How Pharmacy Deserts Threaten Access as Closures Rise Nationwide

In this video from a collaboration between Drug Topics and Mark Cuban Cost Plus Drugs Company, host Erin Albert, PharmD, JD, DASPL, chief of pharmacy relations, network, and professional affairs at Cost Plus Drugs, speaks with Dima M. Qato, PharmD, MPH, PhD, associate professor of clinical pharmacy and spatial sciences at the USC School of Pharmacy, about the growing crisis of pharmacy deserts and what it means for patient access to medications and pharmacy services.

Qato defines a pharmacy desert as a neighborhood that lacks convenient access to a nearby pharmacy. Drawing on more than 15 years of research, she explains how her team has mapped pharmacy access across urban, suburban, and rural communities in the United States, documenting persistent disparities—especially in majority Black neighborhoods compared with majority white neighborhoods in large cities.

Albert and Qato explore how closures are reshaping the pharmacy landscape. Qato notes that independent pharmacies face the highest risk of closure, yet they are often the ones trying to open in underserved areas. At the same time, large chain pharmacies are also shrinking their footprints, opening fewer new locations than they close. Unique pressures from pharmacy benefit managers—including reimbursement rates, network design, and steering of patients—are highlighted as major contributors to worsening pharmacy deserts.

Qato describes the development of a geospatial mapping tool, available at pharmacydeserts.com, which uses census tract–level data and empirically derived distance thresholds to identify communities with poor pharmacy access. The tool is already being used by the FTC, attorneys general, policymakers, and health leaders to guide advocacy, pharmacy siting decisions, and equity-focused policy.

Throughout the video, Qato emphasizes the critical role of pharmacists, independent owners, professional associations, employers, and local officials in advocating for fair reimbursement, stronger network standards, and policies that both open new pharmacies and keep existing ones from closing, ensuring sustainable, local access to medications and care.

“If we continue with our current policies and the trajectories of our current regulations, I think it's just going to get worse in terms of retail community pharmacies. Whether they're chains or independents, more are going to close,” Qato said.