The Potential of Telepharmacy Services in Times of Crisis
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Commentary

The Potential of Telepharmacy Services in Times of Crisis

State level reforms to allow increased use of telepharmacy services would help address the current crisis and expand access to care after the pandemic subsides.

The coronavirus pandemic is highlighting both the value of telemedicine and the costs of burdensome health care regulations. Unleashing the potential of telepharmacy services and eliminating regulations that prevent pharmacists from administering tests would help address the current crisis and expand access to care after the pandemic subsides.

Widespread testing is essential to tracking the virus and reopening the economy, and pharmacies are particularly well-positioned to serve as testing sites. The Department of Health and Human Services has authorized pharmacists to administer COVID-19 tests, but individual state scope of practice laws may still prevent pharmacy testing. Fortunately, governors in at least 32 states, including Florida, California, and New York have issued executive orders allowing pharmacists to provide tests. The remaining states should take similar action.

Beyond the current crisis, 17 states have passed permanent reforms allowing pharmacists to test and initiate treatment for common conditions like strep throat and the flu. Eight other states allow pharmacists to test for these conditions but require that they refer patients to physicians for treatment. Considering that over 90 percent of Americans live within five miles of a pharmacy, expanding testing and treatment authority could greatly improve access to care and help address the looming shortage of primary care physicians.

While social distancing is helpful in reducing the spread of the coronavirus, most people depend on in-person pharmacy services to obtain their prescription medications. Telepharmacy would reduce contact by providing services remotely through telecommunication. There are several models of telepharmacy, but the most relevant to reducing contact are automated dispensing machines or pharmacy kiosks.

The kiosks operate like vending machines stocked common prescriptions, but generally don’t dispense controlled substances. Patients load their prescriptions into the machine and are connected to a pharmacist via an audio-video link. The pharmacist then reviews the patient’s information, provides guidance for safe use, and authorizes the machine to dispense the appropriate medication.

In addition to reducing the risk of exposure, pharmacy kiosks are capable of expanding access to underserved rural areas and providing 24-hour pharmacy services without significant labor costs. However, state-level regulations prevent widespread adoption of the technology. Only nine states currently allow pharmacy kiosks.

Most recently, Florida lawmakers passed HB59 to expand the use of kiosks to community pharmacies and other “indoor environment[s]” such as medical facilities, places of business, and large employer workplaces. State law previously limited their use to institutional settings like long-term care facilities, hospices, and prisons.

Other models of telepharmacy include remote consultation and remote dispensing. In a remote consultation setting, a pharmacist provides guidance to patients via a video or audio link to ensure the safe and proper use of medications. Broader use of remote consultation could help avoid contact in situations where face-to-face interaction is not necessary.

Remote dispensing is another option, wherein a pharmacist manages several remote sites staffed by pharmacy technicians. This is particularly important in rural areas where traditional pharmacies staffed by in-person pharmacists may not be feasible. Only 24 states have laws that allow remote dispensing. Lawmakers should consider permanent reforms enable all forms of telepharmacy.

While several states are temporarily allowing pharmacists to administer COVID-19 tests and embracing healthcare innovations like telepharmacy, these reforms aren’t just a good idea during a pandemic. If adopted permanently, they would also help expand access to care.

Vittorio Nastasi

Vittorio Nastasi is a policy analyst at Reason Foundation where he works on Florida policy issues including education reform and water quality management.