The term pharmacy desert is derived from the term food desert. Just as a food desert is an area with little to no access to a supermarket or grocery store, a pharmacy desert is an area with little to no access to a pharmacy.
Although more than 90 percent of Americans live within five miles of a pharmacy, those five miles can be daunting without transportation. In the United States, almost 2.5 million people who live in rural areas do not have easy access to a pharmacy.
That number only includes people who live in towns with a population between 500 and 5,000 and who are at least 10 miles away from a pharmacy. There is no information on people who live in rural areas with fewer than 500 people or greater than 5,000 who are also 10 miles from a pharmacy. There is also no information on people who live in urban areas with little or no access to a pharmacy.
A New Phenomenon
Access to healthcare has traditionally been a problem in many rural areas, but pharmacy deserts are a newer phenomenon, created by more recent closings of pharmacies. Studies have shown that more than 1,200 independently owned rural pharmacies closed over the past 16 years. That is close to one-fifth of all rural pharmacies.
Ohio, for example, lost 20 rural pharmacies in 2019. Healthcare experts attribute the closures to low Medicaid reimbursement, and to a lesser extent, low Medicare Part D reimbursement. One problem is that PBMs involved in the reimbursement process gain from community pharmacy closures because the PBMs often operate their own mail order and specialty pharmacies.
Moreover, chains are closing stores that are struggling to make a profit. Walgreens, for example, is closing 200 stores.
Telepharmacy as a Solution
One way to solve the problem is through telepharmacy. About half the states allow telepharmacy, and more are moving in that direction. One pharmacist, for example, opened a telepharmacy in Gwinner, North Dakota, where the nearest brick-and-mortar pharmacy was about 20 miles away, making a significant improvement to pharmacy services to the town.
Telepharmacy also works in urban areas. One such telepharmacy is in Chicago in a medical clinic that serves a large Medicaid and Medicare population. Many of the people here had transportation issues and could not get to a pharmacy only a mile away. Putting the pharmacy inside a medical clinic eliminated access problems.
Low reimbursement rates from public insurance programs cannot support a traditional pharmacy in the area.
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