Pharmacy Desert Crisis in the U.S.
Research from Ohio State University reveals that nearly half of all American counties are classified as pharmacy deserts, where residents lack a drugstore within a 10-mile radius. Over the last decade, national data indicates that more than 29% of community pharmacies closed between 2010 and 2021, with closures accelerating to about eight establishments shutting down daily. Major chains such as CVS, Walgreens, and Rite Aid are scaling back their physical locations, contributing to the crisis alongside numerous independent pharmacy closures.
Pharmacy owners cite low reimbursement rates from pharmacy benefit managers (PBMs), rising operational costs, and staffing shortages as the primary drivers of this issue. An analysis conducted by the Rural Health Research Gateway highlights that counties without retail pharmacies are home to larger proportions of low-income, uninsured, unemployed, and elderly residents. Approximately 15.8 million Americans now reside in pharmacy deserts across urban, suburban, and rural areas.
Proponents of mail-order prescriptions argue it provides convenience, but many believe this model cannot effectively replace traditional pharmacies. Mail-order services often detract from local economic activity and do not offer essential health screenings or vaccinations. Additionally, this system lacks the face-to-face interaction that many patients require. Historically, about 85% of Americans have relied on local pharmacies, making the current trend of retail closures particularly concerning for vulnerable populations.
Telepharmacy as an Alternative
Telepharmacy presents a potential solution, operating remote sites staffed by technicians under the supervision of licensed pharmacists. A cohort study published in *JAMA Network Open* found that states with less restrictive telepharmacy policies saw an 11.1% relative reduction in the percentage of populations living in pharmacy deserts. Telepharmacies are twice as likely as traditional stores to establish operations in underserved areas.
However, experts like Kue-Tsemo note that telepharmacy faces significant challenges, including high equipment costs, technician shortages, and a complex web of state regulations regarding staffing and site selection. Furthermore, there are concerns that substituting traditional pharmacies with telepharmacy models may compromise the quality of patient care. Conventional pharmacies provide immediate access to licensed pharmacists, whereas telepharmacy often relies on technicians directed remotely.
Kue-Tsemo emphasizes the importance of in-person pharmacist interactions, warning that without direct patient engagement, there is an increased risk of adverse drug events and complications for those managing complex medication regimens. While technology can enhance access to pharmacy services, it should complement, rather than replace, the personal relationships cultivated between patients and community pharmacists.
As the landscape of pharmacy continues to change, addressing these challenges will require coordinated efforts to preserve the vital role of local pharmacies in American healthcare.
