Retail Closures Threaten Pharmacy Access in Vulnerable Communities

Walgreens and other retail pharmacy closures could significantly exacerbate medication access in vulnerable communities, especially when no alternatives are nearby, according to a study in Research in Social and Administrative Pharmacy.¹

With sparse and vulnerable communities in danger of pharmacy closures and their consequences, researchers hope their findings can encourage chain pharmacies to explicitly consider community risks when consolidating their business.

“Between 2010 and 2021, over 29% of pharmacies across the country closed, exacerbating pharmacy deserts, particularly in low-income, rural, and underserved communities,” a news release from the Ohio State University College of Pharmacy said.² “This trend highlights a widening gap in access to essential health care services and medications, posing significant challenges for patients who rely on their local pharmacy and pharmacist for care.”

The scale of this contraction is unprecedented, with Walgreens planning to shutter 1200 locations over the next 3 years, including 500 in 2025 alone. This strategic shift follows a staggering $8.6 billion net loss in 2024, driven by a weak retail side, declining drug reimbursement rates, and significant competition from e-commerce.³

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

To measure the potential impact, researchers developed a Pharmacy Competition Index (PCI) to identify counties where Walgreens serves as a critical access point with few nearby alternatives. Their analysis identified 334 “sparse-vulnerable” counties, primarily in the southern and western parts of the country, where closures are most likely to create catastrophic access outcomes for residents with limited transportation options.¹

Although Walgreens locations are often clustered in dense urban areas like Chicago and San Francisco, nearly 15% of the 1570 counties they serve were classified as low-competition environments.

For the pharmacists remaining on the front lines, these closures trigger a series of stressful ripple effects. When a nearby pharmacy shuts down, the surviving establishments face a sudden sprint to transfer prescriptions manually, a process described by practitioners as a logistical nightmare that risks critical dosing gaps for patients.^4,5

“Early on, when the Rite Aids closed, we took on new customers, but we took them on tactically, because in this business, you can't grow too quick; you're going to outrun your cash,” Tom DePietro, PharmD, owner of DePietro’s Pharmacy in Pennsylvania, told Drug Topics®. “To not strategically take a patient is, I think, where some pharmacies get in trouble. But it’s hard to not help people who are looking for your help. It's counterintuitive to what most pharmacies came into this profession for.”

This influx of new patients often brings a higher volume of low-reimbursement claims, which can financially strain an existing pharmacy. Pharmacists report that the current economic model is increasingly unsustainable, with some prescriptions resulting in a net loss of $80 to fill due to opaque direct and indirect remuneration (DIR) fees and generic effective rate (GER) fees.^4-6

These financial pressures have already contributed to a massive decline in independent pharmacies, which dropped from over 40,000 stores in 1980 to roughly 21,000 today.⁶

The human cost is equally significant, as retail pharmacies often serve as the “crux of the community,” providing vital clinical services and acting as accessible health care hubs where patients see their pharmacist up to 35 times a year. Qualitative focus groups in the Mountain West highlight that closures lead to increased wait times, staff burnout, and a chilling effect on recruitment as new graduates become wary of the profession’s job security.^4-6 

Pharmacy technicians often bear the brunt of patient frustration during these transitions, dealing with individuals who may now face 80-mile round trips just to secure an antibiotic for a sick child.⁵

Addressing pharmacy deserts requires urgent policy intervention. Potential solutions include supplemental dispensing fees for pharmacies in underserved areas and the expansion of telepharmacy and remote verification. Although mail-order services offer one alternative, they cannot replace essential in-person services like vaccinations, point-of-care testing, and the foundational pharmacist-patient relationship.^2,4

As the nation faces a projected shortage of 122,000 physicians by 2032, protecting the viability of community pharmacy is not just a business necessity but a public health imperative.^2,6

“This study shows that pharmacy competition proximate to Walgreens intersects meaningfully with social vulnerability,” concluded the authors of the current study.¹ “Crowded markets are likely to absorb closures, but sparse-vulnerable communities appear particularly exposed to access shortfalls. Chains considering consolidation should weigh community risk when clustering closures.”

READ MORE: The Impact of Closures, PBM Reform on Community Pharmacy

REFERENCES

1. Kissi-Twum K, Anderson KE, Mattingly TJ. Geographic variation in pharmacy competition and social vulnerability proximate to Walgreens. Res Social Adm Pharm. May 19, 2026. doi:10.1016/j.sapharm.2026.05.008

2. Murphy M, Rodis J. The growing crisis of pharmacy deserts. The Ohio State University College of Pharmacy. April 28, 2025. Accessed July 9, 2026. https://pharmacy.osu.edu/news/growing-crisis-pharmacy-deserts

3. Complete list of Walgreens stores closing updated to 2026. Usearch. 2026. Accessed July 9, 2026. https://usearch.com/dataset/walgreens-stores-closing-list

4. Hastings M. Costs, closures and community: perspectives on operating a rural pharmacy. University of Colorado Anschutz. January 16, 2026. Accessed July 9, 2026. https://news.cuanschutz.edu/news-stories/costs-closures-and-community-perspectives-on-operating-a-rural-pharmacy

5. DiStefano MJ, Chen NC, Asche CV, et al. “The crux of the community”: a qualitative focus group study of the impact of community pharmacy closures in Colorado and Utah. JAPhA. 2025;66(1):102940. doi:10.1016/j.japh.2025.102940

6. Nightengale B. What was, is no more: community pharmacy economics. J Manag Care Spec Pharm. 2020 Jun;26(6):703-705. doi: 10.18553/jmcp.2020.26.6.703.