Independent rural pharmacies are shuttering, killed off by chains; millions of Americans are left in 'drugstore deserts'

Number of healthcare deserts by county, defined as counties where most people lack adequate access to pharmacies, primary care providers, hospitals, hospital beds, trauma centers, and/or low-cost health centers. (GoodRx report; click here for more information.)

"Corner pharmacies, once widespread in large cities and rural hamlets alike, are disappearing from many areas of the country, leaving an estimated 41 million Americans in what are known as drugstore deserts, without easy access to pharmacies," Markian Hawryluk reports for The Washington Post. "An analysis by GoodRx, an online drug-price-comparison tool, found that 12 percent of Americans have to drive more than 15 minutes to reach the closest pharmacy or don’t have enough pharmacies nearby to meet demand. That includes majorities of people in more than 40 percent of counties."

Independent pharmacies are struggling to compete with chains whose relationships with insurers and pharmaceutical benefit managers give them a competitive edge. "Insurers also have ratcheted down what they will pay for prescription drugs, squeezing margins to levels that pharmacists call unsustainable," Hawryluk reports. "As the insurers’ drug plans steered patients to their affiliated drugstores, independent shops watched their customers drift away. They find themselves at the mercy of pharmaceutical middlemen, who claw back pharmacy revenue through retroactive fees and aggressive audits, leaving local pharmacists unsure if they’ll end the year in the black."

Those pressures have whittled away at the number of independent pharmacies. "From 2003 to 2018, 1,231 of the nation’s 7,624 independent rural pharmacies closed, according to the University of Iowa’s Rural Policy Research Institute, leaving 630 communities with no independent or chain retail drugstore," Hawryluk reports.

UPDATE, Nov. 18: A study for the PBMs' trade group, by two Penn State professors, found that the number of independent pharmacies in the U.S. increased 12.9% from 2010 to 2019, while the number of chain pharmacies decreased 0.2%. Also, "CVS Health announced Thursday morning that the company plans to close 900 stores nationwide over the next three years because of what executives described as changes in consumer shopping behavior, population, and the future of health care needs," The Boston Globe reports.