Q&A: Who is Responsible for Addressing the Growing Issue of Pharmacy Deserts?

With the recent closure of thousands of chain and independent pharmacies, experts from several industries are coming together to address the issue of pharmacy deserts. One of the most prominent entities working to alleviate the issue includes pharmacy advocacy and solutions groups like Cencora and Good Neighbor Pharmacy.

“I believe it's all of us,” said Jennifer Zilka, Senior Vice President of Community and Specialty Pharmacy at Cencora and President of Good Neighbor Pharmacy. “It's crucial that pharmacies, trade organizations, advocates, peers, and even patients relentlessly push for the changes that are needed to support the longevity of these pharmacies and the care that they provide to their patients.”

While catching up with Zilka, Drug Topics was also joined by Kyle Pudenz, DBA, Senior Vice President of Data & Analytics at Cencora. His team is filled with data experts trained to identify areas vulnerable to pharmacy deserts, the resources needed for pharmacy businesses, the characteristics of an area’s pharmacy services, and so much more.

Closed pharmacy storefront | image credit: EyeMark / stock.adobe.com

The duo suggested that it takes the efforts of multiple players within the pharmacy industry to truly enact change. However, they were sure to highlight the utmost importance of community pharmacies and how they are uniquely positioned to address pharmacy deserts.

“Community pharmacies are a huge part of the solution to combat these health care deserts, whether it's a pharmacy desert or an overarching, larger-scale health care desert,” continued Zilka. In this part of our interview, Zilka and Pudenz discussed what’s being done to address pharmacy deserts and how their team is assisting pharmacies and communities across the country.

Stay tuned for more from our conversation with Zilka and Pudenz as they provide even more valuable insights into pharmacy deserts and what is being done to address them.

READ MORE: How Pharmacy Deserts are Being Defined, Identified

Drug Topics: Who do you believe holds the responsibility of addressing pharmacy deserts across areas of the US?

Jennifer Zilka: I'll start because I feel really strongly about it, but I believe it's all of us. It's crucial that pharmacies, trade organizations, advocates, peers, and even patients relentlessly push for the changes that are needed to support the longevity of these pharmacies and the care that they provide to their patients. Community pharmacies are a huge part of the solution to combat these health care deserts, whether it's a pharmacy desert or an overarching, larger-scale health care desert. Just given who they are, they're already taking care of these underserved and socially vulnerable communities.

Our Good Neighbor Pharmacy members work tirelessly to look for gaps in care where they're able to maybe provide different services, different products. We have outreached into different communities to make sure that they're caring for their entire community. And then, the teams within Good Neighbor Pharmacy, and Kyle's team within Cencora, we're very passionate about supporting their efforts. In addition to all of us doing all the things we're doing that are really important, one thing we've done internally is worked with Kyle’s team to help our members with detailed snapshots of their communities, and again, look for those gaps where they might be able to provide tailored services or products to those patients.

As part of this effort, we worked with NCPDP (the National Council for Prescription Drug Programs), the CDC’s social vulnerability index, the US Census and American Community Survey. We pulled all of that information together, and this is Kyle’s team that did that, so Kyle, we are eternally grateful for it. We always knew where our Good Neighbor Pharmacies (GNP) were positioned, and we always had a good feel for who their patients were. But through Kyle's team's efforts, we were able to identify that 20% of GNP stores either directly serve or are adjacent to pharmacy deserts, 93.5 million US households are within reach of a GNP store, and 20 million of those reside in a low-pharmacy-access area. We also know that GNP pharmacies can serve more than 47.7 million low-income individuals.

Kyle and his team also did some research around disabled individuals, and there's 26 million disabled individuals, including 5.5 million who face limited access, that are within reach of a Good Neighbor Pharmacy store. Through that data, we've been able to really validate which patient populations our pharmacies are caring for. And we're really passionate about ensuring that our pharmacies have access to that information and are able to tailor their services accordingly. So Kyle, please feel free to expound on that.

Kyle Pudenz: No, I love all the facts and figures. You could join our team anytime, Jenni. But as Jenni said, we really developed this solution, understanding our place in Cencora. How can we help enable our pharmacies [to] serve their communities? The idea is that we can access this data. We can integrate a lot of this together in such a way to give them better visibility and insights into, not just the customers and patients that are coming through their doors already, but what does that greater community actually look like? [We] give some visibility into the broader surroundings and help them better plan some accessible services that they may be able to provide these communities. For many [pharmacies], they can now leverage the data to really prioritize resources. Now they have this understanding of what that larger population looks like and [can] provide some support and interventions in areas where there [is] a greater need for medicine, health care services, and vaccines. All of those things, I think, are super important.

We really went out and found some publicly available data. This is available through US Census information to give us a lot of demographics, but we coupled that with some geospatial analytics to really give us that overlay of the demographics and other factors that really impact social vulnerability. In addition to some of the things Jenni highlighted, [something] like access to transportation [is] a real big one. I think sometimes people wonder ‘Why is the limit within an urban area just 1 mile?’ Well, you have different access to transportation in different areas. The likelihood that someone who's ill or elderly would have to go that far in that scenario without transportation really starts to limit whether or not they are going to be able to access that. By giving our pharmacies information and insights, they can actually develop services to help them reach and connect with these patients to provide those services that they're looking for.

So far, the data has really challenged what our prior assumptions and biases would have led us to previously believe. Pharmacy owners often find that the pharmacy deserts aren't necessarily where they expected them to be previously. In fact, the data and insights shared helps some of those pharmacies recognize that they're actually situated, as Jenni mentioned, either in or directly adjacent to a desert themselves. I think that's been pretty eye-opening. By doing that, where they suddenly have this visibility, now it can help those pharmacists identify new clinical and marketing opportunities that really help them serve their communities even better than they were before.

Drug Topics: What is being done on both state and federal levels to address the growing issue of pharmacy deserts in the US?

Jennifer Zilka: There is a lot of activity. In fact, we've had some wins that we're very excited about at both the national and the state levels. But there's still so much more work to be done that we together can achieve what's needed for pharmacies to remain financially viable. It includes improving reimbursement frameworks, but it also includes helping to expand the clinical care services that pharmacies are able to provide. There is a lot of activity. Unfortunately, we were hoping that some of it would make it across the finish line at the end of the year, and it didn't. And I think, as we all know, we're in the midst of a new administration, which is highly unpredictable, but there does continue to be a lot of activity, visibility, and even legislative bills that are on the table. We are very hopeful, or watching very, very closely, that they will cross the finish line and be included in an upcoming package.

One of them is around stabilization of reimbursement rates. Again, we're watching that one very, very closely. The other one is the Equitable Community Access to Pharmacists Services Act. We call it ECAPS because it's a mouthful. That was introduced last Congress. It had robust bipartisan support. The goal was aiming to ensure, as I mentioned before, that Medicare beneficiaries have access to the essential services, including test and treatment of common infectious diseases, by establishing a Part B reimbursement pathway for pharmacies to deliver those services. Those are a couple examples. There's a lot happening.

Positive change is not guaranteed. But I truly believe—this is an area I'm really passionate about and I spend a lot of time on—if we continue to advocate and ensure that legislators are aware of the danger of losing these pharmacies, and really the danger to their patients and their constituents, I'm very hopeful. That advocacy is essential to ensure accessible health care for our patients and will serve as really our industry's primary defense against the spread of these pharmacy deserts. A lot [is] happening on that front. We're keeping a very, very close eye on it, and we're hopeful that we will see some federal activity. And there's just a ton happening in the states as well. [There’s] a lot of activity and a lot of hope.

READ MORE: Rochester Pharmacy Access Coalition Uniting to Fill Gaps from Pharmacy Closures

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