NAIROBI, Kenya Sep 30 – A policy brief from Strathmore Business School’s Prism Centre reveals a paradox at the heart of Kenya’s growing online pharmacy market. It reveals a relatively strong regulatory framework that is not always translating into safe practice.
A medicine can now be ordered from a phone with the same ease as a meal. A few taps, a mobile-money payment and a courier can bring antibiotics, painkillers or medicines for chronic conditions to a patient’s doorstep.
Convenient? Absolutely.
But when the medicine arrives, who checked the prescription? Who asked about allergies, pregnancy or other medicines being taken? Who confirmed that the product is genuine? And most importantly, who made sure the person buying it actually needed it?
These questions sit at the heart of the policy brief, E-Pharmacy in Kenya: Regulation, Practice and Performance. The research was led in Kenya by Dr. Sammy Masibo, a doctoral fellow at Strathmore Business School’s Prism Centre, with support from Prof. Francis Wafula, the Kenyan Principal Investigator, alongside Dr. Darian Ivayo and Dr. Victor Mulelo, pharmacists and health systems researchers at Prism.
The April 2026 brief examines Kenya’s rapidly evolving e-pharmacy market, comparing what the regulations require with what actually happens when a patient goes online to buy medicine. And the findings tell a complicated story.
Kenya has, on paper, a relatively comprehensive regulatory framework for e-pharmacies. The country scores highly on international measures of regulatory completeness, with rules covering licensing, prescription handling, medicine information, controlled medicines, data security and professional oversight. Yet implementation remains uneven, with significant gaps between what the rules demand and what patients may experience in practice.
To understand what happens beyond the polished websites and convenient shopping interfaces, the researchers followed the e-pharmacy journey from beginning to end.
They reviewed 23 websites and three mobile applications serving the Kenyan public, conducted 364 mystery shopper purchase attempts, tested medicines through the National Quality Control Laboratory and consulted stakeholders across the pharmaceutical sector. They also compared e-pharmacies with 100 brick-and-mortar pharmacies in Nairobi.
The mystery shoppers tested ordinary and high-risk scenarios, including requests made without prescriptions, excessive quantities, overdose scenarios and potentially unsafe medicine use during pregnancy.
What they found was unsettling. When a correct prescription was provided, 81% of purchases were appropriately dispensed. But when shoppers attempted to purchase prescription-only medicines
without a prescription, 72% of purchase attempts were still dispensed. Even more concerning, 87% of purchases involving potentially dangerous requests, including overdose, excessive quantities or unsafe use during pregnancy, were dispensed.
And there was another glaring gap. None of the platforms screened shoppers for pregnancy, allergies or contraindications before dispensing.
The digital convenience, it appears, does not automatically translate into pharmaceutical care.
The research also looked beyond dispensing practices to the medicines themselves. The good news is that most medicines tested met quality standards. But the exceptions are significant. Laboratory testing found that 25% of erythromycin samples tested failed potency requirements, while several samples of falsified Augmentin were detected.
The researchers also found gaps in the information available to consumers. Only 42% of e-pharmacies provided complete medicine information, including side effects and contraindications. Just 31% displayed their registration health safety code, although all platforms provided a phone number, helpline and digital security certificate.
Yet the findings also challenge an assumption that online pharmacies are necessarily more dangerous than their physical counterparts.
When the researchers compared e-pharmacies with brick-and-mortar pharmacies, they found that e-pharmacies were generally less likely to dispense prescription-only medicines inappropriately. For example, bulk antibiotic requests were incorrectly dispensed in 77% of e-pharmacy visits compared with 100% of visits to brick-and-mortar pharmacies in the study.
The problem, therefore, is bigger than the screen. The researchers found that weaknesses in dispensing and safety checks are systemic across the retail pharmacy sector, rather than being unique to online platforms.
Interestingly, size and traffic appear to matter. Higher-traffic e-pharmacies performed better both in regulatory compliance and in the mystery shopper assessments. Market leaders correctly managed 75% of mystery shopper encounters, compared with 47% among other e-pharmacies. They also complied with an average of 10 out of 12 national regulatory requirements, compared with 8.7 among other providers.
For the researchers, this presents an opportunity rather than simply a problem. Regulators could work with these market leaders as strategic partners, using their stronger systems and practices to help raise standards across the sector.
The policy brief proposes practical measures ranging from publishing a publicly accessible PPB register of licensed e-pharmacies and enforcing the display of health safety codes to mandating prescription uploads and introducing stronger electronic prescription systems. It also calls for pre-
dispensing safety screening, better patient information, stronger medicine supply-chain controls and improved coordination among regulators.
The message from the Prism Centre research is therefore not that Kenya needs to start regulating e-pharmacies from scratch. It is that the rules already on the books must begin to work as effectively in the digital marketplace as they do on paper.
That means stronger prescription controls, meaningful safety screening, better patient information and more consistent oversight, particularly as the market grows and more Kenyans turn to digital platforms for their medicines.
The Kenyan team was strongly supported by Prof. Catherine Goodman, the project Principal Investigator, and Dr Benjamin Palafox of the London School of Hygiene & Tropical Medicine. The study forms part of a wider international research collaboration that brings together Strathmore University Business School, The George Institute for Global Health, and the London School of Hygiene & Tropical Medicine.
While the Kenyan team examined the country’s rapidly evolving e-pharmacy landscape, colleagues in India conducted a parallel study, providing a comparative lens on how online medicine markets are regulated and how pharmaceutical care is delivered in the digital space. The collaboration underscores that the questions raised by e-pharmacies are not uniquely Kenyan but part of a wider global challenge of ensuring that regulation, technology and patient safety evolve together.
The research was supported through the Health Systems Research Initiative (HSRI), funded by the UK Foreign, Commonwealth and Development Office (FCDO), the UK Medical Research Council (MRC), and Wellcome. Together, the institutions brought a cross-country perspective to examine how regulation can keep pace with the digital transformation of medicine while ensuring that greater access does not come at the expense of patient safety.
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