Pharmacy Deserts in the United States: A Continuing Crisis

November 18, 2025

Summary

Nearly 48 million Americans now live in pharmacy deserts, areas where access to local pharmacies is limited, up from 41 million in 2021.
Pharmacy deserts disproportionately affect lower income and minority populations, who often face longer travel times, less education, higher poverty, and less health insurance coverage.
Recent years have seen significant pharmacy closures by major chains like Rite Aid, CVS, and Walgreens, with closures hitting Black and Latino neighborhoods hardest.

What is a pharmacy desert?

Pharmacy desert typically means a location where residents do not have reasonable access to a local pharmacy. One definition is that people must travel more than 10 miles to reach a pharmacy. Currently, about 48 million Americans live in a pharmacy desert. In 2021, that number was 41 million.

According to University of Southern California research, one in eight neighborhoods in the U.S. lacks convenient access to a pharmacy. Residents in pharmacy deserts in metropolitan areas have an average round-trip drive of 53 minutes, which covers 18 miles. For those in pharmacy deserts in nonmetropolitan areas, the average trip is 85 minutes and 36 miles.

These deserts are often in lower income neighborhoods, and they affect minority populations more than other populations. Residents in pharmacy deserts tend to have less education and higher poverty levels, and many often lack health insurance. In addition, pharmacy deserts generally have more non-native English speakers and higher crime rates.

Why do pharmacy deserts occur?

Pharmacy deserts are occurring in part because of increased pharmacy closures. Between 2010 and 2021, one in three pharmacies in the U.S. closed. Since 2018, there has been a greater decline in the number of pharmacies.

This year has seen a flurry of announcements regarding pharmacy closures:

In May, Rite Aid filed Chapter 11, and bankruptcy filings revealed that 316 locations would be closed. In October, the company closed all its remaining stores. Rite Aid previously filed for bankruptcy in July 2024 and closed over 70 stores that year. The company had over 2000 stores as of 2023.
In February, CVS announced plans to close 270 stores this year. It closed 900 stores between 2022 and 2024. In October, the company said it acquired some Rite Aid and Bartell Drugs assets across the country and will add 63 new stores.
Walgreens was set to close 500 stores. The company announced in 2024 that it would shut 1200 stores in the U.S. over three years.

A 2024 study showed that pharmacies in Black and Latino neighborhoods had more closures than in white neighborhoods. For Black communities, the closure rate was 37.5% and for Latino communities, it was 35.6%. In white communities, the rate was 27.7%.

Where are pharmacy deserts?

The states with the most pharmacy deserts are Alaska, North Dakota, Montana, South Dakota, and Nebraska. Other states are also experiencing a rise in pharmacy deserts, including Ohio, Oregon, and Arizona:

In Ohio, the number of retail pharmacies declined by 19% from 2015 to 2024. In 2024 alone, there were 215 pharmacy closings in the state.
In Oregon, about 2 million people live in pharmacy deserts, which is an increase from 1.6 million in 2021. Since 2008, over 200 pharmacies have shut down in Oregon.
In Navajo County, Arizona, nearly 120,000 residents have to travel more than an hour and a half roundtrip to reach a pharmacy. In Apache County, about 87,000 people have to travel more than three hours.

Other states are also feeling the pinch:

Over the past 10 years, Maine has lost about 10% of its pharmacies.
In 2024, Michigan lost 131 pharmacies.
In Illinois, 73% of counties are considered to be in pharmacy deserts.
In Texas, 3 million people live in pharmacy deserts.
More than 25% of New Hampshire residents live in a pharmacy desert.
About 8.3% of Massachusetts residents live in a pharmacy desert, and about 7.5% are at risk of living in one.

What are the effects of pharmacy deserts?

There are trickledown effects from the lack of pharmacies in a community. Many people depend on pharmacies as their first line of defense when it comes to healthcare. Pharmacy deserts tend to have up to 40% fewer primary care providers than other areas, so pharmacies play an even bigger role in healthcare. For example, a 2023 study showed that 45% of Americans visit their local pharmacy for care on a regular basis and 58% are likely to go to pharmacies initially for non-emergency medical issues. COVID-19 and flu vaccinations are also increasingly being administered at pharmacies. Between August 2023 and May 2024, pharmacies administered 38 million flu vaccines as compared to 26 million given in doctors’ offices.

When people don’t have access to a pharmacy, they may be less likely to get—and take—their medication. That leads to lower medication adherence, which can have both health and financial implications. When people are non-adherent, their health conditions could worsen, resulting in more doctor’s visits, poorer quality of life, and even increased hospitalizations. That, in turn, can raise healthcare costs. In the U.S., nonadherence costs about $528 billion per year.

Pharmacy deserts can also contribute to health disparities because it is more difficult for residents to get their essential medications and vaccinations. They could then experience delays in treatment and poorer chronic disease management, all of which can worsen outcomes and ultimately widen existing inequalities.

For older people, the effects of living in a pharmacy desert can be especially profound. They may not be able to drive further to pick up their prescriptions, and they are also at greater risk for adverse reactions, medication errors, and drug interactions.

What are potential solutions for pharmacy deserts?

There are a number of initiatives to address these deserts, including telepharmacy, mobile pharmacies, and mail-order pharmacies.

Some states and cities have moved forward on their own in 2025 to deal with the problem:

In Seattle, Mayor Bruce Harrell submitted legislation in October to stop the use of restrictive or negative covenants in commercial leases, which prevents a property from being used as a grocery store or pharmacy. These covenants aim to block competition. But the mayor says that many areas in Seattle need more groceries and pharmacies, which he says are essential services.

In Maine, Senate Bill 239, An Act to Allow Retail Pharmacies to Operate Remote Dispensing Sites in Rural Areas, was passed in May. The bill requires the Maine Board of Pharmacy to adopt rules for licensing and regulating retail pharmacy remote dispensing sites no later than June 2026. The goal is to increase access to pharmacies for people living in rural communities.

In Massachusetts, House Bill 1417 An Act Relative to Pharmacy Deserts was introduced in February. The Act asks the Office of Health Resource Planning of the Health Policy Commission to assess the supply, distribution, and capacity of pharmacies and pharmacological services.

Final thoughts

The increase in pharmacy deserts in the U.S. is a significant problem, affecting millions of Americans, particularly low-income and minority populations. Without some type of intervention, the situation could worsen in 2026, leaving many Americans without access to medicine and care.