Telepharmacy is increasingly seen as a valuable tool to provide important clinical services to remote and underserved areas of the country. Since 2001, when North Dakota became the first state to enact regulations allowing the use of telepharmacy, a number of states have established rules and statutes specifically authorizing dispensing medication to patients via technological means, explicitly not requiring direct contact with a pharmacist.

The most recent versions of administrative rules and legislative statutes governing the practice of pharmacy, as of August 31, 2016, were analyzed for all 50 states. For this study, a state qualified as permitting telepharmacy only if it authorized the operation of telepharmacies for drug delivery to the retail (outpatient) market. Specific authorization for telepharmacy was found in 23 states. Another 11 states have pilot programs or waivers that would enable telepharmacy; and, 16 states have no rules or legislation authorizing telepharmacy. Among those states authorizing telepharmacy there is significant variation in the requirements regulation the operation of telepharmacies. Nearly half of the states authorizing telepharmacy impose geographic limitations (e.g. proximity to other pharmacy/telepharmacy locations), most restrict the types of facilities that may be used as a remote pharmacy location, most have specific rules governing the staffing of telepharmacy locations; and, several have regulations regarding the inter-state provision of telepharmacy services.