In recent years, the decline of community pharmacies has become increasingly alarming, reflecting a broader trend shaping the landscape of healthcare accessibility in the United States. The impending closures of major pharmacy chains like Walgreens, which has announced plans to shut down 1,200 stores by 2027, paint a dire picture for many families, including mine, as we rely on these establishments not just for medication, but as vital health access points.
The Pharmacy Crisis: A Personal Concern
When my father needs insulin, he makes the taxing journey of driving 25 miles round trip to the nearest Walgreens, which often takes nearly an hour. This inconvenience is compounded by the fact that it is the only pharmacy offering essential services like flu shots and basic health consultations within reasonable distance. If this pharmacy were to close, it wouldn’t merely be a logistical challenge—it could lead to severe health consequences for individuals dependent on consistent medication, especially in rural America.
As Walgreens and other pharmacies close, it signals not just an issue of convenience, but rather a slow-motion public health emergency. Families in rural areas, like mine, depend heavily on local pharmacies not only for medication but for survival itself. Losing access to these essential services highlights an ethical failure in prioritizing investor profits over public health.
The Scale of the Problem
From 2010 to 2021, the U.S. witnessed the loss of over 26,000 pharmacies—nearly one-third of retail locations. Currently, around 45 million Americans inhabit “pharmacy deserts”, areas where the nearest pharmacy is over 10 miles away. The acceleration of pharmacy closures is particularly stark, with Rite Aid filing for bankruptcy in early 2023 and CVS announcing the closure of 270 stores earlier this year. Vulnerable communities—those in rural regions, low-income neighborhoods, and communities of color—are disproportionately impacted.
This situation is exacerbated by the emergence of private equity firms in healthcare, as seen with the $10 billion acquisition of Walgreens Boots Alliance by Sycamore Partners in 2025. When profit-driven entities enter the healthcare arena, the result often includes pharmacy closures as a part of business strategy, significantly disadvantaging patients in need.
The Impact of Closures
Pharmacies serve as critical anchors in our public health system, providing essential services such as administering vaccinations and medication counseling. For many individuals, especially those lacking consistent access to doctors, community pharmacies are the primary point of care. Each closure deepens health disparities, often resulting in untreated chronic conditions, delayed vaccinations, and an overall deterioration in public health.
The closure of community pharmacies significantly lengthens the distances individuals must travel to access needed medications. For example, if my father’s Walgreens shuts down, it would double his drive for insulin, adding financial and physical stress on top of already challenging circumstances.
Forces Fueling the Decline of Community Pharmacies
Several interrelated factors are contributing to the decline of community pharmacies:
Broken Reimbursement Models: Pharmacy benefit managers (PBMs) often reimburse pharmacies at rates lower than the cost of dispensing medications. This creates an unsustainable financial model, where pharmacies struggle to stay afloat amidst increasing operational costs. Surveys indicate that 96.5% of independent pharmacists believe that PBMs pose a threat to their survival.
Burnout Among Pharmacists: Over half of pharmacists report experiencing burnout, exacerbated by long hours, increased prescription volumes, and the burden of insurance paperwork. High turnover rates among pharmacy technicians only add to the strain, increasing the risk of costly medication errors and pushing many professionals out of the field.
Geographic Disparities: Each pharmacy closure distances families from essential health services, forcing them into impossible choices between medication and other necessary expenses like food or fuel.
- Limited Authority for Pharmacists: In many states, pharmacists are restricted in their ability to provide comprehensive care. For instance, they often cannot prescribe medications for minor ailments or adjust dosages for chronic illnesses. Expanding the authority of pharmacists, as seen in successful pilot programs, would significantly improve patient access to care.
Proposed Solutions
Addressing the pharmacy crisis requires proactive measures at both state and federal levels. Here are four critical steps:
Incentives for Underserved Areas: The government should implement targeted grants and tax incentives to preserve and enhance pharmacy services in financially vulnerable areas. Additionally, mobile and telepharmacy services could help bridge gaps in access where traditional pharmacies cannot sustain themselves.
Workforce Investment: Safeguarding the pharmacy workforce is crucial. Policymakers should establish enforceable staffing ratios, national training standards, and mental health resources for pharmacists. Just as hospitals require safe nurse-to-patient ratios, pharmacies must ensure appropriate pharmacist-to-prescription ratios for effective care.
Expanding the Scope of Practice for Pharmacists: By recognizing pharmacists as healthcare providers, they could bill Medicare and Medicaid for clinical services, thus enhancing the role they play in managing chronic diseases and conducting preventive health screenings. This change would optimize the use of trained professionals, ensuring patients receive the care they need.
- Addressing the Reimbursement Crisis: Reforming the reimbursement model to ensure pharmacies are adequately compensated for their services will help stabilize the financial health of community pharmacies, allowing them to remain viable in underserved areas.
Conclusion
The potential loss of community pharmacies like my father’s local Walgreens represents more than just a corporate decision; it is a public health crisis that could yield disastrous consequences for countless individuals. As the health landscape shifts, it is imperative that we act decisively to preserve not only the pharmacies but also the essential health services they provide.
Failing to address these changing dynamics means choosing a future where critical healthcare services become even more inaccessible. The solutions exist and are achievable. It is our collective responsibility to advocate for and implement these changes to protect the health and well-being of all individuals, particularly those in the most vulnerable communities. The stakes could not be higher; the time to act is now.
