Whether it's a last-minute script, medical certificate or weight-loss treatment, many Australians are turning to online commercial health platforms for their healthcare. But while this model of care is quickly becoming big business, it also raises some significant ethical and policy issues, including risks to patient safety and consumer protection, according to new Adelaide University research .
Analysing the multi-billion-dollar online commercial health platform sector, bioethicists identified how online platforms are blurring the lines between patient and customer, potentially weakening patient care while increasing the risk of fragmented or inappropriate treatment.
They warn that because of the sector's rapid evolution, regulation has struggled to keep pace, raising concerns about insufficient oversight, unsafe prescribing practices and the unethical influence of commercial interests on treatment decisions.
It's a timely push, especially with the Australian Commission on Safety and Quality in Health Care announcing it has been tasked with developing national safety and quality standards for virtual care .
In 2025, more than 11 million Australians had a telehealth consultation , illustrating just how embedded virtual care and telehealth has become in Australia.
But these commercial online health platforms go well beyond the type of telehealth people might get from their local GP or public healthcare system and often sell questionable products and supplements alongside medications.
Generally sitting outside the traditional healthcare system, online-only services typically market themselves as one-stop shops for expensive private prescriptions – for example, weight loss injectables such as Wegovy or Mounjaro, hair loss medications, or even controversial peptide and testosterone treatments spruiked by influencers.
Lead researcher and bioethicist Dr Hilary Bowman-Smart from Adelaide University's Australian Centre for Precision Health warns that while online commercial health platforms may provide convenient healthcare, they're also creating risks.
"There's no doubt commercial online health platforms are responding to a demand," Dr Bowman-Smart said.
"These platforms can offer care that feels fast and convenient, especially with people facing increasingly long waits and rising costs for their healthcare. However, this doesn't always mean it's high-quality, appropriate or affordable care.
"Many of these platforms get people to sign up to ongoing subscriptions or memberships, similar to Netflix or Amazon Prime. That's not what we think safe and ethical healthcare should be about.
"If people turn to these platforms because they don't have or can't get in to see a regular GP, this can create risks for people taking multiple medications or who have more complex healthcare needs.
"Our concern is that many people's healthcare could become brief phone consults with a doctor they've never met before, or patients just filling out a form or clicking through an online quiz without details being double-checked or verified.
"Additionally, when people log on to a platform selling a specific 'solution', doctors can feel a lot of pressure to prescribe the solution that the patient wants or that the platform promotes, even if they don't feel it's right.
"There's also the risk that important parts of a patient's history or medical records get missed with short consults and the fact that many platforms don't routinely use My Health Record .
"This can harm patients – such as a patient with an eating disorder being prescribed a weight loss injectable – but it can also make doctors feel a loss of professional identity and values, and like they're just reduced to ticking boxes. That's bad for both sides of the equation."
Conducted in partnership with the University of Wollongong , the team of bioethicists were also concerned about the growing influence of commercial interests on healthcare.
Dr Patti Shih from the University of Wollongong said with some platforms used familiar online shopping tactics such as product bundles and discount codes to sell prescription medicines alongside supplements and other wellness products.
"With this model of care, evidence-based treatments can be used as a type of 'Trojan horse' to sell people add-on wellness products and supplements," Dr Shih said.
"For example, someone who is prescribed a hair loss medication may also be sold a 'tailored' plan with daily vitamins and shampoo products for 'optimal results', without those add-ons necessarily having the same medical evidence."
With reports of overdosing , inappropriate prescribing and adverse health effects, researchers say national standards for the sector couldn't come sooner.
"We know this sector is growing, but without good evidence and national standards, we risk profit coming at the expense of high-quality and appropriate care," Dr Bowman-Smart said.
"People need to understand that these online commercial health platforms are very different from traditional healthcare.
"We hope the development of national standards and the upcoming introduction of a National Medicines Record will certainly go some way, but there's still so much we don't know about how this sector is operating and what further safeguards may be needed to protect patients.
"In the meantime, Australians need better information about when online care is appropriate, what to look out for and when they need more comprehensive care."
The research team is now building on the findings through an auDA Foundation -funded project, working not only with the general public, but especially young Australians and people in regional, rural and remote communities to gain better understand their experiences of online healthcare.
The project will include community dialogue groups, a national survey and consultation with healthcare professionals, and will inform a plain-language Health Online Toolkit for consumers and an Action Paper for policymakers, professional bodies and advocates.
