Over the next two years, successful online pharmacies will move beyond improving infrastructure to providing high-level services that will enable patients to comply with drug therapies. According to a recent Report from Forrester Research, Inc. (Nasdaq: FORR), pharmacy sites will use patient compliance programs to add $1.3 billion to their top lines by 2004. ePharmacies will proliferate as they specialize to maximize penetration and establish partnerships to master markets.

Although online demand for prescription drugs is growing rapidly, ePharmacy leaders are struggling with underdeveloped infrastructures. One reason is that although many insurers have relatively open retail pharmacy networks, most limit patients to a single mail-service provider to concentrate bulk-buying discounts. Additionally, delivery delays, often increased by time required to verify first-time and renewal scripts, encourage many patients to fill prescriptions with their offline pharmacies instead of buying them online. Finally, a fragmented regulatory system continues to cost online pharmacies resources for complying with divergent state regulations.

“Forrester believes that online pharmacies will rise to the challenge of selling prescription drugs online — ringing up $15 billion in sales in 2004,” said Elizabeth W. Boehm, analyst at Forrester. “To meet growing demand and capture market share, ePharmacies will build a strong foundation to deliver products and leverage compliance services that boost revenues.”

In an effort to build a strong foundation, ePharmacies will strengthen relationships that support online prescription sales. During the next 12 months, online pharmacies will forge stronger ties with insurance partners by integrating with insurer systems to provide the same real-time copay information that offline stores provide. ePharmacies with brick-and-mortar parents will go beyond order-entry systems and unify customers’ experiences across channels. Online pharmacies will also help drive electronic prescription adoption by creating a standard interface, as well as lobbying for standards across state regulations.

With a secure online retail foundation in place, online pharmacies will focus on compliance programs that expand the industry. Nearly half of all patients fail to take their medication as prescribed by their doctors, and unfilled scripts cost pharmacies about $25 billion annually in lost sales. Forrester projects that ePharmacy-based interactive compliance programs will add $1.3 billion in incremental drug sales by 2004. In addition to boosting sales, driving compliance will improve patient care and enhance communication with physicians.

To capitalize on the opportunity that compliance programs offer, online pharmacies must take advantage of the Internet’s interactivity to strengthen ties with customers. ePharmacies will connect with patients by encouraging them to take their medication and sending email reminders to refill prescriptions. Online pharmacies must also offer patients interactive treatment tools and site-sponsored support groups that complement drug therapies.

The Internet will introduce a level of coordination between pharmacies that doesn’t exist offline. ePharmacies will specialize to maximize penetration by defining their audiences according to insurance plan, locality, or condition and hone their services to address the specific needs of a community. In an effort to maximize reach, insurer sites will rely on brick-and-mortar interface sites to serve customers who prefer in-store pickup, while brick-and-mortar competitors with a complementary geographic reach will form online alliances that create national brick-and-mortar networks.

For the Report “The ePharmacy Opportunity,” Forrester surveyed 3,000 online consumers to explore their attitudes toward purchasing prescriptions and other health products online. Making up 5% of online users, online prescription purchasers outnumber those who have bought flowers online (4%). With 100% growth expected over the next six months, these users are catching up to those who have bought more popular items like videos (9%) and music (14%) online.