Pharmacy closures pose risk for minority communities

A recent study published in Health Affairs analyzed retail pharmacy closures between 2010 and 2021 using data from the National Council for Prescription Drug Programs, county-level data from the National Center for Health Statistics and ZIP Code Tabulation Area data from the American Community Survey. The analysis calculated the number of pharmacies that closed and determined which communities were at the greatest risk of being without a retail pharmacy.

The study built on data from a previous study that analyzed pharmacy closures from 2009 to 2015.

Retail pharmacies play a critical role in the healthcare industry. These facilities are where most patients access prescription and over-the-counter medications, get vaccines and readily communicate with licensed healthcare professionals. However, economic and insurance reimbursement issues have threatened these facilities and their continued prosperity.

Researchers found that between 2019 and 2021, the number of pharmacies in the U.S. increased by 7.7%, from 59,902 to 64,530. At first glance, this data suggests promise in the retail pharmacy landscape with its modest growth; however, a closer look at the data from 2018 to 2021 tells a different story.

Although during the overall study period, the number of pharmacy openings exceeded the number of closures -- 30,773 openings and 26,145 closures -- between 2018 and 2021 the number of closures exceeded pharmacy openings, accounting for a 2.1% loss of pharmacies during that time.

Independent pharmacies generally face greater economic and reimbursement challenges that lead to pharmacy closures; however, independent pharmacies were actually better off between 2018 and 2021, growing by 2.3%. Comparatively, chain pharmacies declined by 5.0% during that time.

Despite independent pharmacies outperforming chain pharmacies in this specific period, the study maintains that independent pharmacies are at a greater risk of closure than retail pharmacies. Specifically, independent pharmacies were at a 233% greater risk of closure than chain pharmacies.

It is important to note that independent pharmacies were more likely to be in Black and Latinx communities. Additionally, these pharmacies were more prevalent in neighborhoods with a higher poverty rate or a larger uninsured population. From this data, the researchers extrapolated that these communities were more likely to be disproportionately impacted by pharmacy deserts.

"These findings suggest that closures could worsen existing racial and ethnic disparities in access to pharmacies, medications, and essential health care services such as vaccinations, naloxone dispensing, and contraception prescribing," researchers emphasized in the study.

In addition to acknowledging the shifts in the retail pharmacy landscape that might be impacting these closures, Health Affairs suggests strategies to help address these closures and the subsequent care gaps that arise.

"Given expected increases in pharmacy closures over the next several years, federal, state, and local policy makers should consider targeted strategies to protect pharmacies most at risk for closing."

The study authors emphasize that commercial and public health payers incentivize patients to use preferred pharmacy networks; however, independent pharmacies are often not included in these preferred pharmacies, resulting in lower use, reduced income and eventual closure of independent pharmacies. The authors suggested that CMS should consider adding regulations that increase the participation of independent pharmacies in the preferred pharmacy network. Additional suggestions include state-level policies to increase reimbursement for pharmacies at risk of closure.

Veronica Salib has covered news related to the pharmaceutical and life sciences industry since 2022.