Patient Access
Lauren Howell, PharmD
A study published in December 2024 in Health Affairs found that more U.S. pharmacies closed than opened between 2018 and 2021 and that independent pharmacies, as well as those in Black and Latinx communities, were most likely to be affected by these closures. The authors believed that policymakers should use these findings to consider strategies to increase public insurance reimbursement rates for pharmacies that are at the highest risk of closure.
The study
Using data from the National Council for Prescription Drug Program’s database, the researchers determined the number and type of retail pharmacies, defined as pharmacies that are open to the general public and dispense prescription medications for local patient populations, in operation in the United States from 2010 to 2021. This was linked to data from the National Center for Health Statistics and ZIP Code Tabulation Area data from the American Community Survey to identify pharmacy, neighborhood, and market characteristics associated with pharmacy closure.
Over the study period from 2010 to 2021, the number of pharmacies in the United States increased by 7.7%. However, from 2018 to 2021, the number of pharmacy closures exceeded pharmacy openings, resulting in a net 2.1% decrease in the number of pharmacies over those 3 years. Black neighborhoods experienced the steepest decline in pharmacies during that time, with 4.8% fewer pharmacies of any type and 12.6% fewer chain pharmacies.
The national pharmacy closure rate from 2010 to 2021 was 29.4% with individual states having varying rates from 17.7% to 40.7%. New York, West Virginia, Vermont, Rhode Island, and Mississippi all had closure rates greater than 35%. During 2018 to 2021, 41 states experienced a net loss of pharmacies.
Pharmacies in rural neighborhoods were at lower risk for closure than pharmacies in urban areas. Pharmacies in predominantly Black and Latinx neighborhoods had closure rates that were higher than those in predominantly white neighborhoods.
Additionally, pharmacies in neighborhoods where at least 20% of residents had incomes below the federal poverty level had a higher risk (34.3%) for closure than those in neighborhoods with lower poverty rates (28%). Pharmacies in neighborhoods with uninsurance rates of 20% or more were at a higher risk for closure than those in neighborhoods with lower uninsurance rates.
Moving forward
The study authors suggest that “The Centers for Medicare and Medicaid Services should consider regulations to increase the participation of independent pharmacies in preferred pharmacy networks for Medicare Part D and Medicaid plans and should establish specific provisions that mandate preferred status for pharmacies at a heightened risk for closure, such as those in Black, Latinx, and low-income neighborhoods or those serving pharmacy deserts.” ■
JAPhA study finds 44 locations in Virginia where adding pharmacy services could benefit more than 10,000 residents
Recent data from the Virginia Board of Pharmacy showed that the number of pharmacies in Virginia decreased by about 6% between June 2016 and May 2024. Based on these data, researchers from Virginia Commonwealth University and the Virginia Board of Pharmacy identified 51 census tracts that qualified as pharmacy deserts, meaning that they had low access to pharmacies and contained mostly low-income residents.
They published their findings on February 10, 2025, in JAPhA, revealing that these pharmacy deserts had a significantly lower percentage of residents under 18 years old, a greater percentage of Black residents, residents who were uninsured, who had Medicare or Medicaid coverage only, had a lower median household income, and had a greater percentage of residents living in poverty. From there, Boyle and colleagues performed a geospatial analysis and identified 44 primarily urban locations where adding pharmacy services could both improve access and decrease pharmacy deserts. Each location that was identified could potentially benefit over 10,000 individuals.
An online, interactive map of the findings can be found at apha.us/VAPharmacyDeserts. ■