By Rachel Ohm
Portland Press Herald
AUGUSTA, Maine — A lawmaker from Somerset County is proposing legislation to improve access to prescription medications in rural Maine communities by allowing pharmacies to set up remote dispensaries.
The proposal, LD 239, from Sen. Brad Farrin, R- Norridgewock, directs the Maine Board of Pharmacy to establish rules for remote dispensing sites where pharmacists could oversee the distribution of prescription drugs without having to be present. The proposal comes amid a declining number of pharmacies across Maine, especially in rural areas that are seeing an erosion of healthcare services.
“This bill aims to keep Mainers living in rural areas able to get their medications in a safe and secure way,” Farrin told the Committee on Health Coverage, Insurance and Financial Services during a public hearing this week.
In the past decade, a tenth of all pharmacies in Maine have closed, according to the Maine Medical Association, which provided written testimony in support of the bill.
The decline has been steeper in rural areas, including Washington County where there’s been a 31% decline in the number of open pharmacies and only 16% of the population lives within a 15-minute drive of a pharmacy.
“While mail-order pharmacies have made a significant contribution in ensuring chronic medications are available to people in these communities, they still lack access to acute medications such as antibiotics that are not easily accessible, and where delaying taking them could cause significant injury or worsening of the disease,” the association wrote.
The proposal presented Tuesday directs the pharmacy board to come up with rules for the remote sites, where a licensed pharmacist would still oversee the labeling and dispensing of prescriptions, but could do so remotely. The board would also have to set minimum staffing levels by pharmacy technicians, and the sites would have to be in areas with a proven lack of access to retail pharmacies.
Exactly what the sites would look like and where they would be located would be contingent on the rules developed by the board, though Farrin suggested that in one scenario a fire station could be a remote dispensing site and it could be staffed by a paramedic overseen remotely by a pharmacist.
“This bill addresses a critical need for improving access to prescription medicines in rural areas while maintaining the necessary safeguards for patient safety and compliance with both state and federal pharmacy regulations,” Farrin said.
The Maine Pharmacy Association and Maine Society of Health System Pharmacists testified neither for nor against the bill, saying in written testimony that the Board of Pharmacy already provides a route for rural areas to partner with licensed pharmacies to disburse medications through the Rural Health Center Pharmacy license.
The association urged lawmakers to look at the existing license type rather than develop new rules, and also urged caution around developing any type of pharmacy license where a pharmacist is not on site.
Jonathan Busko, an EMS and emergency medicine physician in Bangor, told the committee the proposal is needed because in many cases the rule allowing rural health centers to work with pharmacists restricts access to only that clinic’s patients, and there are administrative burdens to setting up the pharmacies in health centers.
“By developing regulations regarding remote dispensing site pharmacies, the Board of Pharmacy will enable retail pharmacies to partner with rural communities to provide access to retail pharmaceuticals via telepharmy,” Busko said.
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