Pharmacy by vending machine

Technology Forum

Prescription drug vending machines may be coming soon to a location near you—or may have arrived already. With only a few clicks and screen touches, such a machine could dispense one or more of a variety of medications. 

InstyMeds, one such automated system, dispenses antibiotics, inhalers, cough syrups, and painkillers in hospitals and clinics across the country. This immediate, round-the-clock access is intended to ease the burden of emergency departments for conditions that may not require immediate attention beyond obtaining a medication. The machines can hold up to 102 drugs for acute ailments but are not used to dispense maintenance drugs for conditions such as hypertension or high cholesterol.

How they work

Prescribers hand out security codes to the patients when they send prescription orders to the InstyMeds system via the facility’s electronic medical record. The patients then punch in the code at the machine’s dial pad and swipe a debit or credit card—cash cannot be used—before the machine dispenses the medication in a prepackaged, labeled container. Patient information, such as prescription benefits, is transferred to the InstyMeds application to obtain insurance approval. If an insurance problem occurs, an InstyMeds call center representative communicates the issue to the patient via a phone at the dispensing machine. If a patient does not have prescription coverage, the machine calculates an out-of-pocket payment price for the medication.

The convenience of using such a machine located within the clinic or provider office could make a waiting line at the pharmacy a thing of the past and potentially save on health care costs.

This technology does not, however, intend to replace the patient–pharmacist or patient–provider relationship. Nevertheless, fearful of how far such technology could go, opponents contend that widespread use of medication vending machines may result in lost opportunities for counseling, particularly when special instructions are needed for any medication. Proponents emphasize the increased access and convenience for patients.

As these machines make their way to airports and other public settings, individuals may find themselves drawn to the ease of obtaining medications not only for acute conditions but also, perhaps, for a continued supply of maintenance medications. New pharmacy innovations continue to emerge, including MedAvail, a dispensing machine in which a patient inserts a handwritten prescription and a pharmacist verifies and dispenses the medication remotely. Pharmacist and patient are linked via live, two-way audiovisual.

Unanswered questions

It is important to consider how this technology may affect quality of medication delivery and use. With quality as a major focus of the new wave of health care, how will medication vending machines fare? If such mechanisms are inevitable, how will pharmacists complement this service? Will virtual pharmacist–patient consultations be the new norm? Will such technology improve or worsen the existing patient–pharmacist relationship? How will the technology affect older adults who may be at increased risk for adverse effects from medications? Many such questions remain unanswered.

Nonetheless, as pharmacists looking to our future, we must consider quality services that hold value to our patients and other health professionals. As technology is sure to evolve, pharmacists must look toward quality improvement in patient care services and provide due expertise in medication management so such technology becomes integrated as a fundamental way of pharmacy practice, regardless of setting.

In this changing culture of health care and technology, now is an opportune time for pharmacists to drive the expectations of patients and other health professionals about the value of pharmacist services within the patient care continuum.

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