Communities At Risk: Pharmacy Closures Threaten Community Health Care Access

Recently, a research group out of the University of Minnesota published a study examining community pharmacy access across Minnesota using geographic information system mapping and active pharmacy license information from the Minnesota Board of Pharmacy. The study found that over the past 16 years, 255 community pharmacies closed, resulting in a net loss of approximately 15%. These findings reflect a broader trend observed in the media and research studies on pharmacy access across different communities.¹

Although the scope of past research has varied across cities, states, or the national landscape, the results have been consistent. Pharmacy closures are occurring rapidly across the country, increasing the number of communities becoming pharmacy deserts and leaving many without access to essential community health resources.

Much of the current research examining pharmacy deserts centers on raising awareness of the declining number of community pharmacies and finding ways to improve the sustainability of the community pharmacy model. Community pharmacy closures reduce access to health resources, with potential impacts on patient and population health. An example of how pharmacy closures affect patient health is their impact on medication adherence due to limited access to pharmacies.

Medication nonadherence is associated with negative clinical outcomes across multiple disease states including cardiovascular, asthma and chronic obstructive pulmonary disorder, depression, diabetes, and transplant success.² Several studies have demonstrated that medication adherence—often measured by the number of days covered—is lower in areas with reduced pharmacy access, particularly for patients with chronic conditions such as hypertension, diabetes, and cardiovascular disease.^3-4 Additionally, medication nonadherence is associated with increased mortality, increased health care utilization (including hospital admissions), and higher direct and indirect financial cost burden for patients and society.⁴

However, medication adherence only tells part of the story. Truly optimizing medication use requires addressing the obstacles that limit patients’ ability to make choices that support their health.⁵ The impact of pharmacy access extends beyond direct medication use to other health services offered in the pharmacy. Community pharmacies are patient resource centers that provide enhanced clinical services—including vaccinations, contraceptive care, harm reduction services, medication management, and point-of-care screening and testing—to deliver accessible, localized care that addresses patient needs.^6-7 Studies show that communities lacking these services experience poorer health outcomes related to these resources.^6,8-9

A proposed solution to diminished access to community pharmacy resources is the advancement of technology and online delivery services, replacing the brick-and-mortar of community care.¹⁰ Although mail-order pharmacies may appear attractive for their convenience, this model creates inequities in who can access this resource and who can fully benefit from it. With the advent of mail-order medication delivery, including Amazon same-day pharmacy delivery, medication access may remain in some areas despite pharmacy closures.¹⁰

However, as of 2025, only 45% of the US was eligible for same-day medication delivery, with urban areas prioritized over rural towns, which leaves a large gap in medication access for those who live in rural pharmacy deserts, those with low digital literacy, or those with language barriers, potentially complicating the successful utilization of online mail-order pharmacy services.¹⁰ Furthermore, patients are less likely to receive full education on their prescriptions, as—by federal mandate—mail-order pharmacies are only required to include printed drug information and a phone number for patients to call with questions. There are no mandatory touchpoints with a pharmacist for mail-order pharmacies.¹¹ The lack of direct patient education creates inequities associated with health literacy and English language proficiency.¹² Although innovative and helpful in bridging medication access, the use of automated pharmacy dispensing services at point-of-care sites (eg, primary care, urgent care, emergency care) is still limited and comes with additional hurdles such as regulatory, staffing, and funding complications.¹³

Thus, in our current health care structure, the loss of access to a community pharmacy implies a loss of access not just to medications but also to trusted health care providers, vaccinations, contraceptive care, harm reduction support, point-of-care testing, and health education, all of which are detrimental to community health. Knowing the potential consequences of the loss of access to community pharmacies necessitates a plan to mitigate community pharmacy closures. Reflecting on the process of creating pharmacy access maps and viewing the methods used by other research groups affirms the utility of graphical representation in understanding population health challenges and advocating for change. The majority of the data sets used in creating these maps are publicly available, as are the resultant maps. These access maps have been used in various settings, including public hearings and local media sources, to advocate for the sustainability of community pharmacy.

Greater responsibility and accountability for monitoring pharmacy access and advocating for policy changes that support community pharmacies are needed to ensure our communities maintain access to health care services. We collectively need to determine where that responsibility lies with local policy makers, public health agencies, and boards of pharmacy.

REFERENCES

1. Moore E, Sorge L, Goldner E, et al. The decline in pharmacy access across Minnesota, 2009-2025. J Am Pharm Assoc (2003). 2026;66(5):103462. doi:10.1016/j.japh.2026.103462

2. Achterbosch M, Aksoy N, Obeng GD, Ameyaw D, Ágh T, van Boven JFM. Clinical and economic consequences of medication nonadherence: a review of systematic reviews. Front Pharmacol. 2025;16:1570359. doi:10.3389/fphar.2025.1570359

3. Qato DM, Alexander GC, Chakraborty A, Guadamuz JS, Jackson JW. Association between pharmacy closures and adherence to cardiovascular medications among older US adults. JAMA Netw Open. 2019;2(4):192606. doi:10.1001/jamanetworkopen.2019.2606

4. Duru EE, Ben-Umeh KC, Anderson KE, Mattingly TJ 2nd. Defining pharmacy access: a review of pharmacy-level research in the United States. Med Care. 2025;63(10):758-763. doi:10.1097/MLR.0000000000002196

5. Sorensen TD, Pestka DL, Brummel AR, Rehrauer DJ, Ekstrand MJ. Seeing the forest through the trees: improving adherence alone will not optimize medication use. J Manag Care Spec Pharm. 2016;22(5):598-604. doi:10.18553/jmcp.2016.22.5.598

6. DiPietro Mager N, Schroeder Hageman T, Bright DR. Pharmacy deserts: a complexity that worsens contraception access in the United States. Contraception. 2025;148:110931. doi:10.1016/j.contraception.2025.110931

7. Guadamuz JS, Alexander GC, Zenk SN, Kanter GP, Wilder JR, Qato DM. Access to pharmacies and pharmacy services in New York City, Los Angeles, Chicago, and Houston, 2015-2020. J Am Pharm Assoc (2003). 2021;61(6):e32-e41. doi:10.1016/j.japh.2021.07.009

8. Akinbosoye OE, Taitel MS, Grana J, Hill J, Wade RL. Improving medication adherence and health care outcomes in a commercial population through a community pharmacy. Popul Health Manag. 2016;19(6):454-461. doi:10.1089/pop.2015.0176

9. Wittenauer R, Shah PD, Bacci JL, Mooney SJ, Stergachis A. Pharmacy access and shingles vaccinations in the US: a propensity score matching analysis. Vaccine. 2026;75:128256. doi:10.1016/j.vaccine.2026.128256

10. Amazon Pharmacy plans to expand same-day delivery of medications to nearly half the US in 2025. Amazon News. October 9, 2024. Accessed September 9, 2026. https://www.aboutamazon.com/news/retail/amazon-pharmacy-expands-same-day-prescription-delivery-united-states

11. Patient medication information (PMI). FDA. Updated October 1, 2024. Accessed September 9, 2026. https://www.fda.gov/drugs/fdas-labeling-resources-human-prescription-drugs/patient-medication-information-pmi

12. Chu JN, Sarkar U, Rivadeneira NA, Hiatt RA, Khoong EC. Impact of language preference and health literacy on health information-seeking experiences among a low-income, multilingual cohort. Patient Educ Couns. 2022;105(5):1268-1275. doi:10.1016/j.pec.2021.08.028

13. Dowell MA. The evolving telepharmacy dispensing landscape. U.S. Pharmacist. 2025;50(10):31-36. https://www.uspharmacist.com/article/the-evolving-telepharmacy-dispensing-landscape