Regulations ease to create opportunities for telepharmacy

The state regulatory environment is on its way toward becoming friendlier to telepharmacy, or the practice of providing pharmaceutical care via telecommunications to patients at a distance, especially those patients living within a “pharmacy desert.”

A telepharmacy operates like a traditional pharmacy except the pharmacist reviews prescriptions and counsels patients from a remote location.

“One advantage to telepharmacy is every step of the prescription process is documented with software,” Roby Miller, director of Cardinal Health’s TelePharm, told Drug Store News. “That gives you better analytics and safety in the pharmacy.” 

Telepharmacies serve as an extension of a traditional pharmacy, where a remote-dispensing pharmacy staffed by a certified pharmacy technician is supervised by a pharmacist at the host site, thereby extending the reach of that host pharmacy into communities that may not be able to sustain a pharmacy operation on its own. Many of those communities had full-scale pharmacies that have since gone out of business, noted Adam Chesler, director of regulatory affairs at Cardinal Health. “But a telepharmacy can still serve those patients with a smaller prescription count,” he said.

“Even if you are in an urban area where a lot of people don’t have cars, when pharmacists can place a telepharmacy close to them, they’re filling prescriptions the day they’re written,” Miller added. “From an adherence standpoint, you just don’t have any lapse from when that prescription needs to be filled.”

Telepharmacies are slowly filling those pharmacy gaps, Chesler said. “There are over 83 in North Dakota alone and more than 120 across the Midwest,” he said, where many states have regulations in place that support the telepharmacy business model. “The number of telepharmacies is increasing exponentially as each state is updating their rules and regulations.”

In Idaho, a state that recently passed legislation making telepharmacies a viable option, a pharmacist can function as the pharmacist-in-charge of up to two remote locations. Currently, 61 cities in Idaho do not have a retail pharmacy, and 28 of those communities are pharmacy deserts, which is defined as not having access to a pharmacy within 10 miles of their home. In Texas, there are as many as 149 pharmacy deserts across the state.

Currently, 20 states have telepharmacy regulations in place. “There’s a wide gamut of what that means,” Chesler said. Cardinal Health is currently working toward homogenizing those regulations to help boost adoption of telepharmacy. “The National Association of Boards of Pharmacy has drafted model language,” Chesler said. “We’re working in seven or eight states now helping them to draft telepharmacy rules. More and more states are understanding it. It’s hard to say exactly how many states are looking at it right now, but that number is definitely increasing.”

North Dakota has been the pioneer of telepharmacy since 2002, conducting proofs of concept that found error rates at telepharmacies occurred about half as often as at traditional pharmacies. And today, both Idaho and Illinois are considered telepharmacy-friendly states with no restrictions on where a telepharmacy can open. Wyoming, New Mexico and Iowa are all working toward that, Chesler added.

There are other advantages to opening a telepharmacy, Miller added. Start-up costs are a lot lower and the turnaround between opening and profit is much faster, he said.

Cardinal Health is committed to the telepharmacy opportunity, Chesler noted. “We have dedicated sales teams that have identified areas in each state that would be most successful,” he said.

“If someone wants to open a telepharmacy, we’ll help them with everything from finding a location to finding financing and outlining their policies and procedures,” Miller said. “We help them every step of the way.”