacies with Tie-ups to Non-pharmacy German Retail Chains…………………………………………………………………………………………..65
Development of On-line Services by Pharmacy Co-operation Groupings in Germany………………………………………………………………………………………………………………66
Table 7: Leading German Pharmacy Co-operation Groups’ Online services…………67
The Future for Mail Order and Internet Pharmacies in Germany…………………………..68

Chapter 4: Mail Order and Internet Pharmacies in Switzerland………………………………………………………………………….71
The Rise of Mail Order and Internet Pharmacy in Switzerland………………………………71
Graph 1: % Share of Swiss Pharmaceutical Market by Channel 2015…………………….71
Table 1: Switzerland – Mail Order Pharmaceutical Sales Compared to other Channels 2007 to 2015 CHF millions at Manufacturers’ Prices………………………………72
Graph 2: Swiss Pharmaceutical Market CAGR by Channel 2010-2015…………………73
Mail order and Internet Pharmacy Channels in Switzerland………………………………..73
Graph 3: Switzerland – Market Shares of Leading Mail Order and Internet ……………75
Zur Rose……………………………………………………………………………………………………………..76
Zur Rose in the Development of Apps and Mobile Technology……………………………77
Pharmadirect………………………………………………………………………………………………………77
Pharmapool………………………………………………………………………………………………………..78
Xtrapharm…………………………………………………………………………………………………………..78
Collaborations with Statutory Health Insurers…………………………………………………..78
Internet Offers by Major Pharmacy Chains…………………………………………………………79
Table 2: Switzerland – Online Services by Leading Pharmacy Chains…………………..79
Conclusions for Mail order and Internet Pharmacies in Switzerland……………………80

Chapter 5: Mail Order and Internet Pharmacies in Austria…..81
Austrians’ Access to Online Healthcare……………………………………………………………….81
Sales of non-prescription products in retail pharmacy and through Mail Order and Internet pharmacies in Austria……………………………………………………………………………82
Graph 1: Sales of Non-prescription Healthcare through all Pharmacy channelsin Aust ria…………………………………………………………………………………………………………….82
Sales of non-prescription products through Mail Order and Internet Pharmacies in Austria…………………………………………………………………………………………………………….83
Graph 2: Turnover and market share of the non-prescription market in Austria through the mail order and internet pharmacy channel 2015-2020……………………..83
Austrian Consumers Seeking Health Information and Using Internet Pharmacies..84
Graph 3: Austria – % Respondents using Internet Pharmacies by the Number of Times they Shopped the Channel in last 24 Months……………………………………………………….84
Graph 4: Austria – % Respondents by Average Value of Cart when Shopping at Internet Pharmacies in last 24 Months……………………………………………………………….85
Reasons why Austrian consumers purchase from online Mail Order pharmacies…85
Graph 5: Austria – % Respondents – Reasons for Shopping Internet Pharmacies…..86
Consumer Awareness and Usage of Online Mail Order Pharmacy Brands In Austria……………………………………………………………………………………………………………86
Graph 6: Austria % Of Respondents Claiming to be Familiar with Internet Pharmacy Brands………………………………………………………………………………………………..87
Graph 7: Austria % Respondents Claiming to Shop Internet Pharmacies by Pharmacy Trade Name……………………………………………………………………………….………88
The Main Players in Austria’s Mail Order and Internet Pharmacy channel………….88
Apotheke Österreich………………………………………………………………………………………….88
Zur Rose…………………………………………………………………………………………………………….89
Apodirekt…………………………………………………………………………………………………………..90
The future for Mail Order and Internet Pharmacy in Austria……………………………….91

Chapter 6: Mail Order and Internet Pharmacies in the UK…..92
The shape of Mail Order and Internet Pharmacies in the UK……………………………….92
Graph 1: UK % All Adults in the UK Who Purchased Online 2015………………………….93
Online Healthcare – Consumers’ Usages and Attitudes in the UK………………………..93
Graph 2: % Adults in the UK seeking health information online 2015…………………94
British Pharmacy Shoppers by Type of Pharmacy they Choose…………………………….94
What do British Pharmacy Shoppers buy Online?…………………………………………..94
Graph 3: UK – Types of medicines bought by online shoppers in the years to August 2014 and August 2016………………………………………………..…………………………..95
Graph 4: Turnover and market share of the non-prescription market in the UK through the Mail Order and Internet Pharmacy channel 2015-2020………….……..…..96
Why Do British Pharmacy Shoppers buy Online?………………………………………………….96
Table 1: UK – Reasons why British Pharmacy Shoppers buy Online……………………….96
Graph 5: UK’s most recognised online pharmacies……………………………………………….97
Mail Order and Internet Pharmacies in the UK…………………..………………………………..97
History of Mail Order and Internet Pharmacies in the UK…………………………………….98
Table 2: Leading Pharmacy Chains and Number of Outlets in the UK 2016…….99
High Street Pharmacy Chains’ Role in Pharmacy e-commerce in the UK…….……..99
Table 3: Top 20 Pharmacy Chains in the UK with Online Pharmacy Status………….100
Multi-channel is Shopping Driving online Pharmacy……………………..…………………..100
Development of Multi-channel Pharmacy Strategies in the UK………………………….101
Boots the Chemist Omnichannel Retail Drugstore in the UK………………………………102
LloydsPharmacy Internet Services in the UK………………………………………………………103
Superdrug………………………………………………………………………………………………………….103
Top ‘Pure Play’ Internet Pharmacies in the UK……………………………………………………103
Pharmacy2U………………………………………………………………………………………………………104
Chemist Direct……………………………………………………………………………………………………104
TheHealthCounter……………………………………………………………………………………………..105
Online Doctor Consultation Clinics in the UK registered as Independent Medical Agencies……………………………………………………………………………………………….105
Dr Thom…………………………………………………………………………………………………………….105
Doctor Fox…………………………………………………………………………………………………………106
HealthExpress.co.uk…………………………………………………………………………………………..106
Online Animal Health Pharmacies in the UK……………………………………………………….106
MedicAnimal.com………………………………………………………………………………………………106
Vet-medic…………………………………………………………………………………………………………..107
Conclusions for Mail Order and Internet Pharmacies in the UK…………………………..107

Chapter 7: Mail Order and Internet Pharmacies in the Netherlands…………………………………………………………………109
Mail Order and Internet Pharmacies in the Netherlands…………………………………….109
Graph 1: Netherlands – % of Internet users making online purchases in 2015…….109
Non-prescription medicines in the Netherlands………………………………………………….110
Graph 2 – Retail sales % share of the Dutch non-prescription market by channel…110
Graph 3: Sales of Non-prescription Healthcare through all Pharmacy channels In the Netherlands…………………………………………………………………………………………….110
Sales of non-prescription products through Mail Order and Internet Pharmacies in the Netherlands…………………………………………………………………………………………….111
Graph 4: Turnover and market share of the non-prescription market in the Netherlands through the mail order and internet pharmacy 2015-2020…………….111
‘Pure Play’ Internet Pharmacies in the Netherlands…………………………………………..112
‘Pure play’ Internet Pharmacy Brands in the Netherlands………………………………….112
Dutch Pharmacy Chains’ Internet-based Multi-channel Strategies………………………113
Table 1: Main Pharmacy Chains in the Netherlands ……….…………………………………..114
Mediq and Benu……………………………………………………………..………………………………….114
Boots Pharmacy Chain in the Netherlands…………………………………………………….…..114
Medsen Pharmacy…………………………………………………………………………………………….115
Online Health and Beauty and Non-prescription OTC Medicine Sales through Druggist Chains in the Netherlands……………………………………………………………………115
Table 2: E-commerce Major Druggist Chains in the Netherlands……………………….115
Independent Pharmacy Websites in the Netherlands……………………………………….116
Online Medical Consultation websites in the Netherlands………………………………..116
Dokteronline…………………………………………………………………………………………………….116
Internet Pharmacies in the Netherlands – Conclusions……………………………………..116

Chapter 8: Mail Order and Internet Pharmacies in Belgium………………………………………………………………………..117
The Shape of Mail Order and Internet Pharmacies in Belgium………………………….117
Graph 1: Belgium – % of Internet users making Purchases through the Internet in the previous 12 months……………………………………………………………………………….117
Sale of non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Belgium………………………………………………………………..118
Graph 2: Sales of Non-prescription Healthcare through all Pharmacy channels in Belgium………………………………………………………………………………………….118
Sales of Non-prescription products through Mail Order and Internet Pharmacies in Belgium………………………………………………………………………………………………….…….119
Graph 2: Turnover and market share of the Non-prescription market in Belgium through the Mail Order and Internet Pharmacy channel 2015-2020……119
Internet Strategies of Major Retail Pharmacy Multiples in Belgium……….…………122
LloydsPharma (Celesio/McKesson)………………………………………………………………….122
Multi-channel Strategies of Co-op Pharmacy Chains in Belgium……………………….122
Conclusions for Mail Order and Internet Pharmacies in Belgium………….………….123

Chapter 9: Mail Order and Internet Pharmacies in Denmark, Finland, Norway and Sweden…….…………………124
Development of Mail order and Internet Pharmacies in Denmark……………………124
Table 1: Denmark – Population Access and Usage Frequency of the Internet 2016……………………………………………………………………………………………………124
Graph 1: Denmark – % of Internet users making Purchases through the Internet in the previous 12 months…………………………………………………………………..125
Graph 2: Denmark – Share of Medicinal and Cosmetics Market by Retail Channel………………………………………………………………………………………………….125
Sale of Non-prescription products in retail pharmacy and through Mail Order and Internet pharmacies in Denmark………………………………………………………………126
Graph 3: Sales of Non-prescription Healthcare through all Pharmacy channels in Denmark……………………………………………………………………………………….126
Sales of non-prescription products through Mail Order and Internet Pharmacies in Denmark……………………………………………………………………………………127
Graph 4: Turnover and market share of the Non-prescription market in Denmark in the Mail Order and Internet Pharmacy channel 2015-2020……………127
Apoteket.dk…………………………………………………………………………………………..127
Virtual Pharmacy Chains in Denmark providing Internet Access……………………….128
Development of Mail order and Internet Pharmacies in Finland……………………….129
Table 2: Finland – Population Access and Usage Frequency of the Internet 2016………………………………………………………………………………… ……………….129
Graph 5: Finland – % of Internet users Making Purchases through the Internet in the previous 12 months…………………………………………………………………………………129
Development of Mail Order and Internet Pharmacies in Norway………………………131
Table 3: Norway – Population Access and Usage Frequency of the Internet 2015……………………………………………………………………………………………………131
Graph 6: Norway – % of Internet users making Purchases through the Internet in the previous 12 months……………………………………………..…………………………………132
Sales of non-prescription products in retail pharmacy and through Mail Order and Internet pharmacies in Norway………………………………..……………………………….133
Graph 7: Sales of Non-prescription Healthcare through all Pharmacy channels in Norway…………………………………………………………..……………………………133
Sales of non-prescription products through Mail Order and Internet Pharmacies in Norway……………………………………………………….…………………………..134
Graph 8: Turnover and market share of the Non-prescription market in Norway through the Mail Order and Internet Pharmacy channel 2015-2020…..134
Table 4: Market Shares of Leading Retail Pharmacy Chains in Norway 2015..…135
Development of Mail Order and Internet Pharmacies in Sweden……………………136
Table 5: Sweden – Population Access and Usage Frequency of the Internet 2015………………………………………………………………………………………………….136
Graph 9: Sweden – % of Internet users making Purchases through the Internet in the previous 12 months…………………………………………………………………136
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet pharmacies in Sweden……………………………………………………………….137
Graph 10: Sales of Non-prescription Healthcare in all Pharmacy channels in Sweden………………………………………………………………………………………………………137
Sales of non-prescription products through Mail Order and Internet Pharmacies in Sweden…………………………………………………………………………………..137
Graph 11: Turnover and market share of the non-prescription market in Sweden through the mail order and internet pharmacy channel 2015-2020…….138
De-regulation of Sweden’s Pharmacy Structure………………………………………………138
Graph 12: Pharmacies owned and market share held by leading Swedish chains in 2015…………………………………………………………………………………………….……139
Sweden’s Leading Pharmacy Chains’ adoption of multi-channel strategies……140
Table 6: Sweden Pharmacy Chains’ URLs…….……………………………………………………140
‘Pure-play’ Internet Pharmacies in Sweden……………………………………………………..140

Chapter 10: Mail Order and Internet Pharmacies in Poland…….……………………………………………………………………141
Table 1: Poland – Population Access and Usage Frequency of the Internet……….141
Graph 1: Poland – % of Internet users making Purchases through the Internet in the previous 12 months………………………………………………………………….142
Polish Consumers Using the Internet for Health Related Information………………142
Table 2: Poland – % Polish Population Seeking Health Related Information from the Internet in Last 12 Months………………………………………………………………..142
Graph 2: Most popular health-related internet searches in Poland 2012 and 2015…………………………………………………………………………………………………143
Graph 3: What Polish internet users bought online in 2015…………..…………………143
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Poland……………………………………………………….…………144
Graph 4: Sales of Non-prescription Healthcare in Polish Pharmacy channels……………………………………………………………………………….…………144
Sales of Non-prescription products through Mail Order and Internet Pharmacies in Poland……………………………………………………………………………………..144
Graph 2: Turnover and market share of the Non-prescription market in Poland through the Mail Order and Internet Pharmacy channel 2015-2020……144
Development of Mail Order and Internet Pharmacies in Poland……………………..145
Estimating the Internet Opportunity for Pharmacy in Poland………………………….145
Growth of ‘Pure play’ Online Pharmacies in Poland…………………………………………146
Table 3: Leading Internet Pharmacies in Poland………………………………………………147
Cefarm 24……………………………………………………………………………………………………….147
Dom Zdrowia, Poland’s first Online Pharmacy…………………………………………………147
Table 4: Dom Zdrowia Selected Financial data…………………………………………………147
Apteki Dbam Zdrowie (I care for my Health) Health Portal and Multi-channel Pharmacy………………………………………………………………………………….147
Independent Retail Pharmacy Chains in Poland……………………………………………….149
Table 5: The largest Independent Retail Pharmacy Chains in Poland…………………149
Dr. Max/Mediq – Owned by Penta…………………………………………………………………..150
Online Shopping Portals…………………………………………………………………………………..150
Conclusions on Mail Order and Internet Pharmacy in Poland……………………………151

Chapter 11: Mail Order and Internet Pharmacies in Czech Republic…….………………………………………………………..153
Table 1: Czech Republic – Population Access and Usage Frequency of the Internet 2015……………………………………………………………………………………………….……153
Graph 1: Czech Republic – % of Internet users making Purchases through the Internet in the previous 12 months……………………………………………………………….…..153
Czech Consumers Seeking Health Information on the Internet………………….………154
Table 2: Czech Republic – % of Population Seeking Health-Related Information on the Internet……………………………………………………………………..……….154
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Czech Republic………………………………………………….…..155
Graph 2: Sales of Non-prescription Healthcare through Pharmacy in Czech Republic………………………………………………………………………………………………….155
Sales of Non-prescription products through Mail Order and Internet Pharmacies in Czech Republic…………………………………………………………………………………………..156
Graph 3: Turnover and market share of the Non-prescription market in Czech Republic through Mail Order and Internet Pharmacies 2015-2020………………….156
The Development of Internet Pharmacies in Czech Republic……………….…….……….156
Docsimon……………………………………………………………………………………………………………157
Collaboration and Multi-channel Models……………………………………..……….……………157
Dr Max Multi-Channel Development……………………………………………..…………………..157
Pilulka.cz – CoPharm and Topfarma Collaboration Model………………..………………..157
Moje Lekarna (My pharmacy)…………………………………………………………..……………….158

Chapter 12: Mail Order and Internet Pharmacies in Slovakia…….………………………………………………………….…..…..159
Table 1: Slovakia – Population Access and Usage Frequency of the Internet 2015…………………………………………………………………………………..……………….159
Graph 1: Slovakia – % of Internet users making Purchases through the Internet in the previous 12 months…………………………………………………………………..160
Slovakian Consumers Seeking Health Information on the Internet……………………161
Table 2: Slovak Republic – % of Internet Users (last three months) Seeking Health Related Information on the Internet……………………………………………………..161
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Slovakia…………………………………………..…………………….161
Graph 2: Sales of Non-prescription Healthcare through all Pharmacy channels in Slovakia………………………………………………………………………………….……..161
Sales of Non-prescription products through Mail Order and Internet Pharmacies in Slovakia……………………………………………………………………………….…….162
Graph 3: Turnover and market share of the Non-prescription market in Slovakia through the Mail Order and Internet Pharmacy channel 2015-2020…..162
The Development of Internet Pharmacies in Slovakia…………………………………..….162
iLekáren……………………………………………………………………………………………………..…..162
Docsimon Slovakia……………………………………………………………………………………………163
Mojalekaren.sk………………………………………………………………………………………..………163
Pharmacy Co-operative Groupings involved in e-commerce………………….…….…..164
Table 3: Slovak Republic – Main Co-operative Pharmacy Groupings – Involvement in e-commerce………………………………………………………………………………………………..164
Wholly-Owned Pharmacy Chains – Participating in e-commerce……………………..165
Table 4: Slovak Republic – Leading Retail Pharmacy Chains – Online services and e-commerce…………………………………………………………………..………………………..165

Chapter 13: Mail Order and Internet Pharmacies in Hungary…….……………………………………………………….……….166
The Mail Order and Internet Pharmacy environment in Hungary………….…………166
Table 1: Hungary – Population Access and Usage Frequency of the Internet 2015………………………………………………………………………………………………….166
Graph 1: Hungary – % of Internet users making Purchases through the Internet in the previous 12 months…………………………………………………………………167
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Hungary……………………………………………….……………..167
Graph 3: Sales of Non-prescription Healthcare through all Pharmacy channels in Hungary………………………………………………………………………………………167
Sales of Non-prescription products through Mail Order and Internet Pharmacies in Hungary…………………………………………………………………………………..168
Graph 3: Turnover and market share of the Non-Prescription market in Hungary through the Mail Order and Internet Pharmacy channel 2015-2020….168
The Development of Internet Pharmacies in Hungary……………………………………..168
Online Services from Hungary’s Main Pharmacy Chains…………………………………..169

Chapter 14: Mail Order and Internet Pharmacies in France………………………………………………………………………….170
Playing catch-up – France and Mail Order and Internet Pharmacies………………..170
Mail Order and Internet Pharmacies in France………………………………………………..170
Table 1: France – Population Access and Usage of the Internet 2015………….170
France – Online Pharmacy Market Values………………………………………………………..171
Graph 1: France – % of Online Shoppers’ Most Favoured Online Shopping Destinations for Beauty and Personal Care………………………………………………………172
Sales of Non-prescription products in retail pharmacy and through Mail Order  and Internet Pharmacies in France…………………………..………………………………………173
Graph 2: Sales of Non-prescription Healthcare through all Pharmacy channels in France…………………………………..………………………………………………………173
Sales of Non-prescription products through Mail Order and Internet Pharmacies in France…………………………………………………………….……………………………………………174
Graph 3: Turnover and market share of the Non-prescription market in France through the Mail Order and Internet Pharmacy channel 2015-2020……………….174
Internet Pharmacies in France………………………………………………………………….……..174
Table 2: France – Number of Authorised Pharmacy Websites by Region……………175
Internet based Services of Leading French Pharmacy Groups and Virtual Chains of Pharmacies………………………………………………………………………………….……175
Table 3: Online Offerings by Leading Voluntary Groupings and Virtual Chains of Pharmacies in France…………………………………………………….……………………………176
The Case of 1001pharmacies…………………………………………………………………………..176
Supermarkets stake a claim…………………………………………………………………………….177
The Future for Internet Pharmacies in France………………………………………………….177

Chapter 15: Mail Order and Internet Pharmacies in Italy…………………………………………………………………………..179
Mail Order and Internet Pharmacy in Italy………………………………………………………179
Table 1: Italy – Population Access and Usage Frequency of the Internet 2015….179
Graph 1: Italy – % of Internet users making Purchases through the Internet in the previous 12 months……………………………………………………………..180
Sales of non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Italy…………………………………………………………………….181
Graph 2: Sales of Non-prescription Healthcare through all Pharmacy channels in Italy……………………………………………………………………………………………………………181
Sales of non-prescription products through Mail Order and Internet Pharmacies in Italy……………………………………………………………………………………………………………181
Graph 3: Turnover and market share of the Non-prescription market in Italy through the Mail Order and Internet Pharmacy channel 2015-2020……………….182
Online Services of Leading Italian Pharmacy Groups and Virtual Chains of Pharmacies…………………………………………………………………………………………………….182
Conclusions – Internet Pharmacies in Italy………………………………………………………183

Chapter 16: Mail Order and Internet Pharmacies in Spain……………………………………………………………………………184
Mail Order and Internet Pharmacy in Spain…………………………………………………..184
Table 1: Spain – Population Access and Usage Frequency of the Internet 2015………………………………………………………………………………………………….184
Graph 1: Spain – % of Internet users making Purchases through the Internet in the previous 12 months…………………………………………………………………….….…185
Spain – Profile of Internet Pharmacy Shoppers and the Types of Products they Choose…………………………………………………………………………………….185
Table 2: Spain – Consumers who Shop Online Pharmacies – What they Buy……186
Sales of Non-prescription products in retail pharmacy and through Mail Order and Internet Pharmacies in Spain………………………………………………………………….186
Graph 2: Sales of Non-prescription Healthcare through all Pharmacy channels in Spain…………………………………………………………………………………….….…186
Sales of Non-prescription product through Mail Order and Internet Pharmacies in Spain…………………………………………………………………………………….…187
Graph 3: Turnover and market share of the Non-prescription market in Spain through the Mail Order and Internet Pharmacy channel 2015-2020…………….…187
The Development of Internet Pharmacies in Spain…………………………………..……..187
Conclusions for Mail Order and Internet Pharmacy in Spain…………..……………….189

Chapter 17: Conclusions of the Report…………………………….190
The Future for Mail Order and Internet Pharmacy in Europe………………………….190
Figure 1: Matrix showing the Evolutionary Splits in the Mail Order and Internet Pharmacy Landscape………………………………………………………………………..191
Factors influencing the Future Shape and Development of the Mail Order and Internet Pharmacy Landscape in Europe………………………………………………….194
The Growth of e-commerce in general as access to the Internet increases and Consumers become increasingly confident in making transactions online………194
Growth in the Non-prescription Mail Order and Internet Pharmacy market……195
Graph 1: Estimated growth of the European OTC market through the Mail Order and Online channel between 2015-2020……………………………………………….195
Graph 2: Estimated growth of the European OTC market between 2015-2020………………………………………………………………………………………..195
Regulatory trends across the European region have had their Impact on both the Shape of the Market and the Speed of Development…………………..196
European Measures to improve Consumer Safety, Security and Trust in Mail Order and Internet Pharmacies……………………………………………………………………….197
The continued consolidation of ‘Pure play’ Pharmacy Ownership and Growth of Cross-Border Clusters………………………………………………………………………………….197
The Response of Retail Pharmacy Chains and other organised Retail Groupings to the Challenges posed by ‘Pure play’ Mail Order and Internet Pharmacies…………………………………………………………………………………………………….198
Multi-channel and Omnichannel Retail Drugstore and Pharmacy Chains………..200
Portals – Collectives of Independent Pharmacies and Variants………………………..201
Conclusion: The shape of the Mail Order and Internet Pharmacy landscape…….201
Appendix: Mail Order and Internet Pharmacy in China…….203
The rise of the digital economy in China………………………………………………………….203
Graph 1: % of Chinese Smartphone Users who use their Device to Shop Online…………………………………………………………………………………………………….203
Figure 1: Percentage of total sales of selected product categories in China through online channels………………………………………………………………………………….204
Internet Pharmacy in China…………………………………………………………………………….204
Alibaba and the Tmall Pharmacy marketplace…………………………………………………205
Alibaba bounces back into Online Pharmacy in China…….……………………………….206
The future of Online Pharmacy in China…………………………..………………………………206
Shanghai Pharma: Bringing an Omnichannel offering to the Chinese pharmacy sector……………………………………………………………..………………………………207
Conclusions on Internet Pharmacy in China………………………………..…………………..208