This policy brief describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy. Reports between May 2006 and December 2011 there were 296 rural communities that lost their only retail pharmacy, and nine communities that lost their only two pharmacies.

Twenty-five counties lost their sole community pharmacy between May 2006 and December 2010. Among these:

• The average population density is 10.4 persons per square mile, compared to 87.4 for the United States.
• The average population decreased by 1.6% between 2000 and 2010. Excluding the largest county, the average decrease was 2.4%.
• The population age 65 years and older increased 5.4% between 2000 and 2010. Excluding the largest county, the 65-and-older population increased 2.1%.
• The average change in the percentage of persons in poverty increased by 0.6 points between 2000 and 2010, from 15.5% to 16.1%, compared to a 4.0 point increase (11.3% to 15.3%) for the United States.
• The average percentage of people younger than 65 years without health insurance was 24.6% in 2010, compared to 16.2% for the United States.
• Nineteen of the 25 counties were designated "whole county" Health Professional Shortage Areas (HPSAs), meaning there was a shortage of primary medical care physicians across the entire county.
• The average number of active doctors per 1,000 persons was 0.44, compared to 2.86 for the United States. Six of the 25 counties (24%) had no active Medical Doctors (MDs) or Doctor of Osteopathy (DOs) in 2010.

Recommendations: Policy makers might weigh the benefit of improved reimbursement policies to sole county pharmacies against the cost of little to no access to primary care health services, such as patient assessments, immunizations, and medication therapy management services, among rural residents.