Objective  To examine the changes in online medicine purchases before and after the coronavirus disease 2019 (COVID-19) pandemic and its correlates among urban young and middle-aged adults.

  Methods  Based on Wenjuanxing online survey platform, adults aged ≥ 18 years were randomly recruited for a electronic questionnaire survey during October 21 – 28, 2021. The collected information on 748 urban adults aged 18 – 59 years and ever purchasing medicine during the past year were finally included in the analysis. Multinomial logistic regression was adopted to examine the correlates of the changes in online medicine purchases.

  Results  Of all the respondents, 178 (23.80%) reported no online medicine purchases before and after the COVID-19 pandemic; 477 (63.77%) reported ever purchasing medicine online before and after the pandemic; and 71 (9.49%) had purchased medicine online only after the pandemic. The results of regression analysis showed that, compared with those not ever purchasing medicine online before and after the COVID-19 pandemic, the respondents with the education of bachelor degree or above were more likely to purchase medicine online after the COVID-19 pandemic (relative risk ratio RRR = 3.64, 95% confidence interval 95%CI: 1.37 – 9.68); the respondents purchasing medicine at medical facilities after the epidemic were less likely to purchase medicine online after the epidemic (RRR = 0.41, 95%CI = 0.22 – 0.75); the respondents with the education of bachelor degree or above and having chronic diseases were more likely to purchase medicine online both before and after the COVID-19 pandemic, with RRR (95%CI) of 2.06 (1.25 – 3.39) and 2.54 (1.65 – 3.92); the respondents living in central and western regions were less likely to purchase medicine online before and after the COVID-19 pandemic (RRR = 0.53, 95%CI: 0.33 – 0.84 and RRR = 0.58, 95%CI: 0.36 – 0.93).

  Conclusion  Under the context of normalized COVID-19 pandemic control, online medicine purchases increased among urban young and middle-aged adults, especially among those with higher education, suffering from chronic disease, and not purchasing medicine at medical facilities.