Pharmacy deserts, areas with low access to prescription medications, are a challenge. There could be nearly 100 million Americans without good access to pharmacies, but pharmacists are not rushing to fill the gap.
A few independent pharmacists are expanding their existing community practices with telepharmacies, either independently or in cooperation with medical clinics or retailers such as grocery and hardware stores, Federally Qualified Health Centers, hospitals, and other provider groups. That leaves pharmacy deserts as a tremendous opportunity.
“There are a number of options, all of them lesser than community pharmacy,” says Anthony Ciaccia, director of government and public affairs for the Ohio Pharmacists Association. Ohio is seeing a surge in pharmacy deserts as unprofitable rural pharmacies close.
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The National Association of Chain Drug Stores notes that 92% of Americans live within five miles of a community pharmacy, but five miles can be an impassable barrier if transportation is difficult. Patients who could walk to a pharmacy now have to drive—if they can.
“A lot of people go to mail order because it’s the best option when your nearest pharmacy is now five, 10, 20 miles away,” Ciaccia says. “Amazon, if they were to enter the prescription market, would likely convert a lot of people because they do convenience better.”
Physicians, nurse practitioners, and other prescribers are already moving in.
“They don’t want to dispense, it isn’t their expertise or their business,” says Adam Chesler, PharmD, director of regulatory affairs for wholesale giant Cardinal Health. “But prescribers are getting judged, and reimbursed, based on patient outcomes. If there is no pharmacy nearby, it only makes sense to fill their patients’ prescription needs.”
The Underserved
Nearly 70% of Americans take at least one Rx drug, a number that is likely to increase as the U.S. population ages. And older patients are among the most likely to have pharmacy access problems
Researchers at the University of the Sciences in Philadelphia found that 39% of Pennsylvania census tracts are pharmacy deserts for older adults enrolled in state pharmaceutical assistance programs. Nationwide, at least 2.4 million rural residents are currently without adequate pharmacy access. And that is just the rural residents who are easy to count.
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“That number only counts people who live in towns with a population between 500 and 5,000 and do not have a community pharmacy within 10 miles,” Chesler says. “We don’t know how many rural residents live in areas with fewer than 500 and more than 5,000 who don’t have a pharmacy within 10 miles. And we have no idea of how many people in urban areas don’t have good pharmacy access.”
Dima M. Qato, PharmD, MPH, PhD, does.
In 2012, about a million residents of Chicago alone lived more than a mile from the nearest pharmacy. That was about 37% of the city’s 2.7 million residents.
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