The paper aimed to analyze the attitude and awareness of pharmacists to the application of digital tools in the activities of Ukrainian pharmacies within holistic marketing. A survey of 745 pharmacists from different regions of Ukraine was conducted. Many pharmacists are wary of the legalization of virtual pharmacies in Ukraine. At the same time, they have a positive attitude regarding such digital tools as free online doctor’s and pharmacist’s consultations and the availability of mobile applications. Almost half of the respondents rate online platforms’ role in pharmacists’ continuous professional development as “very important.” The most popular activities are online testing (70.9%), online training exercised by mentors (51.9%), and corporate webinars (34.6%). Based on the research results, a structured model was developed to improve the customer-centricity of pharmacies within holistic marketing and the process of digitalization.

Digital tools, holistic marketing, online pharmacy, pharmaceutical market, Ukraine

The global COVID-19 pandemic has accelerated the digitalization of all business processes. The pharmaceutical industry is no exception, as it covers an integral part of our lives – our health (Jordan et al. 2021). It should be noted that the introduction of innovative digital approaches to providing the population with high-quality and timely pharmaceutical care creates additional value for customers (Yang et al. 2021). To be exact, customer orientation is the basic concept of holistic marketing. A holistic concept of marketing was proposed by F. Kotler together with K. Keller (Keller et al. 2006). Due to this concept, the interrelated work of all company’s departments can create the most productive cooperation strategy with customers and other stakeholders that will positively impact its sustainable development (Aliekperov 2021). Holistic marketing combines four critical marketing approaches: social and ethical marketing, relationship marketing, internal and integrated marketing (Keller et al. 2006; Aliekperova et al. 2020; Almahrab et al. 2022). When applying innovative marketing tools, pharmacies should consider individual customers’ and other stakeholders’ interests, including society. That is why integrating digital tools into holistic marketing is a relevant area of research.

Analyzing the world experience, we saw that many pharmacies use modern Internet marketing trends. For example, leaders of the US pharmaceutical market, CVS Pharmacy and Walgreens Boots Alliance (Fein 2019), have been integrating their activities into the online environment for a long time. They have used modern digital tools to improve customer engagement (Clark et al. 2017). In the United States, online pharmacies can retail medicines at a distance. Still, they must follow specific requirements: a license for this type of activity and a prohibition on online prescription drugs. Online pharmacies may operate only in the state in which they are registered. The exception is Pennsylvania, which recognizes the pharmacy license of any other US state. The FDA controls the activities of online pharmacies, and accreditation of pharmacies is carried out under the VIPPS program – Verified Internet Pharmacy Practice Sites for compliance with the licensing conditions of the state where the pharmacy is located and where the medicines will be delivered (Brown 2014).

In the European Union (EU), according to Directive 2011/62/EU, online pharmacies are allowed to sell over-the-counter (OTC) medicines (Directive 2011/62/EC 2011). Before Directive 2011/62/EU, there were no general rules for online sales of medicines in the EU, and individual countries regulated such sales independently. For example, in Italy, the Code of Ethics of the Federation of Professional Pharmacists’ Associations prohibited the online sale of prescription and non-prescription medicines (Lombardo et al. 2019).

The COVID-19 pandemic has caused changes in Ukrainian legislation, namely the introduction of online sales of medicines. On September 17, 2020, the Law of Ukraine “On Amendments to Article 19 of the Law of Ukraine “On Medicinal Products” Regarding Electronic Retail Trade of Medicinal Products” entered into force (Resolution of the Cabinet of Minister of Ukraine dated 23/03/2020 № 220).

A pharmacy can carry out online trade of medicines, provided that:

• it is included in the special list of organizations that have the right to carry out online trade of medicines;
• the information must be contained in the License Register;
• the information on the website should allow the customers to make sure that this pharmacy has the right to trade online;
• the option of providing online consultations by a pharmacist (if needed) should be available;
• the shipping cost is indicated.

Online trade of medicines that require a doctor’s prescription and strictly regulated medications is prohibited. Nowadays, pharmacies in Ukraine are actively implementing digital tools in all business processes. So, for a more general study of this issue, closer attention should be paid to the digital transformation of the Ukrainian pharmaceutical market.

The novelty of the work is analyzing the use of digital tools in Ukrainian pharmacies according to the concept of holistic marketing for improving customer experience and creating customer-centered pharmacies. The study’s object is the digital transformation process of Ukrainian pharmacies within holistic marketing. The work aims to analyze the awareness and attitude of pharmacists to digitalization processes in Ukrainian pharmacies within holistic marketing.

To achieve this goal, it is necessary to solve the following tasks:

• to investigate the awareness and attitude of pharmacists regarding the legislative regulation of online trade in Ukrainian pharmacies and its possible risks;
• to analyze digital tools used in pharmacies to increase customer satisfaction and to determine the attitude of pharmacists toward them;
• to substantiate the role of online platforms in the continuous professional development of pharmacists;
• to develop the structured model of the digital tools’ application in pharmacies within holistic marketing.

Today, pharmacies increasingly use digital tools to interact with pharmacists and patients. For example, in 2020, the Netherlands introduced distance consultations with patients (video call, phone, email) to provide continuous pharmaceutical care (Merks et al. 2021). In Poland, since April 1, 2020, pharmacists have been allowed to independently prescribe an electronic prescription to a patient in a dangerous situation – for this purpose, the pharmacist conducts only a diagnostic interview with the patient (Zimmermann et al. 2021). In Ukraine, the digitalization process of pharmacies is also associated with introducing innovative tools. For example, pre-booking of medicines reduces the burden on pharmacists due to the customer’s independent online choice of medicines, and the transfer to an electronic prescription ensures simple and fast dispensing of medicines, taking into account all essential options (INN, dosage, frequency of prescription, etc.) (Motruk 2019).

The introduction of digital technologies can significantly improve the service component of a pharmacy, which has a positive impact not only on increasing the number of loyal customers but also on the financial and economic metrics of the pharmacy, strengthening the brand of the pharmacy and its cheerful consumer’s perception (Yang et al. 2021).

In the context of holistic marketing, online selling of medicines to the consumer is an element of integrated marketing, as the product is sold at a specific price (in particular, there is a flexible loyalty system), the Internet is a specific marketing platform, and mobile applications and websites provide a space for advertising and promotion of the product (Panigrahi et al. 2018). Digital technologies are improving the process of delivering medicines to consumers: using a mobile application and geolocation, consumers find the right medicines at the nearest pharmacy and an attractive price, additionally creating their account with the ability to save the history of previous reservations and purchases, while being able to communicate online with specialists – a doctor or pharmacist (Khan et al. 2019).

However, there is a problem with dishonest websites that distribute low-quality and/or falsified medicines with violations of storage and delivery conditions (Fittler 2021). For example, in Hungary, during the 2020–2021 pandemic, it was found that patients visited online pharmacy websites, most of which were illegal. At the same time, illicit pharmacies significantly outnumbered legal ones. The majority (77.7%) of the identified online pharmacies were known to be unlawful; 55.5% of them sold medicines without a prescription (Pashkov et al. 2021). In June 2013, the U.S. Food and Drug Administration (FDA) identified 1677 websites that sold fake or substandard medicines without appropriate permits (Gabay 2015). The United States Food and Drug Administration launched the BeSafeRx program to address this issue, raising patient awareness about the dangers of purchasing prescription drugs from fake online pharmacies. BeSafeRx provides guidelines for identifying safe online pharmacies and helps patients ensure that the pharmacy is licensed by the patient’s state board of pharmacy (Kumaran et al. 2020).

In addition, the United States Food and Drug Administration provides a «Warning Letter» to the website of pharmacies engaged in illegal activities related to the sale of medicines for the prevention and treatment of COVID-19 (Food and Drug Administration. Fraudulent Coronavirus Disease 2019). Taking into account the US experience in regulating the activities of online pharmacies, it is worth implementing some of its principles in Ukrainian practice, namely, creating a unique institution that will verify the legality of online portals that sell medicines or medical devices, forming a single database with open access for consumers (Lebed et al. 2020). In addition, it is important to raise awareness among pharmacists about the digital transformation of the pharmaceutical business.

A significant problem with electronic commerce in medicines is the risk of increased self-medication among the population, particularly during the global pandemic (Sadli et al., 2018). According to our survey, a relatively large number of respondents (78.1%) drew attention to this problem. The solution is to sell only OTC medicines online. Still, any pharmaceutical care should be accompanied by proper pharmaceutical care, which is almost impossible to fully ensure in the online sales of medicines. Online consultation by a pharmacist or doctor in real-time is a promising area, but it is an additional burden on staff, which directly demotivates and negatively affects work performance. Labor costs can be offset by increased customer loyalty and, consequently, increased profits (Unni et al. 2021).

The results of our research have demonstrated a significant impact of the global pandemic on the increase in the number of online orders of medicines. Almost half of the respondents in our study (45.9%) noted that online orders increased significantly during the lockdown. Accordingly, the need for remote home delivery of medicines has increased. This service helps to protect staff from infection with the COVID-19 virus and other viral diseases. In the UK, NHS England & NHS Improvement initiated a service to deliver medicines from community pharmacies to patients who self-isolate during the COVID-19 outbreak (Allinson 2022). In the United States, many medications are dispensed to patients via mail order or drive-thru service, which was first introduced in the 1990s by Walgreens, one of the largest pharmacy chains in the United States. Its purpose is to provide faster dispensing of medicines for customers who drive up to the window and receive their orders, just like in a typical fast food restaurant. In 2008, the UK pharmaceutical giant Boots launched a similar service to facilitate access to medicines for its customers (Hussain et al. 2021).

In Ukraine, remote delivery of medicines is carried out in cooperation with mail service providers (Nova Poshta, Ukrposhta) and delivery services (Glovo, etc.). The vulnerable categories of the population with chronic diseases, the elderly, and people in self-isolation have the opportunity to receive medicines without leaving their homes (Hirna et al. 2021). In the holistic concept, this can be attributed to aspects of relationship marketing – beneficial cooperation between a pharmacy and a postal operator (courier service) to ensure the consumer’s well-being. Caring for a healthy society and measures to counteract the spread of a dangerous disease is also a manifestation of socio-ethical marketing (Aliekperova et al. 2020). For example, companies care about society and the environment by using an electronic loyalty system, replacing paper price tags with electronic ones, and reducing the use of resources associated with printing leaflets and posters (Khan et al. 2021).

Staff training is about internal marketing, a component of holistic marketing. Despite quarantine restrictions, professionals need to improve and develop their professional knowledge. In this case, digital technologies can be used to improve the professional competencies of pharmacists and their continuous professional development (Gallegos et al. 2021). The vast majority of respondents emphasized that pharmacies conduct periodic staff testing to determine the level of competence, which includes a theoretical component in specialized disciplines and a practical part – service and methods of increasing profits from the sale of medicines. As a result, a high level of competence and professionalism of a pharmaceutical specialist leads to the loyalty of consumers and increases the level of competitiveness of the pharmacy (Nagy et al. 2021).

It is worth noting that digital tools are used not only to train specialists but also to facilitate internal communication within the company. For example, Zoom, GoogleMeet, and other video communication tools are used to hold meetings with the company’s top management and conduct various business meetings. As a relationship marketing tool, CRM systems help establish communication with the company’s main stakeholders, including the client. Another tool for the digital transformation of the healthcare sector in Ukraine is the eHealth electronic healthcare system, which ensures communication between a pharmacist, a doctor, and a patient, for example, when dispensing medicines by electronic prescription (Kotenko et al. 2021).

As we can see, all digital tools used in pharmaceutical activities can be integrated into a unified, holistic marketing model with a customer-centered approach. The integration of critical aspects of the digital transformation of the domestic pharmaceutical market in the context of holistic marketing is summarized and schematically shown in Table 2.

It should be noted that to effectively satisfy consumers’ needs for high-quality, effective, safe, and affordable medicines, this model allows for the comprehensive integration of all components of holistic marketing with the use of digital tools in the activity of the pharmacies. This ensures the sustainable development of the company, its adaptability to environmental factors and competitiveness.

This study demonstrates the positive attitude of pharmaceutical professionals toward applying digital tools. Despite the risks and obstacles associated with the online sale of medicines, experts identify several advantages that create additional value for the consumer, increase customer focus, and thus increase pharmacy profits. With the help of digital tools, pharmaceutical professionals improve their professional level, have more time to provide quality pharmaceutical care for patients thanks to online tools (pre-booking, searching for the cheapest medicines), and the pharmacy itself establishes sustainable and long-term relationships with potential stakeholders, taking care of society and the environment. And all this is a holistic approach; the elements complement each other. Based on the concept of holistic marketing and our proposed model, integrating critical digital tools into a holistic concept of managing a modern pharmacy is a priority for developing the customer-centered pharmaceutical business.

The authors would like to thank all respondents who participated in the survey.