Combatting pharmacy deserts with telepharmacy locations

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Combatting pharmacy deserts with telepharmacy locations

By Michael Johnsen - 05/29/2018
More than 32.6 million Americans live more than two miles from the nearest pharmacy. That distance not only serves as a significant barrier to accessing prescription medicines, but also contributes to the growing nonadherence problem in the United States.

[caption id="attachment_588269" align="alignright" width="150"] Adam Chesler, director of regulatory affairs at Cardinal Health[/caption]

TelePharm, a Cardinal Health company, helps pharmacists overcome those medication barriers by facilitating the opening of telepharmacies as part of a turnkey solution set for interested pharmacy operations. “We work with pharmacists to discuss challenges they’re currently facing and how telepharmacy practices can help them better address patient needs,” Adam Chesler, director of regulatory affairs at Cardinal Health, said. “From the beginning of the process, we help them identify locations best suited for their pharmacy and map out a floor plan that fits the area of interest.”

Many of those areas of interest are markets where currently there is a void of any pharmacy operation — pharmacy deserts.

Pharmacy deserts are prevalent, Chesler noted. According to a recent National Institutes of Health (NIH) study, the number of pharmacies per 10,000 people really hasn’t changed much between 2007 and 2015, but where those pharmacies are located has, especially as more big-box retailers place their stores in high-density markets. According to NIH, there is nearly a three-fold difference in the number of pharmacies per-capita between counties in the highest and those in the lowest quintile.

That begs the question: While 90% of the American population lives within two miles of a pharmacy, where are the other 10% sourcing their medicines?

“Telepharmacy allows improved access to a pharmacist, which can improve adherence,” Chesler said. “Increased access to a pharmacist will increase the number of patients who pick up their prescriptions and take them, leading to improved overall outcomes of therapy and reduced costs of healthcare.”

Not all pharmacy deserts are obvious. David Falk and his team at SavMor Pharmacies identified a pharmacy desert by the number of deliveries they were making to the small community of Atwood, Ill. “We saw a market that was like a desert that wasn’t being fulfilled,” Falk said.

Up until his telepharmacy opened, that rural community of 1,200 people hadn’t seen a pharmacy in town for more than 15 years. “People were driving 10 miles each way to get a prescription filled,” he said. “By adding a telepharmacy there, we knew the patient’s would support the improved access, and there was a lot of business in Atwood that we could tap into.”

Just like food deserts, pharmacy deserts can be located in densely populated areas. Tushar Mehta, who owns two independent pharmacies in the Chicago area, opened a telepharmacy in the heart of an urban community inside a local health clinic to provide convenient dispensing at the point of care.

“Parking can be an issue for residents, [and] not everyone has access to a car,” Mehta said. “Time is a very big concern for patients, especially for parents during the winter months when Chicago sees greater amounts of snow and rain. These conditions make it very difficult for patients to go to the clinic and then go elsewhere for their medications.”

Telepharmacy not only extends pharmacy services into new markets, it expands access to a pharmacist in areas which were previously not economically viable, and drives more prescriptions into existing locations. “The wave of the future is no doubt technology,” noted Dale Colee, owner of Dale’s Southlake Pharmacy in Decatur, Ill. “If you want to survive as a pharmacy in today’s environment, you have to do this.”

Colee began researching telepharmacy after a 340B community health improvement center approached him about opening a pharmacy inside its new Decatur, Ill., clinic. “The fact that we have a telepharmacy has allowed us to cost effectively increase the number of prescriptions we are filling with very low overhead and enabled us to leverage our current pharmacists’ availability,” he said. “They asked us to put [a telepharmacy] onsite as a resource for the community to reduce barriers for people trying to get their medications.”

Part of the appeal of a telepharmacy operation is the flexibility of the business model, whether it’s in a rural or urban setting. All of these examples are singular examples, Chesler said. “The models vary widely across the board,” he said. “This is why independent pharmacists are primed to thrive in this space.”

Currently, there are 23 states that have regulations supporting a telepharmacy model, Chesler said. Moving forward, more states are looking to incorporate a telepharmacy structure into their pharmacy regulations. “Not a month goes by that we don’t get a phone call from a state interested in pursuing telepharmacy,” he said.

As many as five additional states may be incorporating telepharmacy regulations as soon as 2019, Chesler added. “The technology has finally caught up to the [concept],” he said. “That’s been the big game changer [in adoption] — our technological advancements.”

A CE course on telepharmacy will be available at RBC 2018 on Friday, June 29 at 2:45 p.m. To register for the tradeshow, please click here.

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