"Pharmacy deserts" are becoming a bigger problem in low-income neighborhoods

“Pharmacy deserts” are becoming a bigger problem in low-income neighborhoods

Neighborhoods in cities like Chicago are fast becoming places where people can’t fill their prescriptions locally because their pharmacies have closed or don’t accept Medicaid.

Because matter: The pandemic accelerated the growth of “pharmacy deserts” as unprofitable and less profitable stores closed. It’s a worrying trend for urban poor, who are less likely to try online pharmacies and more likely to expire their drug regimens when they can’t get drugs locally.

Driving news: As of December 1, Medicaid patients in Illinois – of which there are 400,000, according to the Chicago Tribune – have been unable to receive their prescriptions from Walgreens, a prevalent chain based in a Chicago suburb.

  • The change came because Aetna, which provides contracts with the state of Illinois to serve Medicaid beneficiaries, dropped Walgreens as a supplier. CVS, one of Walgreens’ main rivals, owns Aetna and CVS Caremark, the pharmacy benefits manager.
  • CVS “has no pharmacies in five key West Side neighborhoods,” according to the Tribune.
  • Illinois state representative Shawn Ford called Aetna’s decision “pathetic” and told the Tribune, “It’s an attack not just on blacks, but on those who are struggling during the pandemic.”

The background: Researcher Dima Qato coined the term “pharmacy desert” in a 2014 article that found there were far fewer pharmacies in Chicago’s black neighborhoods than in white and mixed neighborhoods.

  • Medicaid policies like that of Illinois “are all over the country, where Medicaid determines where and where you can go to get your medications,” Qato tells Axios. “And that leads some pharmacies to have fewer patients, which leads to fewer profits, which leads to closure.”
  • Qato – who recently took up a position as a professor at the University of Southern California and is moving out of Chicago – said the new Medicaid policy in Illinois is generating “a lot of outrage in the community right now.”
  • According to Qato’s definition, people live in a “pharmacy wasteland” if they can’t fill a prescription within half a mile of their homes (for low-income people without a car) and a mile for others.
  • “We estimated that for Chicago at one-third of the city’s population, with a substantial difference in racial makeup,” Qato says.

Between the lines: As pharmacies get the lowest reimbursements for filling Medicaid prescriptions, they are more likely to close shops in low-income neighborhoods and open them in affluent ones, notes Antonio Ciaccia, chief strategy officer at 3 Axis Advisors, a focused consulting firm. on the drug supply chain.

  • “We are seeing a general withdrawal from poor areas,” said Ciaccia, who serves as a consultant to the American Pharmacy Association.

Of note: Studies draw a direct line between drugstore closures and people discontinuing their vital medications, with dire health outcomes.

  • Adults over 50 were more likely to drop their cardiovascular pills after their local drug store closed, according to a study published in the Journal of the American Medical Association in 2019 (of which Qato is the lead author).
  • Benjy Renton, the Middlebury College elder who closely followed the COVID-19 outbreak, noticed on Twitter that the deserts of pharmacies could hold back the administration of vaccines.

What’s next: While “food deserts,” where inner-city residents lack access to fresh, healthy groceries, are a bigger problem in places like New York City, access to pharmacies is a growing concern. The number of pharmacies has decreased by 20% in New York since 2016, according to Jonathan Bowles, executive director of the Center for an Urban Future.

  • “First I will miss the 70 Duane Reades that ended this year,” was the title of an article published in New York Magazine’s “Curbed” on December 30th. (Duane Reade is owned by Walgreens.)

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