Research: Independent pharmacy closures slowing

NEW YORK — After several challenging years, exacerbated by the implementation of the Medicare prescription drug benefit, the rate of independent pharmacy closures has calmed; however, continued closures due to local circumstances are not to be unexpected, and could further hamper access to pharmaceutical services in rural places, according to recent research.



According to the Rural Policy Research Institute’s Center for Rural Health Policy Analysis, the number of independently owned rural pharmacies declined by 12.1% (from 7,624 to 6,700) between March 2003 and December 2013. While the overall trend during this period was downward, the sharpest decline occurred between 2007 and 2009, when the number of these pharmacies declined by 7.2%.



The analysis also found that the number of retail pharmacies that were the only pharmacy in the community declined fairly steadily between March 2003 and May 2009 (from 2,063 to 1,767) but has remained relatively unchanged since then, with 1,773 such pharmacies in December 2013.



“The effects of Medicare Part D were likely felt most sharply and directly in the early years of implementation (2005 to 2008). Lingering effects may be felt as part of overall financial stress on independently owned retail pharmacies and may contribute to closure. However, past research by the RUPRI Center has shown that the precipitating reasons for closure without replacement include other factors, such as retirement and difficulties recruiting a successor,” researchers said.



Researchers noted that the slowing of closures and loss of the only pharmacy in the community are “somewhat encouraging for maintaining the current level of access to pharmaceutical services in rural places,” the trend warrants continued surveillance, as further closures due to local circumstances will not come as a surprise.



“Loss of pharmacists in rural areas, particularly in areas where there was only one pharmacist in the community, can have serious implications for healthcare provision. Independent pharmacists (i.e., those that are not affiliated with a chain or franchise) are of particular concern, as they are more likely to operate in underserved and rural areas and face additional business challenges from their limited ability to negotiate with pharmacy benefit managers, drug wholesalers and health plans,” researchers said.