The Silent Erosion of Healthcare: How Pharmacy Closures Are Creating a Public Health Crisis
Nearly 45 million Americans already live in “pharmacy deserts,” areas where the nearest drugstore is more than 10 miles away. But that number is poised to explode. The recent wave of closures announced by Walgreens, CVS, and the bankruptcy of Rite Aid aren’t simply business decisions; they represent a systemic failure that threatens access to essential healthcare, particularly for the most vulnerable populations.
The Anatomy of a Growing Crisis
The story of one man’s 50-mile round trip for insulin isn’t an isolated incident. It’s a stark illustration of the escalating problem. Driven by a confluence of factors, community pharmacies – often the cornerstone of healthcare access in rural and underserved areas – are vanishing at an alarming rate. Between 2010 and 2021, the U.S. lost over 26,000 pharmacies, nearly a third of all retail locations. This isn’t just about convenience; it’s about life and death.
The PBM Problem: A Broken Reimbursement System
At the heart of the issue lies a deeply flawed reimbursement model. Pharmacy Benefit Managers (PBMs), acting as intermediaries between drug manufacturers and pharmacies, often reimburse pharmacies less than the actual cost of dispensing medication. This “spread pricing” allows PBMs to pocket the difference, squeezing pharmacies’ already thin margins. A recent survey revealed that 96.5% of independent pharmacists feel threatened by PBM practices, highlighting the unsustainable nature of the current system. This isn’t market inefficiency; it’s a deliberate distortion designed to maximize profits at the expense of patient care.
Burnout and Workforce Shortages
The pressures extend beyond finances. Pharmacists and technicians are facing unprecedented levels of burnout, fueled by crushing workloads, chronic understaffing, and the administrative burden of navigating complex insurance requirements. Turnover rates for pharmacy technicians exceed 30% in some regions, creating a dangerous cycle of inexperience and potential medication errors. Just as hospitals struggle with nurse shortages, pharmacies are facing a critical staffing crisis that directly impacts patient safety.
The Rise of Pharmacy Deserts and Health Inequities
The consequences of these closures are not evenly distributed. Rural communities, low-income neighborhoods, and communities of color are disproportionately affected, exacerbating existing health disparities. Losing a local pharmacy can mean missed medication doses, delayed treatment for chronic conditions, and increased emergency room visits. For many, it’s a choice between filling a prescription and putting food on the table. These geographic inequities aren’t accidental; they are the result of systemic failures that prioritize profit over people.
The Role of Private Equity
The acquisition of Walgreens Boots Alliance by Sycamore Partners in 2025 signals a worrying trend: the increasing influence of private equity in healthcare. Historically, private equity involvement in healthcare has often led to cost-cutting measures, including store closures, as investors seek to maximize returns. Extracting value for shareholders becomes the primary objective, often at the direct expense of patient access and quality of care.
Beyond Band-Aids: Solutions for a Sustainable Future
Addressing this crisis requires a multi-pronged approach that goes beyond simply lamenting the closures. We need systemic changes that prioritize patient access and support the vital role community pharmacies play in our healthcare system.
Incentivizing Access in Underserved Areas
Federal and state governments must step in with targeted incentives – grants, tax credits, and loan programs – to keep pharmacies open in areas where they are most needed. Innovative models like mobile pharmacies and telepharmacy kiosks, as demonstrated in Arizona, can help bridge the gap in areas where brick-and-mortar stores are no longer viable. Resources must flow to where the need is greatest, not just where profits are easiest to obtain.
Empowering Pharmacists: Expanding Scope of Practice
Pharmacists are among the most accessible healthcare professionals, yet their potential remains largely untapped. Expanding their scope of practice to include prescribing for minor ailments and adjusting chronic medications – as successfully piloted in Washington state – would significantly improve patient access and reduce the burden on primary care physicians. Recognizing pharmacists as full-fledged providers, allowing them to bill Medicare and Medicaid for clinical services, is a crucial step towards maximizing their contribution to public health.
Investing in the Pharmacy Workforce
Protecting patients begins with protecting the professionals who care for them. Enforceable staffing ratios, national training standards, and robust mental health resources are essential to address the burnout crisis plaguing the pharmacy workforce. Just as safe nurse-to-patient ratios are critical in hospitals, safe pharmacist-to-prescription ratios are vital for ensuring patient safety and quality of care.
The closures of Walgreens, Rite Aid, and CVS aren’t isolated incidents. They are symptoms of a broken system that prioritizes profits over people. The future of healthcare access hinges on our willingness to address these systemic failures and invest in a sustainable model that ensures everyone, regardless of their zip code, has access to the medications and care they need. What steps will policymakers and healthcare leaders take to prevent further erosion of this vital healthcare lifeline?
