Pharmacy Closures Disproportionately Burden Minority, Underserved Communities

When pharmacy closures occur, the need for bulk prescription transfers creates patient burdens that are most felt in minority or underserved communities, according to a study in JAMA Health Forum.¹ Furthermore, study data show that independent pharmacies were less likely to accept prescription transfers due to pharmacy benefit manager (PBM) reimbursement pressures, highlighting a nationwide issue in pharmacy access.

“Since 2019, over 7000 pharmacies have closed in the US, and the pace hasn’t slowed. Just in 2024 alone, more than 2200 pharmacies shut their doors, averaging about 8 closures per day,” according to NFP.² “These closures are being driven by low reimbursement, major retail bankruptcies like Rite Aid, and continued consolidation across the industry.”

The logistical burden of these shifts is often measured in miles and minutes, but for the pharmacists left behind, it is measured in manual labor and patient distress. A closer look at 955 Rite Aid closures reveals that 96.4% of prescription transfers were routed to other major chains, while 68.7% were directed toward PBM-affiliated pharmacies.¹

This pattern reinforces vertically integrated networks but often bypasses local independent pharmacies, which frequently lack the financial cushion to absorb a sudden influx of low-reimbursement patients. For these smaller establishments, taking on a large volume of transferred files can be a logistical nightmare involving manual data entry and the risk of critical dosing gaps.^1,3

READ MORE: Retail Closures Threaten Pharmacy Access in Vulnerable Communities

Tom DePietro, PharmD, a pharmacy owner in Pennsylvania, noted that pharmacies must be tactical in accepting new patients because growing too quickly can cause a business to outrun its cash, yet turning away those in need is counterintuitive to the profession’s mission.³

In minority-majority counties, the geographic impact of these closures is significantly more severe, as transfers exceeding 15 miles were 12 times more common than in majority-White counties. Residents in these underserved areas also face a higher frequency of public transport loss, with 16.9% of transfers in low-density neighborhoods resulting in the disappearance of a nearby bus stop.¹

This creates a pharmacy desert, defined as any area where residents lack reasonable access, typically more than 1 mile in urban settings or 10 miles in rural locations. Today, roughly one-third of neighborhoods in major US cities meet this criteria, and the results are often seen in reduced medication adherence and increased emergency room visits.²

Although some research suggests that the average Medicare patient only decreases prescription use by 1.5% after a pharmacy closure, these broad statistics mask deep racial disparities. For instance, although White patients experience a negligible drop in days of supply, Hispanic patients saw a decline of over 12 days per month following their primary pharmacy’s closure.⁴

Many patients attempt to adapt by switching to 90-day supplies or utilizing mail-order services, but these alternatives cannot replace the clinical services provided by an in-person pharmacist. Community pharmacists are currently the most frequently visited health care providers, with the average patient seeing them up to 35 times a year, often providing essential services like vaccinations and disease management that mail-order options lack.^3,4

The economic environment driving these closures is increasingly unsustainable for practitioners. Independent pharmacy counts have plummeted from over 40,000 in 1980 to roughly 21,000 today, largely due to opaque fees that can sometimes result in a net loss of $80 to fill a single prescription.³

Current policy debates, such as Arkansas’s Act 624, aim to protect local pharmacies by banning PBMs from owning pharmacies or underpaying competitors. However, some industry groups warn that forced pharmacy closure policies could have unintended consequences, potentially increasing national drug spending by $31.7 billion and leading to 44,000 avoidable hospitalizations due to the loss of logistical efficiencies.^2,5

Protecting the viability of the community pharmacy is a public health imperative. As the nation faces a projected shortage of 122,000 physicians by 2032, the role of the pharmacy as a local health care hub becomes even more critical.³

Without urgent policy intervention, such as supplemental dispensing fees for underserved areas, the continued expansion of pharmacy deserts will likely continue to disproportionately erode health equity for the nation's most vulnerable populations.^2,3

“In most industries, closure of a nearby competitor may be a welcome change for financial outlook,” concluded the authors of the current study.¹ “For independent pharmacies, such principles may not be applicable.”

READ MORE: How Pharmacy Deserts Threaten Access as Closures Rise Nationwide

REFERENCES

1. Veeramachaneni S, Ramachandran S, Barnard M. Bulk prescription transfers and access after chain pharmacy closures. JAMA Health Forum. 2026;7(7):e262070. doi:10.1001/jamahealthforum.2026.2070

2. Pharmacy deserts: why they matter for your clients and what you can do about it. NFP. August 6, 2025. Accessed July 13, 2026. https://www.nfp.com/insights/pharmacy-deserts-impact-and-action-steps/

3. Nowosielski B. Retail closures threaten pharmacy access in vulnerable communities. Drug Topics. July 10, 2026. Accessed July 13, 2026. https://www.drugtopics.com/view/retail-closures-threaten-pharmacy-access-in-vulnerable-communities

4. Caputi TL. Patients adapt: the mitigated impact of retail pharmacy closures. Theodore L. Caputi. October 1, 2024. Accessed July 13, 2026. https://www.theodorecaputi.com/files/tc-jmp.pdf

5. The devastating patient effects of forced pharmacy closure policy. News Release. Pharmaceutical Care Management Association. March 9, 2026. Accessed July 13, 2026. https://www.pcmanet.org/press-releases/the-devastating-patient-effects-of-forced-pharmacy-closure-policy/