In fact, two recent studies support the idea that some rural communities could face access challenges if the local pharmacy closes. However, less than one percent of the
So why not solve the rural access problem with a targeted solution for at-risk pharmacies that would cost much less and thereby have a greater chance of success? Rural pharmacists should be asking this question.
RISKS TO PATIENTS IN RURAL AREAS
Eric Shields, Pharm.D., maintains a blog and website for
In an exchange with me following a recent GrizRPh blog post, Eric makes two compelling points about rural pharmacies:
- Access to healthcare would be compromised if a town’s only pharmacy closes and there are no viable alternatives within a reasonable driving distance.
- Pharmacies in rural communities can’t get bigger (as I suggest in Pharmacy Profits & Part D) because they serve small, fixed rural populations that are not growing.
These are very legitimate access issues for individual pharmacies, such as the store where Eric works now. Tobey Schule, RPh (owner of Sykes Pharmacy in
THE SCOPE OF THE RURAL ACCESS PROBLEM
Alas, the plural of anecdote is not data.
To assess the prevalence of rural access problems, I found two recent studies that attempt to quantify the impact of access on individual communities or consumers. There may be more, but these two illustrate the situation.
- Reliance on Independently Owned Pharmacies in Rural America – “In over 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles.” The total population in these communities was 1.7 million people in 2000. This study, which was funded by
HHS’ Federal Office of Rural Health Policy, also generated useful state-by-state maps.
- Consumer Access to Pharmacies in the United States – “Independent pharmacy consumers in rural areas typically have access to 14 competing pharmacies located with 15 miles of their current pharmacy.” This study was funded by the Pharmaceutical Care Management Association and cited by PWC in its study.
In other words, these studies imply fewer access problems than the exaggerated claims that 11,105 pharmacies will close due to AMP.
If rural access is the real problem, then let’s find a solution to that problem.
How about we ask states to designate rural pharmacies that are the sole provider in a community as Critical Access Pharmacies (
Unlike traditional hospitals (which are paid under prospective payment systems), Medicare pays CAHs based on each hospital’s reported costs. Each
NACDS, NCPA, or FMI are pursuing an aggressive, take-no-prisoners approach to a legislative AMP “fix.”
An alternative approach would be to advocate with Congress and/or
My web traffic shows many readers of Drug Channels in the U.S. Senate and House of Representatives. Perhaps they can help pharmacy craft a winning solution for rural pharmacists.
Back to you, Eric.