Pharmacies provide essential care, from medications to vaccinations and more. The loss of a nearby pharmacy hurts the people who rely on it the most. Here’s why more pharmacies are closing—and what you can do to support pharmacy access for all.
Imagine stepping into your local pharmacy—the place where you ask questions, get vaccines, and trust your pharmacist to keep your medications safe. Now, picture that brick-and-mortar pharmacy gone. Community pharmacy workers helped save livesduring the pandemic by staying open and maintaining access to medication while also vaccinating, testing, and treating for COVID-19. What would have happened if they weren’t there?
Across the country, it’s becoming more than a thought experiment for an increasing number of communities. Nearly one in three retail pharmacies has closed since 2010. Those closures hit hardest in Black and Latino-majority neighborhood and rural towns, where independent pharmacies often serve as frontline access to care. Independent pharmacies are closing at a rate of more than one per day and large chain pharmacies are shuttering stores too.
An estimated 45% of U.S. counties are now “pharmacy deserts,” resulting in longer travel times, more missed doses, and fewer trusted health professionals to turn to. For many families, the loss of a nearby pharmacy means losing a lifeline to healthcare and community support, just as pharmacies are needed more than ever.
💡 A pharmacy desert is an area where it takes residents at least 15 minutes—though often much longer—to reach a pharmacy. The actual distance depends on the location. A 10-mile distance counts in rural regions. In cities, a pharmacy desert can mean living more than a mile from the nearest pharmacy. But in low-income urban neighborhoods where fewer people own cars and walk to their pharmacy, a half-mile distance or more qualifies as a desert.
➡️ Pharmacists have always been frontline community clinicians.
Pharmacists do far more than dispense drugs—think of them as frontline clinicians. They’re experts on medication safety, guiding you on how to take meds, avoid side effects, and prevent dangerous interactions. Pharmacists help you navigate everything from vitamins to wellness supplies to screenings for blood pressure, diabetes, and cholesterol, making sure you have what you need to stay healthy.
Given their diverse expertise and commitment to drug safety, pharmacists can also cross-check the information provided to you by your doctor. Recently, one of the authors (Kenzie) was prescribed a new medication to help ease chronic illness-related symptoms. Her local pharmacist – a neighborhood mainstay for as long as she can remember – advised her to discontinue taking one of her other medications that typically did not react well with her new prescription. Without this information, Kenzie would have started a combined medication regimen that put her at risk of several side effects. Before leaving the drive thru, her pharmacist also helpfully let her know that she was due for her first adult tetanus (Tdap) booster. (Is this what it’s like to be a grownup?)
Beyond offering recommendations and reminders, pharmacies have become the go-to spot for vaccines—administering more than 90% of COVID-19 vaccinations—and continue leading efforts to protect communities from respiratory illnesses. Many pharmacies also offer test-and-treat services for common infections like strep, flu, and COVID-19, and in many states, pharmacists can also prescribe medications for HIV prevention, birth control, and substance use treatment.
⚖️ Historical Context: Pharmacies as Breeding Grounds for Health Equity ⚖️
From the homes of indigenous medicine men and women to apothecaries, pharmacies – and their revered roles as sites of education and healing – are almost as old as humanity itself. And at the height of the twentieth century, they became hotbeds for some of America’s most defining social movements. In racially and economically segregated towns where physicians only treated certain segments of the population, pharmacies were hubs for people to buy homegrown remedies, receive life-saving health counsel drawn from ancestral knowledge, and freely engage in cultural expression. And for chemists and other clinical experts from marginalized backgrounds, pharmacies were places where they could build their careers when historically-Black medical training centers were rendered defunct and they were denied admission to other schools, both consequences of Jim Crow.
During the American Civil Rights Movement, efforts to desegregate pharmacieswere much less recognized than lunch-counter sit-ins, department store boycotts, and church rallies, but they were just as commonplace. Because pharmacies have always been commercial hubs for the exchange of medicine, food, and information, activists recognized that pharmacies would be a “critical win” in the ongoing fight for racial justice.
➡️ With everything available online, why is the corner drugstore still needed?
Online pharmacies that are properly licensed can be a safe and convenient way to get prescriptions, but they don’t replace the value of having a local pharmacy. Many healthcare services still require in-person care, like vaccines, health screenings, and test-and-treat visits. Sometimes you need medication right away—an antibiotic, for example, or a new dose of your heart medicine—and waiting for delivery isn’t optimal.
Not everyone has a stable address or reliable internet access, and some medications can be damaged by heat during shipping. Many prescriptions also come with devices or instructions that a pharmacist can walk you through to be sure you’re using them safely and correctly. People with literacy or language barriers may struggle to read labeling instructions—and even for us Nerdy Girls, they can be confusing. Having someone familiar with the product show you what to do is the kind of personalized support many people need (and deserve!). Every day, pharmacists meet patients who’ve been using a medication wrong simply because no one took the time to make sure they understood it.
Most of all, your neighborhood pharmacy offers something no website can: an opportunity for trusted face-to-face connection.
➡️ Why are more pharmacies closing?
Like any other retail business, community pharmacies depend on profit to survive. For years, those profits didn’t just come from behind the counter. Stores made money selling over-the-counter meds, snacks, toiletries, and household goods. Big-box retailers even used pharmacies as “loss leaders”—offering prescriptions at low prices to bring shoppers in for other items. But as online shopping took over and foot traffic declined, those steady retail dollars disappeared, leaving pharmacies with thinner margins and less room to balance their books. That’s only part of the story, though—and not the one that makes headlines.
➡️ How Do Pharmacy Benefit Managers (PBMs) affect pharmacy access?
Have you heard of PBMs? Pharmacy Benefit Managers were created to help lower prescription costs, and sometimes they still do. But often, their complex contracts and after-the-fact fees leave pharmacies earning less—sometimes even less than they spent to fill your prescription – and sometimes, PBMs stand to financially benefit even more than patients from their drug pricing negotiations. PBMs also steer consumers to using “preferred” pharmacies, which can leave others struggling to survive. Today, every one of America’s major health corporations owns a PBM, and although there are dozens of PBMs in the U.S., the largest three control up to 80% of all prescription claims processed nationwide.
A recent Health Affairs study looking into PBM practices for forming Medicare Part Dnetworks found that pharmacies located in low-income, Black, and Latinx neighborhoods were less likely to be labeled “preferred” and more likely to close during the 2014 to 2023 time period studied. Requiring patients to travel longer distances to find in-network pharmacies that can fill their prescriptions completely discounts the reality that reliable transportation—and physical mobility more generally—is not a “given” for many people. This is especially true for Medicare Part D beneficiaries, who are primarily older adults and younger adults with long-term disabilities.
➡️ What challenges are pharmacy teams facing?
Between shrinking profits, unpredictable payments, and lost retail income, even once thriving pharmacies are struggling to keep their doors open. Inside many pharmacies, the strain is hard to miss. Technician pay hasn’t kept up with their growing responsibilities, leading to frequent turnover and short-staffed shifts. Pharmacists often end up stepping in to cover those gaps, leaving less time for patient care and more pressure on everyone. It’s no wonder so many pharmacy teams feel stretched thin—doing their best to keep their communities safe and cared for with pharmacies running often every single day of the week.
➡️ What happens when people lose their local pharmacy?
People are losing access to preventative care and community-based health education, which can worsen long-term health outcomes, increase hospitalizations, and spike overall healthcare system costs. Reduced pharmacy access also leads to more people skipping prescription refills, taking lower medication doses than advised to stretch their supply for longer periods (which can be dangerous), or never receiving their medication in the first place. Beyond the potential impacts on physical health, repeated medical non-”adherence” (placed in quotes because the word “adherence” implies that there is a genuine ability to choose) can have negative effects on people’s mental health by limiting their sense of control over their conditions.
➡️ What is being done about this?
PBM reform has become a major topic nationwide. While federal reform efforts have stalled in Congress, many states (most recently California) are moving ahead with their own laws, and the stance that PBM monopolies need to be reined in has gained major traction across both sides of the political aisle. These reforms vary by state but generally focus on increasing transparency, limiting hidden fees, and helping pharmacies receive fairer reimbursement rates. However, most employer-sponsored insurance plans are regulated at the federal level, meaning state laws can only go so far.
➡️ What more can be done about this?
Pushing back against something as systemic as pharmacy deserts can feel intimidating, but as individuals, we hold a lot of power in pushing policy reforms forward while also serving as caring and attentive neighbors when resources are cut:
✅ Leaders in schools, churches, and other community hubs can incorporate preventative care into their programs in the form of physical and nutritional education. Even small, proactive gestures to promote well-being at every age can reduce the long-term demand for chronic disease medications and reduce healthcare costs overall.
✅ Libraries can encourage the use of confidential meeting spaces and free computer access for telehealth scheduling and appointments.
✅ All of these same institutions can also fundraise public transportation vouchers and organize rideshare/delivery programs that invite community members with car and bike access to pick up prescriptions for the elderly, disabled, and other neighbors in need.
✅ Anyone with access to a phone can call their elected representatives and urge them to actively fight against monopolies caused by PBMs and push for smaller, more localized pharmacies to be included in Medicare Part D networks.
Want to help? Thank your pharmacy team. Ask your neighbors what having a local pharmacy means to them. Call your local officials. Champion better pharmacy access—for every zip code, not just your own. Your voice and your stories matter.
Stay informed. Stay connected. And together, we help keep these essential healthcare hubs open and thriving. Pharmacy for all!
✨ The inspiration for this post was from this article published by the MedShadow Foundation and written by Daphne Berryhill: Why Pharmacies Are Disappearing, And What We Lose When They Do. In this post, MacKenzie Isaac brings an important but often overlooked equity and historical perspective, enriching the understanding of what pharmacy has meant for communities of color and continues to mean today.
Further reading:
When the Neighborhood Pharmacy Closes, ‘Everything Changes’
USC researchers reboot national pharmacy desert map amid wave of drugstore closures
Drugstores and the Color Line: Remembering Pharmacies as Sites of the Civil Rights Movement
How pharmacy deserts are formed
48.4 Million Americans Lack Adequate Access to a Pharmacy
1 in 7 Americans in ‘pharmacy deserts,’ report says
As pharmacies shutter, some Western states, Black and Latino communities are left behind
Pharmacist-Prescribed Contraceptives
The Legacy of James McCune Smith, MD—The First US Black Physician
Pharmacy closures will likely harm rural, inner city Americans
Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025
Medicare Part D Preferred Pharmacy Networks And The Risk For Pharmacy Closure, 2014–23
California PBM Law is a Starting Point for Real Transparency
