Minority Communities, Independent Storefronts Hit Hardest by Pharmacy Closures
Researchers observed data from 2010 to 2021 to better understand recent trends in US pharmacy closures and the specific pharmacy types that have been impacted.
From the year 2010 to 2021, nearly a third of all US pharmacies open to the general public shut their doors, while Black and Latinx communities were disproportionately impacted by these closures compared with predominately White areas of the country. When looking at pharmacy type, independent pharmacies were significantly more likely to close compared with retail locations, according to data from a study published in Health Affairs.1
“Retail pharmacies are increasingly important providers of emergency and preventive care in the US, yet many are at risk of closing. Such closures have been found to contribute to medication nonadherence, specifically among elderly adults in neighborhoods with few pharmacies,” wrote the authors.
In the study, researchers only explored closures from 2010 to 2021, but in 2024, the average pharmacy customer has further experienced a squeeze in access to medications.
Researchers explored the National Council for Prescription Drug Programs’ dataQ database to establish the number and types of US pharmacies in operation from January 2010 to July 2021. | image credit: Иван Грушевич / stock.adobe.com
Fueled by declining reimbursements and a move to mail-order services, the financial stability of many pharmacies has been recognized this year. With Walgreens, CVS, and Rite Aid announcing thousands of shutdowns—along with many more independent locations—the ability of pharmacy owners to keep their doors open has reached a boiling point.
READ MORE: Rochester Pharmacy Access Coalition Uniting to Fill Gaps from Pharmacy Closures
“Rite Aid filed for bankruptcy and shuttered about 500 of its 2,000-plus locations,” wrote Paige Twenter for Becker’s Hospital Review.2 “CVS is closing 900 of its nearly 2,000 locations in a 3-year plan announced in 2021. Similar to CVS, Walgreens is also shutting down sites in a phased approach. In 2019, it announced 200 closures, and in mid-2023, laid plans for another 150. It plans to close 1,200 more, according to a recent earnings report.”
While previous research has been conducted to better understand trends in US pharmacy closures, prior studies have not focused on how closures impact specific minority populations. As a way of updating pharmacy closure literature, researchers explored the National Council for Prescription Drug Programs’ dataQ database to establish the number and types of US pharmacies in operation from January 2010 to July 2021.1
As researchers’ primary outcome, they focused on permanent independent or chain pharmacy closures during the study period. They also identified the net loss of pharmacies in specific states, counties, and neighborhoods. After determining the total number of closures, they stratified community demographics where pharmacies closed by urbanicity, predominant race and ethnicity, percentage of adults over 65, and percentage of individuals with income below the federal poverty level.
“The number of pharmacies in the US increased by 7.7% during the study period, from 59,902 in 2010 to 64,530 in 2021. During this period, 26,145 pharmacies closed and 30,773 opened,” continued the authors.1 When comparing the totality of pharmacy closures with locations that opened during the study period, the pharmacy industry has noticeably expanded.
However, when focusing on specific time frames within the study period, researchers saw significant declines in the latter 3 years. In the first 8 years of the study, pharmacies were opening at a consistently faster rate than they were closing. But from 2018 to 2021, closures exceeded openings, accounting for an overall decrease in 2% of the US’s pharmacies during that time.
Finally, closure rates were highest in predominately Black (37.5%) and Latinx (35.6%) neighborhoods, compared with those that were predominately White (27.7%). Regarding the income of neighborhoods examined, researchers noticed those with at least 20% of the population living in poverty experienced higher risks of pharmacy closure (34.3%) than areas typically above the poverty level (28%).
“Policymakers should consider strategies to increase the participation of independent pharmacies in Medicare and Medicaid preferred networks managed by pharmacy benefit managers [PBMs] and to increase public insurance reimbursement rates for pharmacies that are at the highest risk for closure,” wrote the authors.1
With promising initiatives set to take place in 2025 and beyond—like CMS’s new ability to negotiate on drug prices with manufacturers3—there has been a noticeable shift in how the federal government views access to pharmacies and prescription drugs. However, in order for the industry to return to a time of pharmacies opening faster than them closing, permanent government action is necessary to ensure medication access in communities that are disproportionately impacted by various social vulnerabilities.
“Given expected increases in pharmacy closures over the next several years, federal, state, and local policymakers should consider targeted strategies to protect pharmacies most at risk for closing. Such efforts could include reforms that increase Medicare Part D and Medicaid reimbursement rates for pharmacies most at risk for closure and that expand PBMs’ managed preferred pharmacy networks to include independent pharmacies, especially those in neighborhoods that are or are at risk of becoming pharmacy deserts,” concluded the authors.1
READ MORE: Independent Pharmacist on Navigating the Dynamic Pharmacy Profession
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