ZAVA is the brand name for an
online doctor service and
online pharmacy Zavamed.com run by the
London-based Health Bridge Ltd. Launched in 2011 as DrEd, it was re-branded to ZAVA in 2016.
History
ZAVA was established in 2010 as DrEd.com by former
Dr Thom employees David Meinertz and Amit Khutti.[5] Its website was launched in November 2011 in the UK and Germany with two staff doctors.[6] In 2012, the company raised an
angel round of $1.4 million.[7] In April 2012, DrEd opened in Austria and launched an
emergency contraception delivery service in the UK.[8] On 20 June 2012, DrEd was launched in Switzerland.[9] In early 2014, the business became profitable.[10]
In December 2014, DrEd was launched in
Ireland, offering prescriptions for various medications.[11] In June 2016, the service was launched in France under the new brand ZAVA with four French doctors providing online consultations.[12] In September 2018, ZAVA had 155 employees and served patients in six European countries.[13] It was one of the largest digital healthcare companies in Europe having served more than 2 million patients online, including 400,000 from Germany.[14] In 2018 and 2019, British and German media wrote about ZAVA's stockpiling of key medications, in the context of a potential shortage of
Viagra Connect caused by
Brexit.[13]
In January 2019, DrEd changed its name to ZAVA in Germany. According to the website, the name is derived from the French Ça va? ("How are you?").[15] The firm also announced plans to open an office in Germany.[14] In June 2019, Health Bridge Ltd., which owns ZAVA, raised $32m (£20m) in a
series A round.[16][7] It aimed to expand its service in Europe and open an office in Hamburg.[7][17]
Regulation
ZAVA operates under British and
European Union laws. In the UK, Health Bridge Ltd., the company that owns zavamed.com, is registered with and regulated by the
Care Quality Commission.[4] Health Bridge Limited has a
MHRA permission to sell medicines online.[18] Health Bridge Ltd. Pharmacy is registered with the
General Pharmaceutical Council.[19]
In Europe, the company operates under the European Directive 2011/24/EC on cross-border healthcare that states that prescriptions written by a doctor registered in one
EU member state are recognized in all other member states.[20] However, the legal grounds for ZAVA's services have been questioned in several EU countries. Doctors and pharmacists have highlighted challenges between local doctor treatment and prescription fulfilment from pharmacies due to the European Directive (see "Criticism and controversies").[21][22]
Service
In the EU, ZAVA offers
diagnosis by a doctor using
telemedicine and is offering
Rx prescriptions, which can be delivered using partner
online pharmacies. In the UK, ZAVA has its own in-house registered pharmacy.[2]
ZAVA relies on patients filling in a detailed online medical
questionnaire which is reviewed by a person from its in-house clinical team.[23] The doctors provide medical consultation and can prescribe medicine.[7] ZAVA has provided 5 million paid consultations since its launch.[24]
Criticism and controversies
In Austria
In April 2012, when DrEd was launched in Austria it faced opposition from the Minister of Health
Alois Stöger, the Austrian chamber of physicians and the Austrian chamber of pharmacists.[25] The Austrian association for patient's rights also expressed its concerns about the quality of service that DrEd may provide.[26]
In January 2013, the Austrian consumer magazine Konsument tested DrEd.com by ordering a
gonorrhea treatment and a prescription for a
malaria drug.[27] The editors noted that the online doctor "comically" advised a sex worker of the need to inform her sexual partners of the last three months about her STD infection (which the Austrian law requires). In malaria cases, the editors complained that the online doctor gave them an "unnecessary" preventive treatment, because their test patient was supposed to travel only above 2,500 meters altitude, where the disease was not present. The magazine concluded that Austrian patients should absolutely avoid DrEd or any online medicine service, because they "cannot replace the personal meeting between the doctor and the patient".[27][28]
In 2016, Profil, an Austrian weekly news magazine, tested the DrEd.com service by ordering
Viagra and once against expressed concerns around the quality of online consultation and prescription.[29]
In Germany
In 2011, when the service was launched in Germany, Dirk Heinrich, the chairman of NAV-Virchow-Bund, an association of German physicians, criticized DrEd for prescribing medicines without physical examination. He said that "a diagnosis from an online survey is not a diagnosis, but a guess" and called DrEd "a covert online-pharmacy".[30] In July 2012,
Stiftung Warentest, a German
consumer organisation, tested DrEd with patients allegedly having
bladder infection and
chlamydia infection. In both cases
antibiotics were prescribed without the
urine tests necessary for the diagnosis.[31] DrEd responded with an open letter, questioning the care of the anonymous testers.[32]
In March 2013, the
Federal Ministry of Health questioned the legal grounds on which DrEd was operating in Germany.[33] In October 2013, when DrEd reached an agreement with the pharmacy chain
Ordermed for the
morning-after pill delivery, it was canceled by Ordermed because of its pharmacy partners' objection.[34] In fall 2013, the newly elected
Federal government proposed changes to the law, demanding a direct doctor-patient consultation for the initial prescription of medicines, which was sharply criticized by DrEd.[35] In May 2014, the Bavarian Health Minister,
Melanie Huml, demanded the Federal government to clarify that online prescriptions made outside of Germany were not valid.[36]
In 2016, the Ministry of Health proposed changes to German legislation demanding personal contact between doctor and patient and a ban on online issued prescriptions, which became popularly known as "Lex DrEd" or "DrEd-Verbot" (DrEd ban).[37][22][38] On 11 November 2016, the
Bundestag approved these changes.[38] This ban forced DrEd to work with EU pharmacies outside of the country that offered German delivery.[39]
However, in April 2018, the Chamber of Physicians of
Schleswig-Holstein changed its code to allow online consultations to the state doctors and, in early May 2018, the change happened on a national level, affirmed by the Federal Congress of German doctors.[40] Also in May 2018, the Chamber of Physicians of
Baden-Württemberg approved DrEd as a model project, following its 2016 decision to test telemedicine services within approved model projects where web service is compared to the hospital treatment and evaluated by the Chamber.[41]
In the UK and Ireland
In 2012, when DrEd launched the morning after pill delivery service in the UK, it was criticized for encouraging underage sex.[42] In 2015, when DrEd began offering
STI testing kits online, some doctors criticized the practice, claiming that ordering STI test kits online does not allow patients to receive advice on safe sexual practices the way face-to-face consultations do.[43] In September 2021, ZAVA partnered with Asda to launch Asda Online Doctor.[44]
^
ab"Rezepte von DrEd: Arzt im Netz" [Recipes of DrEd: doctor on the net] (in German). Verein für Konsumenteninformation. 24 January 2013. Archived from
the original on 7 October 2013. Retrieved 4 July 2019.
^"DrEd beschäftigt BMG" [DrEd questioned by BMG]. Pharmazeutische Zeitung (in German). 5 March 2013. Archived from
the original on 20 November 2018. Retrieved 4 July 2019.
^"DrEd kritisiert Koalitionspläne" [DrEd criticizes coalition plans]. Deutsche Apotheker Zeitung (in German). 21 November 2013. Archived from
the original on 21 November 2018. Retrieved 4 July 2019.
^Link, Christiane (26 September 2016).
"Onlineärzte bald offline?" [Online doctors soon offline?]. Die Zeit (in German). Archived from
the original on 27 September 2016. Retrieved 4 July 2019.
^
abKlein, Lothar (11 November 2016).
"Bundestag beschließt DrED-Verbot" [Bundestag adopts DrED ban]. apotheke-adhoc.de (in German). Archived from
the original on 13 May 2019. Retrieved 4 July 2019.