Volume II: Internet Pharmacies and the Online Pharmacy Market: Trends, Perspectives and Challenges.

Regulatory frameworks have not kept pace. That was true when Volume I of this Research Topic launched, and it remains true now — and that gap has deepened since. The post-COVID normalisation of digital health has pushed more patients toward internet-based medicine supply, and the market has responded: AI-driven dispensing platforms, subscription pharmacy models, and social media storefronts have all moved faster than the rules designed to govern them.

Volume I set out the scale of the challenge — supply chain vulnerabilities, shifting consumer behaviour, the limits of enforcement. Volume II asks harder questions: what has changed, what has deteriorated, and where are real-world interventions making a difference? Illegitimate online pharmaceutical trade is still broadly underestimated. Regulatory responses remain jurisdiction-by-jurisdiction patchwork. And the patient safety picture — substandard products, unmonitored self-medication, the erosion of clinical oversight — is not improving.

The problem cuts across institutional mandates. Regulators, clinicians, search engines, manufacturers, patient groups, and law enforcement each see part of the problem. Contributions to this volume should reflect that fragmentation honestly, drawn from real healthcare systems and grounded in evidence from across geographic regions and disciplines.

The collection aims to deepen the evidence base on this evolving market, support internationally coordinated policy responses, and highlight both persistent gaps and innovative solutions emerging across the global pharmaceutical e-commerce landscape.

The collection will cover:

•Post-pandemic shifts in online pharmacy use: which shifts in patient behaviour have proved lasting, and what that means for public health long-term

•AI and machine learning in detecting rogue pharmacies, counterfeit products, and fraudulent health claims

•Social media as a pharmaceutical marketplace — Instagram, TikTok, Telegram — and the practical limits of platform regulation

•Prescription-free access to high-demand medicines, including GLP-1 receptor agonists and other lifestyle drugs, and the clinical risks that follow

•Dark web and crypto-enabled pharmaceutical trade: current scope, trends, and law enforcement capacity

•Cross-border regulatory harmonisation and the role of international bodies in closing jurisdictional gaps

•Antibiotic availability online and its contribution to antimicrobial resistance, with focus on WHO AWaRe Watch, Reserve, and last-resort agents

•Cybersecurity risks and patient data exposure in digital pharmacy platforms

•Subscription and direct-to-consumer pharmacy models: what they do well, where clinical oversight breaks down

•AI-generated medical advice and chatbot-assisted self-diagnosis replacing pharmacist consultation

•Online pharmacies in pharmacy deserts: genuine access solution or added risk for rural and LMIC populations

•Quality control and post-market surveillance of medicines and dietary supplements, new psychoactive substances bought online, including test-purchase and laboratory findings

•Digital Pharmaco- and Nutrivigilance: Challenges in spontaneous reporting of adverse events from online purchases, monitoring the safety of adulterated dietary supplements and the role of "social listening" and AI in detecting emerging public health threats in the e-commerce landscape

•Electronic prescriptions, interoperability, and where e-telepharmacy fits in integrated care

•Pharmacoeconomic analysis of digital health and e-telepharmacy solutions

•Public health interventions, policies and risk mitigating strategies for online pharmacies, online dietary supplement sale and substandard, counterfeit medicines and health product use