Background In recent years, mail-order pharmacies have been accepted by increasingly more patients, and the prospects for mail-order pharmacies are optimistic. This article explores the patients’ satisfaction factors addressed in Business to Customer (B2C) mail-order pharmacy reviews and analyzes the sentiments expressed in the reviews. The goal of this work is to help B2C mail-order pharmacy enterprises identify patients’ concerns, continuously improve the health services level. Methods This paper was based on the Latent Dirichlet Allocation (LDA) topic model. From a B2C mail-order pharmacy of integrated e-commerce and a vertical B2C mail-order pharmacy (JD.COM and J1.COM, respectively), 136,630 pieces of over-the-counter (OTC) drug review data posted from January 1, 2015 to December 31, 2018 were selected as samples and used to explore the satisfaction factors of B2C mail-order pharmacy patients regarding the entire drug purchasing process. Then, the sentiments expressed in the drug reviews were analyzed with SnowNLP. Result Categorization of the 12 factors identified by LDA showed that 5 factors were related to logistics; these 5 factors, which also included the most drug reviews, made up 38.5% of the reviews. The number of factors related to drug prices was second, with 3 factors, and reviews of drug prices made up 25.5% of the reviews. Customer service and drug effects each had two related factors, and a smaller percentage of these reviews (13.95%) were related to drug effects. Patients still maintain positive opinions of JD.COM and J1.COM. However, some opinions on logistics and drug prices are expressed.Conclusion The most important task for mail-order pharmacies is to improve logistics. It is better to develop self-built logistics. Both types of B2C mail-order pharmacies can improve patient viscosity by implementing marketing strategies. With regard to customer service, focusing on improving employees' service attitudes is necessary.