What is a Pharmacy Desert?

A “pharmacy desert” is any area with poor access to Rx medications. Pharmacy access lags because of lower income, insurance status, higher prices, poor transportation, long distances, or a combination of those factors.

Dima M. Qato, PharmD, MPH, PhD, assistant professor of pharmacy at the University of Illinois, Chicago, launched the term “pharmacy desert” in a 2014 article in Health Affairs. The authors built on the concept of “food deserts” used by the U.S. Department of Agriculture-a census tract in which a substantial number of residents have low access to a supermarket or a large grocery store. The agency defines low access as more than one mile from a supermarket or a large grocery store in an urban area and more than 10 miles in a rural setting. 

When Dima and coauthors mapped pharmacy deserts in Chicago in 2012, they found 32% of Chicago census tracts, home to about one million people, were pharmacy deserts. Pharmacy deserts were concentrated in the city’s South and West sides in neighborhoods that were largely Black or Hispanic. 

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Cardinal Health used the USDA’s 10-mile measure to map rural pharmacy deserts for this article. They found 2,177 rural towns between 500 and 5,000 population without a pharmacy within 10 miles. 

In 2018, health policy researchers at the University of the Sciences in Philadelphia used the same 10-mile measure to evaluate pharmacy access for older patients enrolled in a state pharmaceutical assistance program. They found 39% of Pennsylvania census tracts are pharmacy deserts. 

Like urban pharmacy deserts, USP researchers found that rural pharmacy deserts have a lower density of both chain and independent pharmacies, fewer 24-hour pharmacies, and fewer pharmacies offering delivery services. But unlike urban pharmacy deserts, rural Pennsylvania pharmacy deserts are predominately female, married, and white, reflecting the overall make up the state’s rural population.

Pharmacy deserts can also affect medication pricing. A 2017 study in The Journal of Allergy and Clinical Immunology found that the highest prices for esomeprazole in greater Nashville, TN were in zip codes with the lowest median income. The highest prices for captopril were in areas where patients had to travel more than six miles to fill their scripts.

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