China Tightens Rules on Online Prescription Drug Sales

China’s National Medical Products Administration (NMPA) has issued comprehensive new guidelines to regulate the online retail of prescription drugs, introducing strict requirements that include a ban on artificial intelligence-driven prescription review and a prohibition on live-streaming promotions for prescription medications. The guidelines, published on May 25, 2026, aim to bring order to the country’s rapidly expanding e-pharmacy sector, which surpassed 800 billion RMB ($110 billion) in transaction volume in 2025.

Background: A Booming Market with Growing Risks

The new regulatory framework, formally titled the “Guidelines for Compliance in Online Prescription Drug Retail” (《处方药网络零售合规指南》), was issued under notice number 药监综药管函〔2026〕282号 and consists of 4 chapters and 42 articles. According to Xinhua News, the guidelines cover general provisions, compliance requirements for business operators, compliance requirements for business activities, and compliance requirements for third-party platform management.

China’s online drug retail market has grown explosively, reaching 700 billion RMB in 2024 and exceeding 800 billion RMB in 2025, according to NMPA data. However, this rapid expansion has been accompanied by mounting safety concerns. An NMPA official told Xinhua that routine monitoring and inspections have revealed “incomplete compliance management systems, unsound compliance operation mechanisms, and insufficient understanding of compliance management” among many platforms and online retailers, with “illegal sales of prescription drugs still occurring from time to time.”

Key Provisions: AI Ban and Live-Streaming Restrictions

At the heart of the new guidelines is a clear prohibition on the use of artificial intelligence for prescription review. The guidelines explicitly state that “prescription review work must be carried out by licensed pharmacists, and shall not be implemented by other positions or artificial intelligence,” as confirmed in the NMPA’s official policy interpretation.

The guidelines also ban the use of marketing-oriented short videos, live-streaming promotions, and private-domain sales tactics to induce consumers to purchase drugs inconsistent with their treatment purposes. Other key requirements include real-name verification for all prescription drug purchases and special provisions requiring guardian consent for purchases by minors.

These measures directly address documented industry problems, including the “instant prescription” phenomenon — particularly for weight-loss drugs such as GLP-1 agonists (semaglutide, tirzepatide) — where prescriptions were issued with minimal medical consultation through online platforms.

Expert Perspectives: Balancing Access and Safety

Industry experts have broadly welcomed the guidelines, viewing them as a necessary step toward sustainable industry development. Liang Jialin (梁嘉琳), a standing committee member of the Digital Health Special Committee of the China Health Management Association, emphasized that the guidelines are “not to restrict development, but to deeply integrate regulatory requirements into the ‘full-subject, full-process, full-element’ regulatory system for online prescription drug sales, ensuring that while improving service accessibility, the bottom line of medication safety is firmly guarded.”

Zhang Yue (张玥), Chairman of Aoyou International, highlighted the market implications, noting that “with the deepening of the prescription outflow policy and the full opening of medical insurance online payments, the market space is immeasurable in the long term.” Zhang added that the guidelines “unify national compliance standards, plug regulatory loopholes that previously existed, and will significantly enhance consumer trust in online drug purchasing.”

Regulatory Evolution and Enforcement

The new guidelines represent the latest step in China’s decade-long effort to regulate online drug sales. The legal foundation was established with the revised Drug Administration Law in 2019, followed by the comprehensive “Measures for the Supervision and Administration of Online Drug Sales” in 2022. The draft version of the current guidelines was released for public comment in September 2025, with the final version formally issued on May 22, 2026.

According to the NMPA’s policy interpretation, enforcement priorities will include the ongoing “Qingyuan” (清源) consolidation campaign targeting drug business operations, online-offline integration checks to ensure consistent product quality, and comprehensive oversight of third-party platform quality management systems.

Industry Impact and Outlook

In the short term, industry analysts expect a one-to-two quarter adjustment period as non-compliant businesses are forced to exit the market. However, the long-term outlook is positive. The unified national standards create a level playing field for compliant operators and lay the groundwork for full integration with medical insurance online payment systems and electronic prescription circulation networks.

As Zhang Yue noted, “Standardization is the only path for the industry to grow bigger and stronger. Ultimately, it will achieve a win-win situation where patient medication safety is guaranteed and industry development is orderly.” The guidelines signal China’s commitment to balancing innovation in digital health with patient safety — a challenge that regulators worldwide are grappling with as e-pharmacy continues its global expansion.

This article was based on reporting by Xinhua News and the NMPA’s official notice.