When Pharmacies Close, Low-Income Neighborhoods Lose

The escalating closure of U.S. pharmacies tends to hit independent drugstores and low-income neighborhoods, a new analysis in JAMA Internal Medicine says.

One in eight pharmacies had closed between 2009 and 2015, which "disproportionately affected independent pharmacies and low-income neighborhoods," the analysis led by researchers from the University of Illinois at Chicago wrote in JAMA Internal Medicine.

"From 2009 to 2015, the total number of U.S. pharmacies increased by 7.8% from 62,815 to 67,721," the analysis shows. "Of the 74,883 pharmacies in operation at any point during this period, 9,564 (12.8%) had closed by 2015."

The study comes amid a period of time when large drugstore chains are increasingly adding more healthcare services led by CVS Health, Walgreens Boots Alliance and Walmart. These chains also offer retail clinics at many of their stores that are staffed by nurse practitioners and other clinicians.

But the added services of the large chains and their closer ties with health insurers could be hurting independent chains and some Americans in low income neighborhoods.

When these larger chains form narrow or "preferred networks" that offer financial incentives to stick with one of the larger chains, independent drugstores have been harmed, the research indicates. But the JAMA research also suggests more could also be done that would allow pharmacies to provide more care and access to U.S. patients, particularly in urban areas. And that argument lays some of the blame for independent drugstore closures on U.S. policymakers and lawmakers.

"These findings suggest that policies aimed at reducing pharmacy closures should consider payment reforms, including increases in pharmacy reimbursement rates for Medicaid and Medicare prescriptions," researchers wrote in their three-page analysis in a "research letter" published online Monday.

"The findings also suggest the importance of understanding the influence of preferred pharmacy networks in order to protect independent pharmacies most at risk for closure, especially in urban areas," the researchers wrote. "Such efforts are important because pharmacy closures are associated with non-adherence to prescription medications, and declines in adherence are worse in patients using independent pharmacies that subsequently closed."

Though the report didn't address closures since 2015, hundreds of drugstores have closed since that time.

Walgreens has closed several hundred drugstores after it bought a portion of Rite Aid's pharmacies and there have also been retail pharmacies that have filed for bankruptcy protection like Fred's and Shopko, which also have led to hundreds of store closures and acquisitions by larger and regional chains of the prescription files of these bankrupt chains. CVS, Walgreens, Rite Aid and other larger chains bought or won access to these pharmacies' prescription files at auctions and other sales.