Telepharmacy as an innovative concept for the delivery of pharmaceutical services in Bulgaria

Background and Aim : Telepharmacy has emerged as a transformative model for delivering pharmaceutical services remotely through digital and telecommunication technologies. In Bulgaria, persistent regional disparities in pharmacy distribution, a growing elderly population, and advancing digital infrastructure create both the need and the conditions for telepharmacy implementation. This narrative review aims to analyze the conceptual framework, technological prerequisites, regulatory landscape, and practical opportunities for telepharmacy within the Bulgarian healthcare system. Methods : A structured literature search was conducted between December 2025 and March 2026 across PubMed, Scopus, and Google Scholar, supplemented by national regulatory documents and reports from international organizations. A total of 362 records were identified, of which 67 met the inclusion criteria. A thematic synthesis approach was applied to organize findings into major categories: conceptual frameworks, technological infrastructure, regulatory aspects, and practical applications. Results : Telepharmacy encompasses four core components—remote pharmacist-patient communication, electronic prescribing and digital health records, therapy monitoring systems, and digital health promotion—applicable across community, hospital, and consultative domains. Bulgaria demonstrates favorable prerequisites for implementation, including 83% digital connectivity and an operational National Health Information System since 2020. However, significant barriers persist: telepharmacy lacks an explicit definition in national legislation, remote dispensing of prescription medicines is prohibited, and regional disparities in pharmacy coverage remain pronounced. Conclusion : Telepharmacy represents a viable and promising strategy for improving equitable access to pharmaceutical care in Bulgaria, particularly in rural and underserved areas. Its full integration into the healthcare system requires the development of a clear regulatory framework, sustained investment in digital infrastructure, and coordinated collaboration among public authorities, academic institutions, and the pharmaceutical profession.