U.S. pharmacy closures leave 1 in 7 Americans struggling to get prescriptions

Drugstore Closures Create Healthcare Crisis

The corner pharmacy used to be as reliable as the post office. You could walk in, pick up your prescriptions, get a flu shot, and ask the pharmacist about that weird rash.

Now, for nearly 50 million Americans, the nearest drugstore is more than a 15-minute drive away. Rite Aid is gone. Walgreens is shrinking. CVS keeps closing locations.

And the consequences go far beyond inconvenience, because when people cannot get their medications, they end up in emergency rooms instead.

Rural Areas are Hit Hardest

New GoodRx data shows 48.4 million people—1 in 7 Americans—live in pharmacy deserts, meaning they’d need to drive more than 15 minutes to reach nearby pharmacies.

The problem has grown rapidly.

Between 2010 and 2021, one-third of all pharmacies nationwide closed. That decline picked up speed after 2021.

Over just the two years from 2022 through 2024, more than 7,000 pharmacies closed nationwide, and in 2024 alone, 2,800 pharmacies closed.

For people in these areas, getting a simple prescription filled now requires planning an entire day around the trip.

Rite Aid Closes All 1,288 Stores

After 63 years in business, Rite Aid closed all of its remaining stores as of early October 2025, after two bankruptcies.

The chain had been struggling for years, but Rite Aid filed for Chapter 11 protection for a second time on May 5, 2025, and began closing all of its stores.

The company sold its prescription files to CVS, Walgreens, Albertsons, Kroger, and other pharmacies. For customers, that meant finding a new pharmacy, transferring records, and often driving farther than before.

Walgreens Shuttering 1,200 Locations by 2027

Walgreens announced it will close 1,200 stores over the next three years, with 500 closures set for fiscal year 2025.

The company reported a $3 billion loss in late 2024 and said about 25% of its stores were unprofitable. In July 2025, the private equity firm Sycamore Partners acquired Walgreens Boots Alliance in a $10 billion deal.

California has been hit hardest with 35 closures, followed by Massachusetts and Colorado. San Francisco alone lost 12 stores.

CVS Has Closed Over 1,100 Stores Since 2021

CVS is closing 270 additional locations in 2025, piled on top of the roughly 900 stores they already axed between 2022 and 2024.

The nation’s largest pharmacy chain says it is focusing on health services like MinuteClinics and its insurance subsidiary Aetna.

But the closures leave communities with fewer options.

Combined, nearly 770 CVS and Walgreens stores closed their doors in 2025 alone, and that does not even count the smaller chains getting wiped out entirely.

Rural States Face the Worst Shortages

Rural areas are impacted most, with the highest percentage of counties with pharmacy deserts in Alaska at 82%, North Dakota at 81%, Montana at 79%, South Dakota at 74%, Nebraska at 70%, Kansas at 68%, and Wyoming at 61%.

In some areas, the drive is brutal. In nonmetropolitan pharmacy deserts, residents face average round-trip travel times of 85 minutes and distances of 36 miles to reach a pharmacy.

In Arizona’s Navajo County, more than 108,000 residents travel nearly two hours round trip to refill a prescription.

Cities Are Losing Pharmacies Too

Urban neighborhoods are not immune. In Boston, 15,000 residents live in pharmacy deserts.

In Chicago, Black and Latino populations are disproportionately affected compared to white residents.

In San Francisco, one resident with a chronic neurologic condition says she has seen five pharmacies close near her home in the past decade.

When her local Walgreens shut down, she lost the ability to walk or take the bus to get her medications and now depends entirely on her husband to pick them up.

Missed Medications Cause Serious Health Problems

The consequences go beyond inconvenience. Research shows living in a pharmacy desert increases the likelihood of severe health issues due to medication non-adherence.

If you live in a pharmacy desert, you are more likely to have a heart attack or to be readmitted to the hospital, and it can all be traced back to adherence.

Studies have shown that nonadherence to medications to prevent cardiovascular disease has been associated with a significant increase in the risk of premature death from any cause, hospitalization for heart attack or heart failure, and coronary revascularization procedures.

Pharmacy Benefit Managers Squeeze Profits

Much of the blame falls on pharmacy benefit managers, the middlemen who process drug claims. The top three PBMs, OptumRx, Express Scripts, and CVS Caremark, manage 79% of prescription drug claims.

PBMs often reimburse pharmacies less than the cost of acquiring and dispensing medications.

Not only are drugs being sold below acquisition cost, but business expenses like staff salaries, utilities, and property taxes are not being reimbursed.

In a 2025 survey, 96.5% of independent pharmacists said PBMs and plan reimbursement for Medicare Part D threatened their survival.

Independent Pharmacies Fight to Survive

Independent pharmacies already serve more than 15 million patients across the U.S., and two-thirds serve areas with populations under 50,000.

In rural towns, they are often the only option left. At some independent pharmacies, prescriptions cost $100 to fill, but PBMs reimburse as little as $4.

When the Shopko chain left Greenfield, Iowa, a town of just over 2,000 people, the community was left without a pharmacy until an independent operator stepped in within days.

But staying open is a constant struggle.

Telepharmacy Expands in 28 States

Telepharmacy is allowed in 28 states and enables remote communication between pharmacists and patients for services such as prescription requests and medication counseling.

The results have been promising.

A 2023 study found that states implementing less restrictive telepharmacy laws saw an 11. 1% relative decrease in the population living in pharmacy deserts.

One pharmacist opened a telepharmacy in Gwinner, North Dakota, a town of about 500, and turned a pharmacy desert into a profitable operation.

Mail-Order and Mobile Units Help Some

Mail-order pharmacies offer discounts for 90-day supplies and maintenance medications, making them a cost-effective option for some patients.

Mobile pharmacy vans staffed by pharmacists and technicians bring medications directly to underserved areas.

But these solutions have limits.

Mail order and pharmacy delivery are often associated with delays in therapy, reduced interaction time with a health care professional, and additional costs.

Patients still overwhelmingly prefer to fill medications at a brick-and-mortar location.

Congress Weighs PBM Reform Bills

A bipartisan group of House leaders introduced the Pharmacists Fight Back Act, which calls for pharmacy prescription reimbursements to be based on drug acquisition costs plus dispensing fees for federal programs including Medicare and Medicaid.

The bill would also ban patient steering that funnels people into PBM-owned pharmacies. Since January 2024, at least 3,179 pharmacies have closed their doors.

Whether reform passes could determine if the neighborhood pharmacy survives or becomes a memory.

This article was created with AI assistance and human editing.

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