Telepharmacy is an emerging solution to address medicine access disparities in India, particularly in rural and underserved areas. However, its adoption is hindered by outdated legal provisions, limited administrative capacity, and infrastructure gaps. This study explores telepharmacy governance from a local administration perspective, examining legal frameworks, stakeholder insights, and state-level initiatives. A qualitative exploratory approach was used, involving analysis of 25 legal and policy documents, 25 stakeholder interviews (including regulators, municipal officers, pharmacists, and technology providers), and case studies from Kerala, Rajasthan, and Himachal Pradesh. Thematic analysis, supported by descriptive statistics, chi-square testing (χ² = 14.62, p = 0.023), Kruskal-Wallis comparisons (H = 6.12, p = 0.047), and a Weighted Barrier Index (WBI), identified five priority challenges: legal ambiguity (WBI = 4.5), administrative gaps (4.2), infrastructure limitations (4.0), unclear pharmacist oversight (3.6), and data privacy concerns (3.1). Kerala demonstrated the highest readiness, while Himachal Pradesh showcased innovative community-led models. Findings emphasize the need for telepharmacy-specific laws, integration with the Ayushman Bharat Digital Mission, AI-driven prescription validation, and targeted training for local administrators. Telepharmacy should be recognized as a governance innovation, not just a technological advancement, requiring coordinated central, state, and local reforms to scale services equitably and strengthen India’s healthcare delivery system.
Gupta et al. (Tue,) studied this question.