Rural and Urban Pharmacy Presence – Pharmacy Deserts


Community pharmacies play a crucial role in patient safety, particularly in optimizing safe medication use. Understanding the geographic distribution and availability of community pharmacies is important in developing policies that will strengthen pharmacist-patient connections and support safe continuity of care. The purpose of this brief is to examine the availability of community pharmacies and their provided services in rural areas of the U.S. The brief also provides a deeper analysis of counties with no retail pharmacies (i.e., pharmacy deserts) based on metropolitan/nonmetropolitan locations.

In 2021, there were 138 counties with no retail pharmacy, including 101 noncore, 15 micropolitan, and 22 metropolitan counties. By most measures, the proportion of the population considered vulnerable, including nonwhite, uninsured, unemployed, and income below the federal poverty level, is higher in noncore counties with no retail pharmacies than in other counties with no retail pharmacies. Further, the percent of population aged 65 and older and the percent aged 85 and older are higher in noncore and micropolitan counties with no pharmacy than in metropolitan counties.

Pharmacy deserts lead to issues of reduced access for populations in lower socioeconomic and rural locations. Telepharmacy constitutes one possible solution to pharmacy deserts, given its potential to improve access in these needy areas. Despite the possibility of using telepharmacy to improve access to health services in medically underserved regions, only around half of U.S. states have passed legislation authorizing telepharmacy. To scale up pharmacy services in the U.S., tackling matters of reimbursement, licensing, and data security will be crucial.

RUPRI Center for Rural Health Policy Analysis
Joanne Constantin, Fred Ullrich, Keith Mueller