November 26, 2014
The Community Drugstore: An Oasis in Low-Income ‘Pharmacy Deserts’ 

Chicago—A recent study lamented the existence of “pharmacy deserts” in predominately black and Hispanic neighborhoods of Chicago that lack access to prescription medications but also pointed out the critical role played by independent community pharmacists in serving those communities.

The study, published recently in the journal Health Affairs, notes that efforts to determine the wide disparity in use of prescription medications has focused on affordability but, “the segregation of residential neighborhoods by race or ethnicity also may influence access to the pharmacies that, in turn, provide access to prescription medications within a community.”

To determine that, the University of Illinois–led study examined whether trends in the availability of pharmacies varied across communities in Chicago. They looked at the geographic accessibility of pharmacies to determine whether so-called “pharmacy deserts,” or low-access neighborhoods, were more common in segregated black and Hispanic communities than elsewhere.

Results indicated that, from 2000–2012, the number of pharmacies was lower in segregated minority communities than in segregated white communities and integrated communities.

“In 2012 there were disproportionately more pharmacy deserts in segregated black communities, as well as in low-income communities and federally designated Medically Underserved Areas,” according to the authors. “Our findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability. Such policies could include financial incentives to locate pharmacies in pharmacy deserts or the incorporation of pharmacies into community health centers in Medically Underserved Areas.”

The study found that about 32% of Chicago’s 802 communities met the definition of “pharmacy deserts,” being both low access and low income.
Interestingly, independent community pharmacies comprised a 20% higher share of the pharmacies serving majority-black communities, compared to the Chicago population as a whole, according to the study.

When pharmacy disparities worsened between 2000 and 2012, it was because the number of pharmacies (especially chains) in majority-white communities increased 20% without an expansion in minority communities, according to the report.

The Health Affairs study suggested incentivizing more pharmacies to locate in these areas by increasing Medicare and Medicaid reimbursement as well as expanding a provision in the Affordable Care Act (ACA) boosting payments for primary care providers to include pharmacies as well.

A blog from the National Community Pharmacists Association goes even further stating, “Congress should enact an “any willing pharmacy” policy for Medicare drug plans. That would give Medicare patients in these underserved areas greater access to discounted or ‘preferred’ copays for their prescription drugs at their independent community pharmacy.” A bill currently in the House of Representatives would allow community pharmacies located in a medically underserved area to participate in all Medicare drug plan networks, including the plan’s discounted or "preferred" network.

U.S. Pharmacist Social Connect