Pharmacy Closures Impact Minority Communities The Most

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Earlier in May, Pharmacy Times reported that 2024 might be the year of the pharmacy closure, as Rite Aid, CVS, and Walgreens were expected to close over 1500 pharmacy locations over the next two years. c

In addition, they reported that local pharmacies are also closing, and as those two things combine, patients will end up in a pharmacy desert.

The School of Pharmacy, in collaboration with the @pharmacists & mentioned by @AP has released an interactive map visualizing pharmacy closures to highlight the importance of healthcare access in communities.

See the map, created by Lucas Berenbrok: https://t.co/jFqkJ8X4Xm pic.twitter.com/Lr3WlnYl0d

— Pitt Pharmacy School (@pittpharmacy) June 3, 2024

“We have unfortunately had a high level of pharmacy closures across PA – that includes rural and urban areas. These are areas where individuals depend on their pharmacist not just for prescriptions, but also for day-to-day advice” @SenatorHaywood #SenDemPolicy #PharmacyClosures pic.twitter.com/0BDwHgmglu

— Senator Katie Muth (@SenatorMuth) April 15, 2024

“You’re the smoking cessation counselor, you’re the suicide prevention counselor”—waves of pharmacy closures nationwide take a toll. https://t.co/Af9Q0NlDdU

— FORTUNE (@FortuneMagazine) June 3, 2024

As Boston University’s paper, The Brink reported, a pharmacy closure is not like closing a hardware store or a department store, it can make existing inequitable health outcomes even worse. When Walgreens decided to close four of its drug stores located in predominantly Black and Brown neighborhoods in 2022, politicians like Sen. Ed Marley (D-Mass), Sen. Elizabeth Warren (D-Mass) and Rep. Ayanna Pressley (D-Mass) took notice and called for the company to replace the stores, citing the creation of food apartheid areas and pharmacy deserts. 

“These closures are occurring within the larger legacy of historic racial and economic discrimination that has created significant pharmacy and food deserts and lack of access to transportation in these neighborhoods,” the politicians pointed out to Walgreens CEO Tim Wentworth in a letter

In St. Louis City, nearly 45,000 people–53% of those Black residents–live in a pharmacy desert.

The latest closure of the North City Walgreens exacerbates this issue and decreases access to healthcare.

I sent a letter urging @Walgreens to reverse its decision. pic.twitter.com/F20FBRrpz0

— Congresswoman Cori Bush (@RepCori) March 28, 2024

According to experts, major retail pharmacy chains closing represents a disruption in the healthcare chain, as pharmacies often facilitate everything from vaccinations to over-the-counter medication to baby formula.

Cole Brahim, an associate professor of health law, policy, and management and the coordinator of the Boston University Medicaid Policy Lab, told The Brink that the reason for the closures is Capitalism. 

“I’m working for free a lot… And I don’t mind. I love to serve the community. But I kind of resent having to do that because of large corporations, huge pharmacy benefit managers, that are making millions of dollars a year.” | @APhttps://t.co/8Ry6LJNHyx

— APCI (@_APCI) June 4, 2024

“Often, it’s the whole retail store—Walgreens, CVS, Rite Aid—that shuts its doors because of financial struggles, which are in part due to increased competition. If a store or pharmacy isn’t bringing in enough revenue to cover costs, or if the store could do better elsewhere, it closes. This particularly affects retail stores in low-income neighborhoods, as customers have less money to spend and margins in these stores may be less favorable.”

Brahim continued, “Revenue shortfalls and workforce constraints end up shifting the limited number of pharmacies from lower- to higher-income neighborhoods, which in turn further exacerbates the health inequities that already exist. The impacts of pharmacy closures in low-income neighborhoods are both immediate and long-lasting. Losing a pharmacy—which very well may be the only nearby pharmacy—means lack of access to critical medications, which in turn may mean more patients with uncontrolled chronic conditions, longer courses of illness, and sometimes serious or life-threatening complications.”

As the Associated Press reports, residents of largely Black neighborhoods and Latinx have less access to pharmacies than people who live in majority-white neighborhoods. As Healthcare Brew reports, exacerbating the closures of independent pharmacies is a new rule from the Centers for Medicare and Medicaid Services that has resulted in less reimbursement for pharmacies than they had received from the government programs in the past.

The National Community Pharmacists Association (NCPA), a group that represents the interests of more than 19,000 pharmacies across the country, sounded the alarm on that front in February and called for the Biden Administration and Congress to take action.

“Nearly a third of independent pharmacy owners may close their stores this year under pressure from plunging prescription reimbursements by big insurance plans and their pharmacy benefit managers,” NCPA CEO and Pharmacist B. Douglas Hoey said.

“This is an emergency. And if Congress fails to act again, thousands of local pharmacies could be closed within months, and millions of patients could be stranded without a pharmacy.”

“If a third of all community pharmacies close, and if more than 90 percent stop accepting Medicare Part D, it will be a catastrophe for seniors, a hardship for most other patients, and a devastating blow to the overall health care system,” said Hoey. “This demands immediate action by Congress and the administration.”

In 2023, a study from researchers at the University of Houston documented the impact that these closures had on medically underserved areas. The lead author of the study, Dr. Omolola Adepoju, a clinical associate professor and the director of research at the Humana Integrated Health System Sciences Institute, told the University of Houston, “Pharmacies have always been the frontline health care access points for families in medically underserved areas, but that’s going away. In these areas, which are mostly minority communities with serious socioeconomic challenges, it is adding to existing health care disparities.”

Adepoju continued, “We must address this issue by considering not just the economic impact of closures but also the broader health outcomes of the affected communities. Our research provides critical insights that can inform policy decisions and improve equitable health care access.”

Adebosola Karunwi, a third-year medical student at the University of Houston and co-author of the study, echoed the concerns of Adepoju and said that access to medication is a critical healthcare need.

“That added distance can have serious consequences. A diabetic who faces a long walk or multiple bus rides to get their insulin prescription filled might not do it, instead skipping doses or blood tests. We’re already seeing hospitals using services like UberHealth to deliver medications and get people to their appointments,” Karunwi said. “But more needs to be done. In this day and age, there’s no reason anyone shouldn’t be able to get the health care they deserve.”

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