Strategic analysis of online pharmacy implementation: a scoping review and SWOT-based framework

The expansion of online pharmacies, a key development in digital health, has influenced both patient care and health system operations. Despite their benefits, these platforms face regulatory, infrastructural, and safety challenges. This study aimed to provide a strategic overview of online pharmacy implementation and propose operational strategies. A scoping review was conducted following the six-stage framework proposed by Arksey and O’Malley. A systematic search was performed in PubMed, Scopus, Embase, Web of Science, and Google Scholar for studies published between 2015 and June 2026. After screening 496 records, 37 studies met the eligibility criteria and were included in the analysis. Data were analyzed using the framework analysis approach developed by Ritchie and Spencer and were subsequently categorized according to a SWOT framework and associated implementation strategies. Online pharmacies offer several potential advantages, including lower indirect costs, improved access to pharmaceutical services, and enhanced medication management. However, challenges such as digital inequalities, logistical constraints, and cybersecurity concerns remain significant. Key opportunities include integration with telemedicine, emerging regulatory frameworks, and the adoption of innovative technologies. Major threats involve regulatory gaps, counterfeit medicines, self-medication, and financial sustainability challenges. Eleven implementation strategies were identified to support the safe and sustainable development of online pharmacy services. Online pharmacies have the potential to serve as an important complement to health systems by reducing indirect patient costs, may contribute to improving equity in access, and enhancing the quality of services. Realizing this potential requires coherent policymaking, investment in infrastructure, and the use of novel technologies such as artificial intelligence.