By John Norton
The Rural Health Research & Policy Centers recently issued a brief called “Characteristics of Rural Communities with a Sole, Independently Owned Pharmacy“. It lent further credence to concerns expressed by the National Community Pharmacists Association (NCPA) that ill-advised policies such as outdated, low reimbursements for generic prescription drugs and exclusion of Medicare Part D “preferred pharmacy” plans can cause financially-strapped independent community pharmacies to close or limit their services, which can have an especially devastating impact for patients in less-populated areas.
Why does this matter? Well, according to the 2014 NCPA Digest, Sponsored by Cardinal Health, over 70 percent of community pharmacies are located in areas with populations of less 50,000 people. In many instances these small businesses are the only accessible health care provider for those communities.
If these pharmacies were forced to close or limit their services, their patients would either have to travel long-distances to the next closest pharmacy or rely on impersonal mail order pharmacies. Neither scenario is optimal for maximizing the potential benefits of the prescription drugs and reducing the massive adherence problem that plagues America.
As for the Rural Health Research & Policy Centers’ brief, there were many interesting findings including:
- Last year more than 2.7 million people lived in rural communities served by a sole, independently owned pharmacy;
- Of those residents, 27.9 percent were living below 150 percent of the federal poverty line;
- Estimates from 2012 found 36.3 percent of these residents depended on public insurance and 15 percent were uninsured;
- If the one remaining independent community pharmacy were to close, the next retail pharmacy would be more than 10 miles away for 69.7 percent of rural communities; and
- They reiterate that since the implementation of the Medicare Part D prescription program there has been a significant decline in the number of pharmacies in rural areas, an indication that the plans’ designs have terms and conditions that are extremely unfavorable to independent community pharmacies and rural beneficiaries.
Taken together those four statistical bullet points paint a stark picture. For many rural Americans it is a slippery slope if their only local pharmacy closes or scales back its services. Left without nearby pharmacy alternatives and limited financial resources, these patients through no fault of their own could see their health compromised.
We should not allow people to fall through the cracks as victims of circumstances beyond their control. That’s the main reason why health care public policy should always place a premium on maintaining access to services for patients no matter where they reside.