Nearly 30% of pharmacies in the United States shut down between 2010 and 2021, according to a recent study published in Health Affairs. While the industry initially saw growth, the trend reversed from 2018 to 2021, with closures outpacing new openings. The decline in pharmacies has raised concerns about access to medications and primary care, leaving both patients and healthcare providers struggling to adapt.
Pharmacy closures are more than just an inconvenience—they create significant barriers to care, particularly in rural and underserved communities. Without easy access to prescription medications, patients often face difficult choices that can have severe health consequences.
The Struggle for Medication Access
Sarah M. Worthy, CEO of DoorSpace, highlights two major issues communities face when pharmacies shut down.
“The first problem communities face when they lose access to a pharmacy is they see patients struggle to properly manage conditions requiring consistent access to their medication,” Worthy explains.
While some patients can rely on mail delivery programs to receive their medications, regulations in many states prevent certain prescriptions—particularly mental health medications—from being shipped. This leaves patients scrambling for alternatives.
One of the most immediate consequences is that patients begin rationing their medications, stretching out doses to make them last longer while trying to figure out how to refill their prescriptions.
“This means patients may skip doses for several days while they’re trying to arrange the time and transportation to get to the nearest pharmacy that may now be over an hour away, instead of 20 minutes, by car,” Worthy says. “This inconsistency in access to their medication leads to lower quality outcomes for chronic conditions.”
For individuals managing diabetes, heart disease, or mental health disorders, skipping doses can have serious, even life-threatening consequences. Gaps in treatment can lead to emergency room visits, hospitalizations, and worsening health over time.
Loss of Preventative and Primary Care
Beyond prescriptions, pharmacies serve as essential access points for preventative healthcare. Many offer vaccinations, over-the-counter medication guidance, and even primary care services through in-house nurse practitioners. When a pharmacy closes, these services disappear, further limiting healthcare access for already vulnerable populations.
“The second problem is that many of these pharmacies are also providing some form of primary and/or preventative care, and when they close, that community loses that preventative care,” Worthy says.
This has ripple effects on community health. Without local pharmacies, people may be less likely to receive timely flu shots, childhood immunizations, or guidance on managing minor health issues before they escalate into emergencies.
“These pharmacies often provide vaccinations and help advise customers on over-the-counter medications for minor ailments and injuries,” Worthy adds. “Many also have an advanced nursing practitioner who comes in on a part- or full-time basis to see patients for regular primary care and non-emergency health concerns.”
Decades of research have linked easy access to primary care with improved long-term health outcomes and lower overall healthcare costs. Pharmacy closures disrupt that access, leading to higher rates of unmanaged chronic diseases, more emergency care visits, and greater healthcare spending over a lifetime.
Addressing the Pharmacy Desert Crisis
Solving the problem of pharmacy deserts will require a multi-faceted approach. Expanding telehealth and mail-order medication options could help mitigate some of the access issues, though regulatory barriers need to be addressed. State and federal policies could also incentivize pharmacies to remain open in underserved areas through financial support, grants, or tax breaks.
Investing in mobile pharmacy services is another potential solution. Some communities have begun deploying mobile health clinics to bridge the gap, bringing medications, vaccinations, and even basic healthcare directly to areas affected by pharmacy closures.
Ultimately, policymakers and healthcare leaders must recognize the vital role pharmacies play in both medication access and broader healthcare delivery. Without intervention, pharmacy closures will continue to exacerbate healthcare disparities, particularly for rural and low-income populations.
As Worthy warns, “When this access is lost from a pharmacy closure, that community suffers more chronic conditions and pays higher costs over their lifetime.”
The crisis of vanishing pharmacies is not just about losing a place to pick up prescriptions—it’s about losing an essential pillar of community healthcare. Addressing the issue now could help prevent long-term consequences for millions of Americans who rely on pharmacies for both everyday and critical medical needs.