48 Million Americans Live 10+ Miles from the Nearest Pharmacy

One in seven Americans -- roughly 48.4 million people -- now live in a pharmacy desert, defined as an area more than 10 miles from the nearest pharmacy. Nearly half (46%) of the nation's 3,143 counties contain at least one pharmacy desert. The crisis is accelerating: over 7,000 pharmacies closed between 2022 and 2024, with 2,437 closures in 2024 alone -- averaging about eight pharmacy closures per day. This matters because pharmacies are not just places to pick up pills. They are the most accessible healthcare touchpoint in most communities. Americans visit their local pharmacy 14 times per year compared to five visits to their primary care physician. When a pharmacy closes, residents lose access to immunizations, chronic disease management counseling, blood pressure screenings, medication therapy management, and the pharmacist who catches dangerous drug interactions. For elderly patients without reliable transportation, a pharmacy that is 10 or 20 miles away might as well be 200 miles away. The downstream health effects are measurable. Patients with low medication adherence have hospital readmission rates of 20.0% compared to 9.3% for patients with high adherence. Medication nonadherence among patients with chronic diseases costs approximately $100-300 billion annually in avoidable healthcare spending. Every pharmacy that closes pushes more patients toward nonadherence. This problem persists structurally because the pharmacy business model is broken at its foundation. Reimbursement rates from pharmacy benefit managers (PBMs) have been driven below the cost of dispensing for many medications, making it impossible for pharmacies in low-volume areas to remain solvent. The three largest PBMs -- CVS Caremark, Express Scripts, and OptumRx -- process nearly 80% of all prescriptions and have no financial incentive to maintain pharmacy access in unprofitable markets. Until the reimbursement economics change, closures will continue to accelerate.