British e-pharmacy MedExpress is aiming to launch its American arm Zip Health to dispense drugs online in the US next year.

The online pharmacy has more than 500,000 customers in the UK and is hoping to become fully licensed in every US state before the end of the first quarter in 2020.

It is currently in the final stages of securing licences to prescribe medications in California and Texas.

MedExpress founder Dwayne D’Souza said that by so far targeting states with a population greater than five million, the company is already eligible to sell to about 70% of people in America.

However, he added it will only begin marketing Zip Health – and soft-launch its website – once fully licensed in the remaining US states.

D’Souza said: “We can compete by bringing our UK expertise to the US.

“Most of the companies already in America have only come along recently – we’ve been doing this for several years in the UK.

“We have hundreds of thousands of registered patients that we’ve treated, so we have pedigree in doing this.

“But it’s a lot of work – this is certainly not a trivial task to complete.”


Why the Zip Health US expansion has proved challenging

D’Souza said the biggest problem with expanding into America has been the issue of licensing – because pharmacies need permission from each of the 50 states to sell prescription drugs there.

The process of applying for and gaining a state licence can take up to a year to complete, he added.

Furthermore, only qualified doctors with a licence from a given US state can prescribe medicines there.

zip health
American doctors must obtain a license in every one of the 50 states to prescribe drugs to patients across the country (Credit:

This differs greatly from the system in Europe, where a permit to sell and prescribe drugs in one nation applies to all EU member states.

MedExpress has doctors with medical and pharmaceutical licences in 25 US states – and is working towards setting up a network of licensed doctors across the country.

D’Souza said: “If you’re only licensed in half the states, it’s difficult to go out there and market yourself to the whole country – it wouldn’t be very effective.”

Dermatica – a dermatology-specific online pharmacy that sits alongside MedExpress in the HeliosX Group, also headed up by D’Souza – has already soft-launched in the US.


How does MedExpress’ online pharmacy service work?

D’Souza launched MedExpress in 2013, and it has achieved rapid growth providing solely online services, while high-street competitors like Boots and Lloyds Pharmacy continued to focus on their vast store network.

To access the range of prescription drugs it offers, customers fill out an online consultation form, which is then looked at by MedExpress’ medical team.

They decide whether or not it is appropriate to prescribe a certain medication – and if it is, they will dispatch it the same day to the customer’s address.

Zip Health
MedExpress founder Dwayne D’Souza

This process is not only more convenient than a face-to-face GP appointment, but D’Souza said it also allows MedExpress to make its drugs cheaper, as less time is taken up for the doctor per customer.

He added that the e-pharmacy is careful with the medicines it offers, in an effort to ensure customer safety – for example, MedExpress does not supply controlled drugs like painkillers.

It also uses AI to filter consultation forms and assess whether or not customers meet the “exclusion criteria” that rules them out of receiving a prescription online.

Despite the safety procedures in place, the wider online pharmacy sector – which includes about 2,000 businesses in the UK – has attracted significant controversy.

It has been criticised by medical groups and charities, including the Royal College of GPs, Patients Association and DrugWise, which say the consultation forms can be manipulated by patients to get the medication they want – even if a doctor would not be willing to prescribe them.

Online pharmacists also don’t have access to full medical records, while an investigation by The Times found that some companies were dispensing opioids without first contacting a doctor.


How MedExpress will provide further help to patients in the future

In 2018, MedExpress generated revenues in excess of £12m ($15.8m), and and is now one of the UK’s biggest online pharmacies with over 500,000 customers.

The largest customer base has prompted D’Souza to look at which other services it can provide.

This will involve trying to understand its users, and offering a more wholesome service by going beyond the pharmaceutical setting.

For example, if a customer wants a prescription drug for weight loss, MedExpress may look at offering nutritional advice alongside any medication.