In the last two years, more than 2,700 retail pharmacies have closed. That includes everything from big-name chains to local independent drugstores, and it leaves many employees without convenient access to their medications. For benefit consultants, this trend directly affects the health, equity and costs for the populations they serve.
What’s Happening: A Look at the Numbers
Since 2019, over 7,000 pharmacies have closed in the U.S., and the pace hasn’t slowed. Just in 2024 alone, more than 2,200 pharmacies shut their doors, averaging about eight closures per day. These closures are being driven by low reimbursement, major retail bankruptcies like Rite Aid and continued consolidation across the industry.
The result? A growing number of what public health experts call pharmacy deserts.
What Exactly Is a Pharmacy Desert?
A pharmacy desert is more than just a rural problem. It’s any area, urban, suburban or rural, where people lack reasonable access to a pharmacy. That usually means:
- More than one mile away in urban areas.
- Two miles in suburban areas.
- 10 miles in rural regions.
However, distance isn’t the only factor. Even if a pharmacy technically exists nearby, lack of public transportation, limited hours or closures of independent stores can make access nearly impossible, particularly for lower-income communities or those with mobility challenges.
Today, roughly one-third of neighborhoods in our largest cities meet the criteria for being a pharmacy desert.
Why It Matters for Employers and Employees
For employees living in these areas, the ripple effects are real:
- Reduced adherence to medications, particularly for chronic conditions like diabetes or hypertension.
- Limited access to vaccines and preventive care services that many pharmacies now provide.
- Increased healthcare costs driven by ER visits, unmanaged conditions and higher absenteeism.
- More missed work days.
- Health equity concerns, particularly for minority and rural populations.
Even access to high-demand medications like GLP-1s for diabetes and weight management can become limited, making it harder for employees to take control of their health.
What Consultants Can Do
Consultants can help clients respond through several strategies:
- Promote Mail-Order and Telepharmacy
Encourage employers to work with pharmacy benefit managers (PBMs) that offer reliable delivery services and virtual consultations. Companies like Mark Cuban’s Cost Plus Drug Company offer affordable direct-to-consumer options. - Support Telehealth Integration
Make sure your clients’ benefit designs include virtual pharmacist consultations to bridge access gaps. - Advocate for Biosimilars
Promoting biosimilar adoption, such as alternatives to Humira, can drive savings and help stabilize pharmacies by improving margins on commonly prescribed therapies. - Boost Wellness Programs
Incorporate pharmacy-based services like immunizations and screenings into employer wellness offerings to make up for lost access in communities with limited brick-and-mortar pharmacies. - Use Data to Identify Risk Areas
Review workforce demographics and locations to pinpoint areas most affected by pharmacy closures and then tailor benefit strategies accordingly.
Spotlight: What’s Happening in Arkansas
One state to watch is Arkansas, where Act 624 was signed into law earlier this year, which will ban PBMs like CVS Caremark, Express Scripts and OptumRx from owning or operating pharmacies as of January 1, 2026. The law also prevents them from steering patients to their own pharmacies or underpaying independent competitors.
The intent is to protect local pharmacies, but all 23 CVS pharmacies in Arkansas could close, impacting 340,000 people and creating additional pharmacy deserts, especially in rural areas.
The law is now tied up in federal court, with major PBMs challenging its legality. Other states, including Vermont and New York, are watching closely. The outcome could shape how other states approach PBM reform and pharmacy access going forward.
Final Thoughts
Pharmacy deserts are growing, and they have real consequences for employee health, equity and cost. While benefit consultants cannot control the closures, clients can guide their employees toward solutions that help their people stay healthy and protected, no matter where they live.
References:
- Skylar Jeremias. “How Pharmacy Deserts, Biosimilars, and Market Trends are Shaping Managed Care,”AJMC, 2024.
- Tom Murphy and Kasturi Pananjady. “As Pharmacies Shutter, Some Western States, Black and Latino Communities Are Left Behind,” AP, 2024.
- NCPA Staff. “ICYMI: Maps Show Increased Closures and Pharmacy Deserts,” NCPA, 2024.
- Paige Minemyer and Noah Tong. “PCMA, Navitus Health Solutions File Lawsuit Against Arkansas PBM Legislation,” Fierce Healthcare, 2025.
- Maia Anderson. “How the Arkansas PBM Ban May Affect Pharmacy Access in the State,”Healthcare Brew, 2025.
