How pharmacists can help bridge pharmacy gaps

In this article:

• What are pharmacy deserts?
• How lack of access affects patients
• Why pharmacy deserts exist
• Creating opportunities for pharmacists
• Advocacy
• The bottom line

In this article

• What are pharmacy deserts?
• How lack of access affects patients
• Why pharmacy deserts exist
• Creating opportunities for pharmacists
• Advocacy
• The bottom line

Access to medication shouldn’t have to depend on where you live. However, for many patients, the walk or drive to the closest pharmacy is becoming increasingly longer. 

Pharmacy deserts affect millions across the country, especially underserved low-income and minority communities. In some places, patients have to travel surprisingly far just to fill basic prescriptions. Advocacy, new service models, and a bit of out-of-the-box thinking from pharmacists could help bridge some of these gaps.

What are pharmacy deserts, and where are they?

Almost 16 million Americans live in pharmacy deserts, which is about 5% of the country, and the problem isn’t limited to a few states. Some people have to drive more than 15 minutes just to reach a pharmacy, making it difficult to fill prescriptions or shop around for a better price.

Pharmacy deserts are areas where people have difficulty accessing a pharmacy. These areas have limited options for picking up prescriptions and other pharmacy services. While some patients live more than a mile from the closest pharmacy in big cities, out in rural America, that gap can stretch past 10 miles, or sometimes much more. 

Pharmacy deserts aren’t spread out evenly. Certain communities and low-income neighborhoods may struggle the most. These areas tend to have a higher proportion of uninsured residents and fewer residents with a post-secondary education. 

Still, big cities aren’t immune. Major chains, such as Walgreens, have closed hundreds of stores, leaving new gaps behind in urban areas. Without sufficient pharmacists nearby, many locals may lack the necessary support for their healthcare needs. 

Demographic or regional examples of communities affected include: 

• Black and Latino neighborhoods in major cities 
• Rural counties with declining populations 
• Areas with high poverty or unemployment rates 
• Communities with limited public transit or car ownership

How the lack of access affects patients

A lack of access to a pharmacy can affect patients in different ways. It can affect not only their ability to get their medications but also their overall health outcomes.  

Reduced medication adherence and delayed refills

Patients who cannot easily access a pharmacy may skip doses or delay refills. Long drives can make it a hassle to pick up medications on time, and many rely on family or public transit to get to pharmacies. If those options disappear, prescriptions just don’t get filled.

Worsened chronic disease outcomes

Poor access to medication can cause a dangerous cycle. People with diabetes can see their blood sugar spike when they miss insulin. Antihypertensives only work when patients take them every day, and skipping doses may increase the risk for heart attacks and strokes. Hospital visits can become the only option for problems that could’ve been prevented.

Limited preventive care and health screenings

Patients do more than just fill their prescriptions at pharmacies. They often stop by the pharmacy to receive flu shots, have their blood pressure checked, and undergo other health screenings. Patients often forgo getting these check-ins without a nearby pharmacy, and as a result, seemingly minor health issues may go unnoticed until they develop into something more serious.

Key preventive or monitoring services done at pharmacies may include: 

• Blood pressure, cholesterol, and glucose screenings
• Flu, shingles, and COVID-19 vaccines 
• Smoking cessation counseling 
• Birth control and emergency contraception access

Financial and emotional stress

Traveling farther to fill prescriptions means extra time and money. For many families, this can add significant financial pressure. It can also cause stress or anxiety about missing doses, especially for those who are juggling work and kids.

Reduced medication safety

Pharmacists are key to catching drug interactions and clarifying how to take medications safely. Patients who don’t have regular access to a pharmacy may not have that safety net. Mistakes in dosing or interactions may lead to more significant health problems down the line without regular check-ins with a pharmacist.

These effects are not mutually exclusive. Some patients may experience multiple negative effects simultaneously.

Why pharmacy deserts exist

Several factors may contribute to pharmacy closures, creating areas where people have difficulty accessing prescription medications. These factors may include economic hardships and geographic challenges. 

Economic problems

Many pharmacies may struggle to stay open, especially independent ones. Insurance companies may not be paying enough to cover rent, staff, or inventory. Increased competition and online shopping are also changing patient habits. If a pharmacy can’t stay in the green, locations may shut down.

Rural hurdles

Rural areas may face direct challenges due to their location. Fewer patients reside there, making it challenging to operate a profitable pharmacy. Delivery costs also increase, and travel times can be lengthy. When the numbers stop adding up, these places may lose their only pharmacy.

Digital divide

Online pharmacies and telepharmacy sound promising, but many patients in underserved areas may not have reliable internet or aren’t comfortable with digital health tools. Older adults and low-income families may find that online prescription services are out of reach.

Local pharmacies are part of the backbone of health care in many communities. A lack of them could spell out trouble for many patients.

Turning gaps into opportunities for pharmacists

Gaps in medication access provide pharmacists with opportunities to assist patients in need. That could mean suggesting different solutions in their own pharmacies or joining other projects that help reduce pharmacy deserts.

Mobile and telehealth programs can be helpful solutions. Mobile pharmacy vans bring medications and basic health checks right to underserved neighborhoods. Pop-up vaccine clinics at schools or churches can also reach people where they already are. Telepharmacy enables pharmacists to counsel patients remotely, which can be particularly helpful for medication reviews.

Other potential pharmacist-led ideas may include: 

• Medication adherence programs via text or app reminders 
• Home delivery or drive-up refill services 
• Partnerships with food banks or senior centers 
• Grant-funded mobile health units serving rural areas

Pharmacists can also offer preventive care and screenings in underserved areas by teaming up with local clinics or other community health centers. Public health departments may also need help with vaccine drives. Nonprofits can provide funding or volunteers for outreach programs that pinpoint specific needs of the community.

Advocacy and next steps

Pharmacists can help make impactful changes by getting involved in conversations about policy. Many lawmakers don’t fully understand the impact of pharmacy deserts on communities, but a pharmacist can articulate the actual effects on patients. 

Talk to patients directly

Get to know which patients are struggling to reach your pharmacy or afford their medications. Consider tracking refill delays or frequent transfers to identify small “deserts” within your own community. Share that data with local health departments, doctors’ offices, or community boards, as they may not realize the severity of the access gaps until someone in the field brings it to their attention.

Build local connections

There is an abundance of local resources pharmacists can use to help advocate for reduced pharmacy deserts. Local pharmacies can share delivery routes with one another or coordinate outreach for patients who live farther out. Pharmacists can also partner with local nonprofits or churches to set up vaccine or brown bag events. 

Advocate at the state level

Pharmacists can directly advocate by joining their state pharmacy association’s advocacy committees or attending legislative days. Issues like PBM reform and fair reimbursement can directly affect access. It may be helpful to share personal stories to demonstrate the credibility of these efforts.

Educate patients on their options

Teach patients about trying mail-order options or synchronizing medication pick-up days to reduce travel. Automatic refills or 90-day supplies can help reduce missed doses for those living farther away.

Small actions can add up. Advocacy isn’t only about policy but about using your role as a pharmacist to remove barriers one partnership or conversation at a time.

Bottom line

Prescription access isn’t the same for everyone in the United States. Pharmacy deserts leave millions of Americans without easy access to the medications and care they need. Patients may end up skipping refills or paying higher costs just to stay on their treatment plan. The problem may come from a mix of economic pressures and policy barriers. Still, pharmacists can help close these gaps through mobile or telehealth services and local advocacy that brings care back to where it’s needed most.