Factors influencing the online sale of prescription medication in Iran: insights from a qualitative content analysis

Abstract Background The digital transformation in healthcare has presented both opportunities and challenges for the online sale of prescription medications, particularly in developing countries such as Iran. Online pharmacies have the potential to enhance access, convenience, and affordability; however, the absence of a robust regulatory framework and concerns about patient safety, counterfeit medications, and market monopolization pose significant obstacles. This study aims to explore the critical factors influencing the online sale of prescription medications in Iran to inform policy and practice. Methods A qualitative study was conducted using a conventional content analysis approach. Seventeen semi-structured interviews were carried out with stakeholders, including pharmacists, legal experts, and policymakers, between July and October 2024. Themes and sub-themes were identified using an inductive approach, and data were analyzed using MAXQDA software. The trustworthiness of the data was ensured through credibility, dependability, confirmability, and transferability measures. Results The analysis identified six main themes and 20 sub-themes influencing the online sale of prescription medication in Iran: Legal and Regulatory Challenges, Ethical Considerations, The Role of the Pharmacist, Patient Behavior and Safety, Technology and Infrastructure, and Economic Implications. Key barriers included regulatory ambiguities, ethical concerns such as data privacy and equity, and limitations in technological infrastructure. Participants proposed solutions, including establishing clear legal frameworks, multidisciplinary oversight panels, and secure technological platforms. Conclusion The study underscores the need for comprehensive legal and regulatory frameworks, ethical safeguards, and robust technological infrastructure to support the safe and equitable implementation of online prescription medication sales in Iran. These efforts should address malpractice risks, enhance patient trust, and ensure equitable access, paving the way for a sustainable digital transformation in pharmaceutical services.