More US Pharmacies Closed Than Opened In 2018-21; Independent Pharmacies, Those In Black, Latinx Communities Most At Risk.

In recent years, federal and state policy makers have expressed concern about retail pharmacy closures throughout the US. However, there is a dearth of timely information on the extent of such closures. We linked data from the National Council for Prescription Drug Programs on all US retail pharmacies to county-level data from the National Center for Health Statistics and ZIP Code Tabulation Area data from the American Community Survey to determine the number and percentage of pharmacy closures during the period 2010-21; identify pharmacy, neighborhood, and market characteristics associated with pharmacy closure; and estimate the risk for closure for independent pharmacies relative to chain pharmacies. We found that of the 88,930 retail pharmacies operating during 2010-20, 29.4 percent had closed by 2021. The risk for closure for pharmacies in predominantly Black and Latinx neighborhoods was higher than in White neighborhoods. Independent pharmacies were at greater risk for closure than chain pharmacies across all neighborhood and market characteristics. Policy makers should consider strategies to increase the participation of independent pharmacies in Medicare and Medicaid preferred networks managed by pharmacy benefit managers and to increase public insurance reimbursement rates for pharmacies that are at the highest risk for closure.