Pharmacy Density Data Reveal Rural Health Care Access Gaps

According to newly released pharmacy density data in the Australian Journal of Rural Health, pharmacy access has reached low levels, calling for policymakers to drive more equitable distribution of pharmacy services nationwide.¹

With similar trends in the US and other nations, experts have persistently petitioned for a transformation of pharmacy access, especially in rural and underserved areas of the world.

“As pharmacies close, more and more individuals are left without easy access to medications, with disproportionate consequences for certain communities,” according to a study in JAMA Network Open.² “Patients in higher social vulnerability index counties with a lower primary care practitioner density had a 30% to 40% higher likelihood to reside in regions with pharmacy deserts. These findings highlight how disparities compound to create barriers to access basic health care.”

To contextualize this crisis, the landmark Australian study analyzed 6032 community pharmacies across 336 statistical area level 3 (SA3) regions in 2024.¹

Despite metropolitan areas averaging a density of 2.09 pharmacies per 10,000 people, remote and rural areas actually maintained a higher nominal density of 2.63.

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

However, this higher density obscures a severe geographic challenge, as community pharmacy density tends to drop significantly along with the geographic area of a region increasing. Vast regions of inland Australia lack basic pharmacy coverage within a reasonable 25-kilometer travel radius.¹

This leaves regional residents highly reliant on a sparse network of pharmacies that often struggle with severe workforce shortages, meaning there are far fewer actual pharmacists per community pharmacy compared with metropolitan hubs.

Furthermore, several isolated communities, such as Daly-Tiwi-West Arnhem in the Northern Territory, have a population of over 18,300 people but contain zero community pharmacies, representing extreme pharmacy deserts.¹

Spatiotemporal Barriers and Compounding Vulnerabilities

In the US, research indicates that counties with higher social vulnerability indices and lower primary care practitioner density are the most likely to be designated as high-density pharmacy deserts.^2,3

When local pharmacies close in these vulnerable regions, patients face severe barriers to obtaining life-saving chronic medications, especially if they lack public transit or internet options to seek alternatives.²

Moreover, geographic distance is only half of the accessibility equation. In rural areas like Vermont, where a significant portion of the population is older and highly dependent on medication, spatiotemporal analysis reveals that pharmacy access drops drastically on weekends.³

With no 24-hour pharmacies operating in the entire state of Vermont, rural patients seeking urgent, after-hours prescriptions must travel long distances to hospital emergency rooms, transforming a simple medication pickup into an emergency care crisis.

Retail Realities vs Evolving Frontline Care

This growing spatial divide occurs at a time when the clinical responsibility of the pharmacist is expanding.^3,4

Today, community pharmacies are rapidly evolving into neighborhood health hubs, offering disease state management, test-to-treat services, and preventative screenings. Patients with chronic conditions interact with their pharmacists an average of 13 times a year, compared with just 7 visits with their primary care physician.

Yet, even as pharmacists work at the top of their clinical licenses, they operate within fragile retail business models.^4,5

Comprehensive US market analysis reveals an annual community pharmacy business turnover rate of 6.2%. Independent pharmacies face the highest volatility, with a massive 152.7% churn rate over a 14-year period, frequently closing within their first 5 years of operation.⁵

Although many of these closures represent lucrative acquisitions where patient files are seamlessly moved to nearby locations, sudden store closures can still disrupt patient adherence and widen existing health care divides. Resolving these overlapping geographic and commercial pressures is essential for pharmacists who seek to remain frontline pillars of community health.^4,5

“Correlates of community pharmacy density, and particular SA3s with lowest‐quintile community pharmacy density, could inform legislation, policies, and decisions related to pharmacy premises and workforce,” concluded the authors of the current study.¹ “Future studies of community pharmacy density across Australia should assess the correlation between community pharmacy density and general practice density and incorporate additional subnational area characteristics (e.g., socioeconomic status) and community pharmacy accommodations (e.g., opening hours).”

READ MORE: Pharmacy Closures Disproportionately Burden Minority, Underserved Communities

REFERENCES

1. Leach MJ, Griffin E. Community pharmacy density across remote, rural, regional and metropolitan areas of Australia: an ecological study. Aust J Rural Health. 2026 Apr;34(2):e70169. doi: 10.1111/ajr.70169

2. Catalano G, Khan MMM, Chatzipanagiotou OP, et al. Pharmacy Accessibility and social vulnerability. JAMA Netw Open. 2024;7(8):e2429755. doi:10.1001/jamanetworkopen.2024.29755

3. Roubin S, Holler J, Kedron P. Urban-rural disparities in spatiotemporal accessibility of pharmacy care: a case study of Vermont, USA. BMC Health Serv Res. 2025 Nov 19;25(1):1484. doi: 10.1186/s12913-025-13653-1

4. Pharmacies are an emerging access point for patient care: Explore their evolving role. Point of Care Marketing Association. September 30, 2025. Accessed August 26, 2026. https://pocmarketing.org/resources-insights/pharmacies-are-an-emerging-access-point-for-patient-care-explore-their-evolving-role

5. Mattingly TJ, Sahu M, Anderson KE. Community pharmacy turnover and context of openings and closings by ownership type. JAMA Health Forum. 2025;6(8):e251988. doi:10.1001/jamahealthforum.2025.1988