Study Highlights Independent Pharmacies’ Role in Caring for Underserved Patients

By Kevin Schweers

Independent community pharmacies play a key health role in underserved, inner-city communities and that fact is reaffirmed by some of the results of a study in the November Health Affairs, which also urged policymakers to consider incentives to foster more pharmacies in neglected areas.

The study’s authors examined pharmacy and patient access data in Chicago between 2000 and 2012. Their findings included the following:

  • About 32 percent of Chicago’s 802 communities were “pharmacy deserts,” meaning their residents met the researchers’ criteria for both low pharmacy access and low income.
  • More than half of Chicago’s pharmacy deserts were in communities where the population was more than 50 percent non-Hispanic black, or what the authors termed “segregated black communities.”
  • Independent community pharmacies comprised a 20 percent higher share of the pharmacies serving majority-black communities, compared to the Chicago population as a whole.
  • Between 2000 and 2012, pharmacy disparities worsened. While the number of pharmacies (particularly chains) in majority-white communities increased 20 percent during that time period, there was no such expansion in minority communities.

“Our findings suggest that public policies aimed at improving access to prescription medications may need to address factors beyond insurance coverage and medication affordability,” the authors wrote. “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.”

Specifically, they suggested incentivizing more pharmacies to locate in these areas by increasing Medicare and Medicaid reimbursement. They cite a provision in the Affordable Care Act (ACA) boosting payments for primary care providers and suggested expanding this to pharmacies as well.

NCPA would go two steps further.

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.

Fortunately, more Medicare drug plans will include locally owned pharmacies in “preferred” networks starting in 2015. That’s encouraging and comes after concerns were expressed by patient advocates, Members of Congress of both political parties and NCPA. But too many independent community pharmacies remain excluded from such arrangements, even if they are willing to meet the drug plan’s contract terms and conditions.

In addition, pharmacists could be better utilized as primary care providers in medically underserved areas such as these, if Congress enacted H.R. 4190. The Patient Access to Pharmacists’ Care Coalition, which includes NCPA, has established a website here with more information on this topic.

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