It's becoming more typical for pharmacies to close in rural regions. Closures make it harder for people to get their drugs and make them less likely to take their medications as prescribed. Telepharmacy may be a viable solution to this issue; however, there is less data on the correlation between telepharmacy and the quality of medicine use. Our research aimed to fill this need by evaluating the quality of tele pharmacies catering to remote regions in comparison to regular pharmacies that assist them. Methods: We got dispensing data for the first 18 months of operation from three tele pharmacies and three regular pharmacies in the upper Midwest. We looked at how well people stuck to their noninsulin diabetic drugs, renin-angiotensin system antagonists, and statins. We also looked at how older individuals used high-risk medications inappropriately and how those with diabetes used statins. All metrics were computed according to Medicare Part D criteria. We used generalized linear regression to figure out how telepharmacies in remote locations are different from regular pharmacies. We modified our models to account for possible sociodemographic and clinical variables. Outcomes: A total of 2,832 patients provided 4,402 observations for the quality metrics. After adjusting for covariates, we found no significant differences between tele pharmacies and conventional pharmacies for noninsulin diabetic drugs, renin-angiotensin system antagonists, statins, and high-risk pharmaceuticals. But those with diabetes used statins more often at telepharmacies than in regular pharmacies. Conclusion: We discovered that the quality of drug dispensation at telepharmacies catering to remote regions was comparable to that of conventional pharmacies. Communities who are thinking about adopting telepharmacy should know that the findings show that telepharmacies are a good way to make medications more available and that using telepharmacy won't hurt the quality of medication usage.