An Examination of Determinants Affecting Consumer Purchasing Behaviour for Pharmaceutical Products on e-commerce Platforms: a Systematic Review
Main Article Content
Page: 1986-2000
Abstract
As digital technology advances, consumers increasingly purchase pharmaceutical products through e-commerce due to easier access, competitive prices and product variety. However, studies examining the determinants of online purchases of prescription and over-the-counter (OTC) medicines remain limited. This study seeks to determine the elements that influence customers' decisions to purchase pharmaceuticals through e-commerce platforms. A systematic review was performed utilizing databases including PubMed, Scopus, ScienceDirect, Google Scholar, and Garuda. This study is limited to publications from 2012 to 2025. The data were analyzed using the TDF and COM-B frameworks. Results showed that eleven overarching themes influence consumers' decisions to purchase medicines through e-commerce platforms. These themes include price and cost savings, medicine and service quality, data security and privacy, risks and limitations, accessibility and convenience, product availability, logistics and delivery services, insurance policies and integration, user experience, customer service, and social or habitual factors. Preliminary evidence suggests that price may be a more influential factor in studies conducted in Asian developing countries, whereas quality, data security, and regulatory considerations were more frequently reported in the limited number of studies from developed countries.
Downloads
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
Al-Debei M, et al. Trust in digital health platforms: A cross-national study. Health Inform J. 2020;26(2):1005-1020.
Almalki M, Alzahrani A, Alghamdi A, et al. Consumers’ perspectives on online pharmacy services in Saudi Arabia: A cross-sectional study. Int J Environ Res Public Health. 2021;18(17):9348. doi:10.3390/ijerph18179348
Anderson K, Lopez M. Pricing strategies in digital pharmacies. J Consum Health. 2020;14(1):78-92.
Bandivadekar M. Online pharmacy market: Growth, trends, COVID-19 impact, and forecasts (2023-2028). Mordor Intelligence. Accessed September 27, 2025.
Bandivadekar SS. A study of consumer online buying behaviour for medicines in India.
Baid AN, Ghosh A. Factors affecting the shift of consumers towards e-pharmacies.
Chen L, Wang R. The role of online reviews in healthcare purchasing decisions. Patient Educ Couns. 2021;104(5):1120-1128.
Cokro F, Arfenda LB, Hadiyanto. Profile of online drug purchasing in the marketplace by students at the Faculty of Medicine and Health Sciences in Jakarta, Indonesia.
Ely JW, Osheroff JA, Chambliss ML, Ebell MH, Rosenbaum ME. Answering physicians' clinical questions: Obstacles and potential solutions. J Am Med Inform Assoc. 2000;7(6):553-564. doi:10.1136/jamia.2000.0070553
Erawati AD, Manurung MT, Zulaika C. Factors affecting consumers buying drugs online.
Ersoz S, Nissen A, Schütte R. Risk, trust, and emotion in online pharmacy medication purchases: A multimethod approach incorporating customer self-reports, facial expressions, and neural activation.
Ferawaty, Antonio W, Anggraeni A. Factors affecting customers' intention towards online pharmacies in the Indonesian market.
Fittler A, Vida RG, Kaplar M, Botz L. Consumers turning to the internet pharmacy market: Cross-sectional study on the frequency and attitudes of Hungarian patients purchasing medications online.
Gharaibeh L, Alameri MA, Al-Kabariti AY, Alsa'd AA, Abed A, Karameh N, Aldeeb ID. Practices, perceptions, and trust of the public regarding online drug purchasing: A web-based survey from Jordan.
Grant MJ, Booth A. A typology of reviews: An analysis of 14 review types and associated methodologies. Health Inf Libr J. 2009;26(2):91-108. doi:10.1111/j.1471-1842.2009.00848.x
Gupta S, et al. Counterfeit drugs in e-commerce: A global review. Health Policy Technol. 2023;12(1):100-115.
Hakansson A. E-commerce of pharmaceuticals: Benefits and risks. Int J Environ Res Public Health. 2021;18(3):1336. doi:10.3390/ijerph18031336
Hooche, et al. Challenges in online medicine sales. EMA Reports. European Medicines Agency; 2021.
Jacobs W, Amuta AO, Jeon KC. Health information seeking in the digital age: An analysis of health information seeking behavior among US adults. Cogent Soc Sci. 2017;3(1):1302785.
Kim H, Park S. User experience design in e-pharmacy platforms. Comput Human Behav. 2020;110:106392.
Lakho A, Joyo AS, Siddiqui HA. Impact of perceived usefulness, ease of use, value, risk, and trust on online purchase intention of medicines: Role of consumer engagement.
Lee B, Brown C. Consumer behavior in online pharmacy platforms. Health Mark Q. 2019;36(2):112-130.
Lim WM, Ting DH, Bonaventure V. E-commerce service quality on consumer satisfaction and loyalty: A systematic review. J Retail Consum Serv. 2022;65:102859. doi:10.1016/j.jretconser.2021.102859
Liu J, Zhou Y, Jiang X, Zhang W. Consumers’ satisfaction factors mining and sentiment analysis of B2C online pharmacy reviews.
Morgan R, Carter D. Risk perception in online drug purchases. J Health Commun. 2019;24(8):560-572.
Moureaud C, Hertig J, Dong Y, Muraro IS, Alhabash S. Purchase of prescription medicines via social media: A survey-based study of prevalence, risk perceptions, and motivations.
Nguyen NP, Simkin L, Canhoto A, Mortimer G. The dark side of digital personalization: An agenda for research and practice. Int J Inf Manage. 2020;55:102141. doi:10.1016/j.ijinfomgt.2020.102141
Nguyen T, White P. Fake reviews and consumer deception in e-health markets. J Med Internet Res. 2022;24(3):e30145.
OECD. E-commerce in the time of COVID-19. OECD Policy Responses to Coronavirus (COVID-19). Accessed September 27, 2025.
Orizio G, Merla A, Schulz PJ, Gelatti U. Quality of online pharmacies and websites selling prescription drugs: A systematic review. J Med Internet Res. 2011;13(3):e74. doi:10.2196/jmir.1795
Page MJ, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71
Purnomo C, Tan PHP. Factors that influence consumers' purchase intention when buying over-the-counter drugs online.
Statista. E-commerce share of retail sales worldwide. Accessed September 27, 2025.
Susilo D, et al. Digital transformation in the pharmaceutical industry: Trends and challenges. Health Policy Technol. 2021;10(2):100512.
Singh KP, Kumar P. Factors influencing e-pharmacy adoption in India: A study of user experiences through interpretative phenomenological analysis.
Sumi SF, Evan MAM, Hasan R, Hossain MA, Rahman MS. Dynamics of customers’ online medicine purchase intention.
Vogler S, Leopold C, Zuidberg C. The sale of medicines over the internet: A landscape assessment of national policies. Health Policy. 2016;120(3):315-322. doi:10.1016/j.healthpol.2016.01.011
Wang S, Liu L, Zhi Y. Analysis of factors affecting online drug purchase – based on factor analysis.
WHO. A survey of the quality of medicines was conducted by the United Nations Commission on Life-Saving Commodities for Women and Children. Accessed September 27, 2025.
WHO. Guidelines on online sale of medicines. WHO Press; 2020.
WHO. Guidelines on regulatory measures for online sale of medicines. World Health Organization; 2022.
Wilson E, Lankton N. Demographic differences in e-pharmacy adoption. Health Serv Res. 2023;58(1):45-62.
Zhang L, et al. Factors influencing online pharmaceutical purchasing behavior: A systematic review. BMC Health Serv Res. 2020;20(1):1-12.
Zhang Y, et al. Trust and risk perception in e-pharmacy adoption: A meta-analysis. Int J Med Inform. 2022;158:104678.
Moor BL, Anderson AR. Evaluating study quality in cross-sectional research: Application of the AXIS tool. Res Nurs Health. 2019;42(6):567-574. doi:10.1002/nur.22075
Almomani A. Critical appraisal of qualitative research: Lessons learned and practical guidance. J Nurs Res. 2023;31(2):123-132.
Dobersek U, Wy HL, Simpson J. The use of Mixed Methods Appraisal Tool (MMAT) in health sciences: A systematic review. J Mixed Methods Res. 2021;15(3):281-298. doi:10.1177/15586898211012345
Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for behaviour change and implementation research. Implement Sci. 2012;7(1):37. doi:10.1186/1748-5908-7-37
Michie S, van Stralen MM, West R. The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):42. doi:10.1186/1748-5908-6-42
Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458. doi:10.1136/bmjopen-2016-011458
Hong QN, Fàbregues S, Bartlett G, et al. The Mixed Methods Appraisal Tool (MMAT) version 2018 for information professionals and researchers. Educ Inf. 2018;34(4):285-291. doi:10.3233/efi-180221
D’cruz AC, Mokashi VN, Pai SR, Sreedhar D. The rise of E-pharmacy in India: Benefits, challenges, and the road ahead. Indian J Pharmacol. 2022;54(4):282-291. doi:10.4103/ijp.ijp_445_21
Badan Pengawas Obat dan Makanan Republik Indonesia. Kajian evaluasi penerapan 2D barcode dalam program pengawasan obat dan makanan tahun 2022. Pusat Riset dan Kajian Obat dan Makanan (Pusakom); 2022.
Yu Y, Yan M, Wang QH. From offline to online: How do health insurance policies drive the demand for online healthcare services? In: Pacific Asia Conference on Information Systems (PACIS). 2016:387. Accessed September 27, 2025.