American Pharmacists Month: Pharmacy Deserts Growing in US Despite Rising Awareness

More than a decade after the term “pharmacy desert” was coined, awareness of the issue has grown, but the number of Americans affected has as well, reaching an estimated 48 million patients’ communities. Despite a collective understanding regarding these access shortage areas over the years, as well as several leaders spearheading initiatives to address pharmacy deserts, some experts believe this type of health care shortage is inevitable.

“When we say pharmacy desert, we’re not just talking about there being no CVS or Walgreens in the area,” Kimberly Kue-Tsemo, PharmD, clinical pharmacist at George Washington Medical Faculty Associates, told Drug Topics. “We’re talking about a much broader issue as far as health care access and health equity.”

Although 2026 has seen unprecedented change across several areas of the pharmacy profession, from pharmacy benefit manager (PBM) reform to the unprecedented expansion of technology in pharmacy, store closures are becoming even more prominent. These continued closures, Kue-Tsemo argues, will be the reason pharmacy deserts may never be completely solved.

In the final week of American Pharmacists Month, we caught up with Kue-Tsemo to get an expert perspective on the magnified pharmacy desert issue across health care.

READ MORE: Pharmacists Fill Care Gaps as Community Health Workers

Structural Financial Pressures Drive Mass Retail Closures

Recent data underscores the reality behind these persistent shortages, with just under 50 million Americans currently living in a pharmacy desert compared with 41 million patients in 2021. According to Kue-Tsemo, this widening gap is largely driven by community pharmacy closures, which saw approximately 30% of retail pharmacies shut down between 2010 and 2021.

This contraction reflects a broader national decline where store closures began accelerating in 2018 due to corporate consolidation and severe reimbursement squeezes. Major retail chains continue to scale back, as seen in Walgreens’ ongoing multiyear downsizing strategy, which includes confirmed 2026 closures across Illinois, California, and multiple other states. Independent neighborhood drugstores face even steeper hurdles, being more than twice as likely as major chains to close.^1,2

Experts at the 2025 National Academies Pharmacy Workshop highlighted that pharmacies frequently face unpredictable reimbursement terms from PBMs, sometimes incurring losses between $80 and $100 per prescription on widely prescribed brand medications such as glucagon-like peptide-1 (GLP-1) receptor agonists.³

Vulnerability Metrics Highlight Deep Inequities

The impact of these store closures is not distributed evenly across the population. Kue-Tsemo emphasizes that pharmacy deserts are concentrated in historically marginalized areas, tracing these access barriers back to decades of housing segregation, discriminatory lending, and systemic economic disinvestment.

A 2025 study published in JAMA Network Open introduced a novel pharmacy vulnerability index, revealing that 57.1 million individuals in the contiguous US live in pharmacy deserts, with 28.9 million additionally depending on a single “keystone” pharmacy for essential access. Small, rural communities experience particularly high dependency, with 14.3% of residents relying on a single practice.⁴

In urban settings, closures disproportionately harm Black and Latino neighborhoods, where pharmacy closure rates reach 38% and 36% respectively, compared with 28% in White communities. When these vital access points disappear, patient adherence to critical cardiovascular and anticonvulsant medications drops significantly over the subsequent year.^1,3

Structural Barriers and the Limits to Digital Alternatives

Despite emerging models such as mail-order delivery and telepharmacy offering partial relief, Kue-Tsemo notes that pharmacy deserts will remain an enduring challenge until underlying financial structures are reformed.

National consensus reports reinforce that mail-order operations cannot serve as a complete substitute for brick-and-mortar pharmacies. Physical locations remain essential for vital in-person clinical services, including vaccinations, acute disease testing, over-the-counter consultations, and a growing list of additional offerings.³

Similarly, manufacturers’ direct-to-patient delivery programs fail to solve the crisis because they create fragmented care, increase medication error risks, and leave patients without a comprehensive overview of their drug regimens.

To safeguard remaining access points, health policy experts advocate for critical access pharmacy designations with enhanced reimbursement rates. Furthermore, 36 states have passed legislation enabling pharmacists to bill for clinical services, providing a sustainable path toward maintaining essential community health care access.³

“We know that telehealth could extend care, but it can't replace infrastructure; local providers, trusted relationships that we know you have to have to make care work,” Jennifer Hammons, PharmD, DrPH, director of rural health advancement at the Appalachian College of Pharmacy, told Drug Topics®. “But you know who can? Pharmacists; we're already doing it.”

READ MORE: American Pharmacists Month Resource Center

REFERENCES

1. Nearly 1 in 3 retail pharmacies have closed since 2010, widening health disparities. University of Southern California. December 3, 2024. Accessed October 26, 2026. https://schaeffer.usc.edu/research/pharmacy-closures-united-states-health-affairs/

2. Cottongim N. Walgreens closing stores: updated list of closed locations for 2026 - page 10. Black America Web. August 5, 2026. Accessed October 26, 2026. https://blackamericaweb.com/2026/08/05/walgreens-closing-stores-updated-list-2026/10/

3. Berenbrok LA, Carpenter D, Salgado TM, et al. Building on the 2025 National Academies Pharmacy Workshop: pharmacy deserts in the United States. Health Aff Sch. 2026;4(10):qxag256. doi:10.1093/haschl/qxag256

4. Mathis WS, Berenbrok LA, Kahn PA, et al. Vulnerability index approach to identify pharmacy deserts and keystone pharmacies. JAMA Netw Open. 2025;8(3):e250715. 2025 Mar 3. doi:10.1001/jamanetworkopen.2025.0715