Steps must be made to preserve pharmacy access for those who need it most.
There was a time when the corner drugstore was as dependable as the bank on Main Street or the church steeple. Neighbors picked up prescriptions, grabbed cough syrup, and leaned on the pharmacist for advice or reassurance. The pharmacy wasn’t just a store—it was a community anchor.
Today, that anchor is slipping away. More towns, whether out in farm country or tucked inside city neighborhoods, are finding themselves without a local pharmacy. Experts call them pharmacy deserts, but what the term really describes is families driving 30 miles for blood pressure pills, waiting days for insulin deliveries, and watching once-bustling storefronts stand empty. Pharmacy deserts are becoming one of the quietest, yet most serious, challenges in American health care.
A pharmacy desert is any community where residents lack reasonable access to a drugstore. In plain language: If it takes half a day off work, 2 bus rides, or gas money a family doesn’t have to reach a pharmacy, that neighborhood qualifies.
Ned Milenkovich, PharmD, JD, is chair of the health care law practice at Much Shelist, PC in Chicago, Illinois, and former vice chairman of the Illinois State Board of Pharmacy. He can be reached at 312-521-2482 or nmilenkovich@muchlaw.com.
Imagine a mother with 2 children and no car riding multiple buses across town to get an antibiotic. Picture a retired farmer driving an hour each way to refill heart medication. Consider an older widow unfamiliar with the internet who is told that her only option is to order prescriptions online. That is what life in a pharmacy desert looks like—neighbors left behind not by choice, but by circumstance.
Pharmacies are not merely pill dispensaries. They also provide vaccines; dispense inhalers, insulin, nicotine patches, emergency contraception, and lifesaving naloxone; offer rapid strep and flu testing and, in some states, even prescribe antivirals when appropriate; furnish blood pressure checks, glucose monitoring supplies, and point-of-care counseling for chronic diseases; help patients navigate insurance hurdles, prior authorizations, and medication substitutions; and stock durable medical equipment (eg, canes, walkers, blood pressure cuffs) that keep people safe at home.
Pharmacists are often the first to catch dangerous drug interactions or to explain complicated directions in everyday language. Without access to those services, communities face more than inconvenience—they face real risks to health and safety.
Several forces are pushing pharmacies out of neighborhoods, and together they create a perfect storm.
Pharmacy deserts do not strike evenly across the country. They land hardest where people are already at a disadvantage, such as rural America, lowincome neighborhoods, and older patients and those with disability. The fallout is significant: Patients skip refills, chronic conditions worsen, preventive services (eg, vaccines) fall through the cracks, and. all too often, untreated conditions send people to emergency departments—visits that cost far more than supporting a neighborhood pharmacy.5
Pharmacy deserts are not inevitable. With the right choices, access can be preserved via the following:
Pharmacy deserts are not just a local inconvenience; they are a national economic and health issue. Nonadherence to prescriptions already costs the US health care system nearly $300 billion each year in avoidable hospitalizations and complications.6
Guaranteeing access to pharmacies is one of the most cost-effective ways to cut that waste while improving health outcomes.
Pharmacies also carry social and economic weight. They provide jobs, support Main streets, and serve as trusted neighborhood institutions. Their disappearance leaves not only medical gaps but also boarded-up storefronts and weakened communities.
The bankruptcy of Rite Aid, the retrenchment of Walgreens under private equity, and the downsizing of CVS are not just business stories. They are warning signals that pharmacy deserts will keep spreading unless deliberate action is taken.
Pharmacies are more than places to pick up pills. They are safety nets, counselors, and community fixtures. Without them, families are left to make impossible choices about their health. The challenge is clear: Either take steps to preserve pharmacy access now or watch more neighborhoods and towns drift into deserts they never asked to inhabit.
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