Pharmacy Deserts: Closures Hit Hard as Seniors Rely on Local Drug Stores
A wave of pharmacy closures announced by major drugstore chains this week is raising concerns about access to vital medications for older adults, particularly in underserved communities.
Walgreens' plans to shutter a "significant" number of its 8,600 U.S. stores and Rite Aid's announcement of up to 500 closures come on the heels of industry-wide trends pointing towards a shrinking brick-and-mortar pharmacy landscape. CVS has shuttered about 600 stores since 2022 and plans to close 300 more this year.
Experts warn these closures could create "pharmacy deserts," areas with limited access to pharmacies, disproportionately impacting older adults who rely on these establishments for essential medications, health screenings, and consultations.
According to a 2023 report by the AARP, nearly nine in ten adults aged 65 and older take at least one prescription medication, highlighting their dependence on pharmacies for maintaining health and well-being.
Approximately 12% of individuals aged 65 and older are reported to use ten or more prescription and/or nonprescription drugs weekly. According to the American Society of Consultant Pharmacists, adults aged 65 to 69 average 15 prescription medications annually, while those between 80 and 84 years old average 18 prescription medications annually.
Dr. Michael Hogue, Dean and Professor of Loma Linda University School of Pharmacy, says these closings can cause a major problem for many of us who have no option for health care other than our local pharmacy.
For many communities, the closure of the pharmacy and loss of the pharmacist means that healthcare services, not just drugs, are harder to reach.
A Perfect Storm of Challenges
Industry analysts cite several factors contributing to the decline of brick-and-mortar pharmacies. A key culprit is falling reimbursement rates from pharmacy benefit managers (PBMs) – the middlemen who negotiate drug prices between insurers and pharmacies.
PBMs have squeezed profit margins for pharmacies, making it difficult for some locations to remain financially viable, especially in areas with lower volumes of prescriptions filled.
"The current pharmacy model is not sustainable," said Tim Wentworth, CEO of Walgreens, in a recent call with analysts. Wentworth pointed to "persistent pressures on the U.S. consumer" and "recent marketplace dynamics" as additional contributing factors.
The ongoing labor shortage further complicates the situation. Pharmacies struggle to attract and retain qualified pharmacists, leading to reduced hours, longer wait times, and potential medication shortages. These factors, coupled with the rise of mail-order pharmacies, contribute to traditional drugstores' decline.
Impact on Seniors: More Than Just Medications
For many older adults, pharmacies are more than just places to fill prescriptions. They often serve as trusted healthcare resources, offering consultations with pharmacists, health screenings, and medication adherence programs. Closures leave seniors with limited options for these vital services, potentially leading to poorer health outcomes.
Rural pharmacies play a crucial role in their communities. They often serve as touchstones, where staff members know everyone's names, answer questions about mail-order prescriptions, and even recognize signs of serious illness.
Beyond the critical issue of medication access, these closures will also disrupt the shopping routines of many older adults. Drugstores are a one-stop shop for a variety of needs for seniors, often carrying everyday essentials like toiletries, over-the-counter medications, greeting cards, and even groceries.
The convenience of picking up prescriptions alongside these daily items can be a big advantage, especially for those with limited mobility or transportation options. The loss of a local pharmacy can force seniors to travel farther or rely on others to obtain these essential goods.
Dr. Sarah Jones, a Northwestern University gerontologist, laments the local pharmacy's loss.
The loss of a local pharmacy can be particularly detrimental to older adults who may have difficulty traveling long distances or lack reliable transportation to access medication refills.
Seniors Benefit from Local Pharmacies
While mail-order pharmacies offer convenience and potentially lower costs, they may not be the ideal solution for all seniors. One major concern is the lack of personal interaction with a pharmacist.
Seniors often have questions about medications, side effects, or potential interactions with other drugs. A local pharmacist can provide valuable guidance and ensure medications are safe for individual needs.
Additionally, mail-order deliveries can take several days, which can be problematic for medications that must be refilled regularly or for those requiring immediate access.
There have been occasional reports of medication errors in mail-order fulfillment, such as receiving the wrong medication or dosage. This risk is mitigated at a local pharmacy where a pharmacist can double-check the prescription before dispensing.
What Lies Ahead?
The future of pharmacy access for older adults remains uncertain. Some experts believe the industry will consolidate, with a few large chains dominating the landscape. Others predict a rise in alternative models, such as telehealth consultations with pharmacists or partnerships with community centers to offer medication dispensing services.
We need innovative solutions to ensure that older adults, especially those living in underserved communities, have access to the medications and healthcare services they rely on.
She says collaboration between policymakers, healthcare providers, and community organizations is crucial to address this growing challenge.
Long-Term Care Facilities Can Also Be Impacted
The wave of drugstore closures is likely to have a ripple effect on the long-term care sector as well. Many long-term care facilities, especially in rural areas, rely on local pharmacies to deliver medications, provide medication management services, and offer consultations with pharmacists.
Closures could disrupt these established relationships and lead to logistical challenges in ensuring residents receive their medications on time and correctly.