Study links pharmacy access to narrower racial disparities in medication use

A new Health Affairs study from the National Pharmaceutical Council, the University of Washington and the University of Southern California finds that better access to community pharmacies is associated with more equitable prescription drug use across racial and ethnic groups. The research also introduces a new disparity index to measure pharmaceutical inequity as U.S. pharmacy closures raise fresh concerns about access.

Why it matters: - Better access to community pharmacies is linked to higher prescription drug use and smaller racial and ethnic gaps in medication use. - The findings suggest pharmacy location is a structural barrier that can affect who gets needed medicines and who does not. - The research comes as pharmacy closures and low reimbursement pressure access in rural and underserved communities.

What happened: - A study published in Health Affairs examined community pharmacy access and prescription drug use across racial and ethnic groups. - The research was led by the National Pharmaceutical Council, the University of Washington and the University of Southern California. - The paper, “Access to Community Pharmacies Associated With Reduced Racial and Ethnic Disparities in Use of Prescription Drugs, 2010–19,” uses 14 years of pharmacy location data and a decade of medication use estimates. - The study is the first to directly link community pharmacy access to racial and ethnic disparities in medication use.

The details: - Researchers defined community pharmacy access as the share of people living within a 10-minute walk or drive of a community pharmacy, measured county by county from 2010 to 2023. - The team linked those access measures to medication use across 27 health conditions. - The analysis adjusted for age and disease burden so populations with greater health needs were compared more fairly. - The authors created a new disparity index to show how evenly prescription drugs are used across racial and ethnic groups. - Where community pharmacy access was higher, medication use was higher and disparities were narrower. - A 1% increase in the share of a state’s population living within 10 minutes of a community pharmacy was associated with a 0.52% decrease in racial and ethnic disparities in medication use. - The association was strongest for Black populations. - The pattern held even for conditions that account for the most prescription drug use. - Eighty-two percent of people in the U.S. live within 10 minutes of a community pharmacy. - Access gaps still affect rural residents and American Indian and Alaska Native populations. - Between 2018 and 2023, the number of community pharmacies fell. - Independent and rural pharmacies were hit hardest. - Today, 138 U.S. counties lack even one community pharmacy. - Low reimbursement rates from pharmacy benefit managers have added financial pressure on community pharmacies and contributed to closures.

Between the lines: - The study adds a measurable link between geography and inequity in medicine use, not just in pharmacy availability. - The disparity index could give policymakers and researchers a common tool to track gaps across states and conditions. - The results point toward access policy, not just patient behavior, as a lever for reducing medication disparities. - The findings also suggest that pharmacy closures may deepen existing rural and socioeconomic inequities.

What's next: - The authors say policymakers should consider fair reimbursement, targeted investment and support for the services community pharmacies provide beyond dispensing prescriptions. - The new disparity index could be used to monitor whether access changes improve equity over time. - If community pharmacy access keeps shrinking, the study suggests disparities in medication use are likely to widen.

The bottom line: - Preserving community pharmacy access appears to be a practical way to improve both prescription use and racial and ethnic equity in medicine access.