Travel-related savings through a rural, clinic-based automated drug dispensing system

For rural patients, access to pharmacies is often impeded by geographical and financial factors. The number of available pharmacies may be limited, and the extensive travel needed to access them is time consuming, potentially dangerous and, due to rising fuel prices, increasingly expensive. We describe the benefits of a clinic-based, automated medication dispensing system (ADDS) implemented in two rural communities in the Adirondack Mountain region of New York State. To estimate distance saved by utilizing the ADDS at the clinic, data from 268 consecutive patient encounters was imported into a mapping software package. Clinic Trip and Pharmacy Trip distances were calculated, with Miles saved estimated as the difference. Cost savings estimates were generated, with results reported as percentage of median per capita money income by county. Patients lived significantly closer to both clinics than to nearest traditional pharmacies, and saved an average travel distance of 32.6 and 18.0 miles per encounter. Cost estimates suggest travel-related savings of dollar 12.23 and dollar 6.75 per encounter, or 3.4% and 1.7% of weekly income. Considering the median out of pocket expense (dollar 13.31) for acquiring a prescription, patients traveling more than 35 miles round trip to obtain medications spent more on travel than on the medication itself. Placement of ADDS can significantly reduce the travel distances required for drug procurement in rural communities, and can provide acutely needed medications without travel-related delay. Such systems can provide considerable travel-related savings to the rural poor, where travel-related costs can exceed average drug costs.