Researchers recommended less restrictive policy regarding telepharmacies to improve access to medications and pharmacists, while ultimately improving outcomes and adherence to treatment regimens.
States that adopted looser telepharmacy policies have experienced a decrease in pharmacy deserts, and telepharmacies were found to be more likely than traditional pharmacies to be in areas of high medical need, according to the results of a study published in the Journal of the American Medical Association.
Although most US residents live within 5 miles of a community pharmacy, patients across the country have experienced difficulty accessing pharmacy services in rural and urban settings. Obstacles include nationwide pharmacy closures, transportation, disability, and economic challenges. Collectively, they can create pharmacy deserts, where patients have difficulty obtaining medications.
Telepharmacy can benefit patients who live far away from traditional pharmacies by providing timely access to medication and a pharmacist, which can improve outcomes and adherence to treatment regimens. Currently, telepharmacy is permitted in 28 states, yet some states impose burdensome policy restrictions on the practice, according to the study.
The investigators sought to explore the extent to which adopting telepharmacy statues and regulations may be associated with improved access to medications by reducing the number of pharmacy deserts. Additionally, they aimed to determine the extent to which telepharmacies were in medically underserved areas or populations (MUA/Ps).
Twelve US states were included in the study, with 8 intervention states (Arizona, Idaho, Indiana, Iowa, Nebraska, New Mexico, Texas, and Wyoming) and 4 control states (Kansas, Ohio, Oklahoma, and Utah).
Among the control states, the mean number of telepharmacies before the intervention period was 0.25. The number of telepharmacies in intervention states before the intervention period was 2.25. In the postperiod (after the intervention year), the mean number of telepharmacies in intervention states experienced an increase to 7.25, while the mean remained the same among control states.
Investigators found that across the study periods, the percentage of geographic areas defined as pharmacy deserts and the percentage of the state’s population living in a pharmacy desert decreased faster in states that adopted pro-telepharmacy policy.
The observed mean absolute percentage of places defined as pharmacy deserts declined from 26.7% (95% CI, 15.1%-38.3%) to 25.5% (95% CI, 14.4%-36.7%). This contrasts with rates in control states, which remained unchanged at 19.0% across all periods. The 1.2 percentage point decrease among intervention states translates to a 4.5% (1.2 percentage points of 26.7 percentage points) relative decrease in the percentage of places defined as pharmacy deserts.
Over the study period, higher percentages of telepharmacies were located in a MUA/P compared with traditional pharmacies located in a MUA/P (pre-period in MUA/P: 63.2% of telepharmacies [12 of 19] versus 33.9% of traditional pharmacies [5984 of 17,511]; P = .01; intervention year in MUA/P: 59.0% of telepharmacies [23 of 39] versus 33.7% of traditional pharmacies [5948 of 17,638]; P = .002; post-period in MUA/P: 62.7% of telepharmacies [37 of 59] versus 33.7% of traditional pharmacies [5998 of 17,800]; P < .001).
Lastly, of 3972 places defined as a pharmacy desert either in the year prior to or the year of the policy change and that had a traditional pharmacy as their nearest pharmacy, 98 (2.5%) transitioned to a nonpharmacy desert the following year and 80 (2.0%) had a telepharmacy open as the nearest pharmacy.
Study investigators observed that telepharmacies were more than twice as likely than traditional pharmacies to be located in areas of high medical need. This reaffirms the viability of telepharmacies to be an alternative to traditional pharmacies, but noted the need for additional studies to fully understand the association between burdensome policies that prevent the implementation of telepharmacies and patient safety.
“Adopting less restrictive statutes and regulations for telepharmacy appears to be a solution to restoring pharmacy access and can support improvements in public health for underserved patients in rural and urban areas,” the study authors concluded.
Urick BY, Adams JK, Bruce MR. State telepharmacy policies and pharmacy deserts. JAMA Netw Open. 2023;6(8):e2328810. doi:10.1001/jamanetworkopen.2023.28810