Too far to fill: The growing problem of pharmacy deserts in America

Equity in healthcare series – part 9

Millions of Americans now live in areas with limited or no access to pharmacies, revealing a growing health equity crisis that demands urgent attention.

Pharmacy deserts are increasing

Pharmacy deserts—areas where there are too few pharmacies to meet community needs—remain a growing concern across the U.S. A recent study found that 17.7% of the U.S. population lives in a pharmacy desert.

These deserts are most common in underserved communities. Often those with lower income and education levels, higher rates of uninsured or publicly insured individuals, and greater burdens of chronic illness such as hypertension and heart disease. Black and Hispanic communities are also disproportionately affected:

• 39.5% of Hispanic neighborhoods are pharmacy deserts.
• 38.5% of Black neighborhoods.
• Compared to 28.2% of diverse neighborhoods and 26.7% of white neighborhoods.

Why is this happening?

One major driver is the ongoing wave of pharmacy closures. Between 2010 and 2020, nearly 30% of retail pharmacies closed. And the trend continues:

• CVS: Announced plans in February 2025 to close 270 stores this year.
• Walgreens: In May 2025, Walgreens announced further closures following its 2024 plan to shut down 1,200 stores.
• Rite Aid: Filed for Chapter 11 bankruptcy in May 2025, its second filing in less than two years. Rite Aid has reduced its pharmacy count from 2,000 in 2023 to 1,240. It plans to close or sell all remaining New York locations and exit the Philadelphia market entirely.

Rural areas are especially vulnerable

Small towns and rural communities face some of the greatest risks. The five states with the highest rates of pharmacy deserts are:

• Alaska
• North Dakota
• Montana
• South Dakota
• Nebraska

Other states are seeing increases as well. For example:

• Ohio: The number of people living in pharmacy deserts rose from 1.6 million in 2021 to 2 million today.
• Oregon: The number increased from 600,000 to approximately 937,000 over the same period.

With more than 90% of prescriptions in the U.S. filled at community pharmacies, these closures can seriously compromise healthcare access, especially for those already facing disparities.

Potential solutions

1. Mail order pharmacies
Mail order eliminates transportation barriers by delivering medications directly to patients’ homes. It often offers 90-day supplies, making it a convenient option for individuals managing chronic conditions.

2. Remote dispensing pharmacies
These locations use technology to connect pharmacy technicians with off-site pharmacists, who supervise prescription filling through video and other tools. One pharmacist can oversee multiple sites, extending coverage to underserved areas.

3. Mobile pharmacies
State-regulated and staffed by pharmacists, technicians, or community health workers, mobile pharmacies meet specific requirements for storage, equipment, and safety. They bring pharmacy services directly to communities lacking permanent locations.

Final thoughts

Pharmacy deserts aren’t going away, and in some places, they’re expanding. As the pharmacy landscape continues to shift, patients and providers alike must explore new ways to access essential medications. Expanding innovative models like mail order, remote dispensing, and mobile units could help close the gap and ensure equitable access to care.

Further reading

• Pharmacy deserts: A growing problem in the U.S.
• Mental health in rural America: Barriers to care
• Exploring underrepresentation in clinical trials
• A shift in language: How healthcare is tackling stigma

References

• Locklear, Mallory. A New Metric to Identify—and Prevent—Pharmacy Deserts.
• Guadamuz, Jenny S., Alexander, G. Caleb, Kanter, Genevieve, P., and Qato, Dima Mazen. More US Pharmacies Closed Than Opened in 2018-201; Independent Pharmacies, Those In Black, Latinx Communities Most At Risk.
• Kwan, Noelle. The Impact of Pharmacy Deserts. .
• Knauth, Dietrich. Rite Aid files for second bankruptcy in two years.
• Worden, Zackary. Rite Aid to close all pharmacies in New York State amid second bankruptcy filing.
• Mosbrucker-Garza, Kristen. Rite Aid closing all its stores in Philadelphia, selling off HQ.  
• Harris, Christopher. CVS to close more than 270 stores in 2025.  
• Meyersohn, Nathaniel. Why Walgreen, CVS and Rite Aid are closing thousands of drug stores across America.  
• Mathis, Walter S., Berenbrok, Lucas A., Kahn, Peter A., Appolon, Giovanni, Tang, Shangbin, and Hernandez, Inmaculada. Vulnerability Index Approach to Identify Pharmacy Deserts and Keystone Pharmacies.  
• Marsh, Tori. 48.4 Million Americans Lack Adequate Access to a Pharmacy
• Murphy, Michael, and Rodis, Jennifer. The growing crisis of pharmacy deserts.
• As Pharmacies Shutter, Some Western States, Black and Latino Communities are Left Behind.
• Sukalo, Aziz, Catic, Tarik, Skrbo, Armin, Zunic, Lejla, and Masic, Izet. Mobile Pharmacies Throughout History. .
• Walgreens closing dozens of stores across 17 states: Here’s where
• Walgreens closing roughly 1,200 stores

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