Pharmacies are an essential component to the delivery of health services to rural areas. Local, independent pharmacies situated in rural communities are continuing to close their doors, leaving individuals vulnerable with few resources for health services and medication.

Between March 2003 and March 2018, 16% of independently owned rural pharmacies shut down, a drop of more than 1,200 retail pharmacies. Between 2007 and 2009, a sharp decrease of rural pharmacies was noted and attributed to the implementation of Medicare Part D, as seniors who used to pay cash for their prescriptions were now utilizing their insurance, which meant that pharmacies were paid less than the out-of-pocket drug cost.

630 rural communities lost their only pharmacy between 2003 and 2018, while 302 communities lost all but one pharmacy in their area.

Some are placing the blame on pharmacy benefit managers, middlemen that are driving up the cost of medications. Independent pharmacies are often reimbursed less than what they paid for the medication, leaving small pharmacies struggling to cover costs.

For large chains, such as CVS or Walgreens, a reimbursement is a minor factor contributing to revenue, as these large stores have retail sales to keep their company above water. For small, independently owned pharmacies, most of the money they make comes from medication reimbursements.

If you’re a CVS or Walgreens, these issues are not deal breakers for your business, but for a rural, independently-owned pharmacy, these problems are the difference between providing local customers with convenient health services and going out of business.

The closures of rural pharmacies pose significant obstacles to individuals residing in these communities. Local pharmacists advise residents about prescriptions, respond to inquiries regarding mild illnesses that can be treated with OTC medications, monitor blood pressure and glucose levels, provide immunizations such as the flu shot, and support other health providers in the area. Individuals in these communities that lose their only pharmacy are required to travel long distances for health services (an obstacle for individuals with limited mobility) or rely on mail order program that cannot provide clinical services to their customers.

The success of independent pharmacies is crucial for rural communities to receive the convenient and necessary health services in their area. The decline in rural pharmacies has continued throughout 2018, but at a slower rate, as small pharmacies are standing tall, making their presence felt in their local community and industry.