Pharmacy deserts result in poor health for some rural areas

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Capital News Service

MI Pharmacy Deserts Map

LANSING – Sgt. Sheila Peters, the Alger County emergency management deputy director, has lived in her Upper Peninsula county her whole life. She said a 45-minute drive to the closest pharmacy isn’t unusual. 

That’s because Peters lives in a pharmacy desert, defined as being more than a 10-mile drive from the nearest drug store.

And in the winter, Peters said, U.P. roads can be especially treacherous, which makes the drive for medicine that much more difficult. 

In Burt Township in Alger County, the nearest pharmacy is 39 miles away, one of the furthest drives to a pharmacy in Michigan, according to a map from Cardinal Health.

Among the state’s 230-plus pharmacy deserts are Ransom Township in Hillsdale County, Whitefish Township in Chippewa County, Montmorency Township in Montmorency County, Powell Township in Marquette County, Norwich Township in Missaukee County, Lovells Township in Crawford County, Nottawa Township in Clare County, Lee Township in Allegan County and Norman Township in Manistee County. 

The term “pharmacy desert” can be traced back to a 2014 publication by Dima Qato, a pharmacy professor at the University of Southern California.

Heather Christensen, the president of the Michigan Pharmacists Association, said some state residents have to drive more than an hour to get to a pharmacy. 

Drug stores provide more than just medicine though: They provide clinics, measure blood pressure and test for diseases such as the flu and COVID-19. 

Even with the government sending vaccines to pharmacies in rural areas, there are still communities that aren’t able to get them.

The existence of a pharmacy desert “pretty much goes hand-in-hand that you’re not having primary care,” Christensen said.

If people can’t get to a pharmacy, they might not start taking necessary medications, she said, although since the pandemic began, some pharmacies have started mailing medicines.

The rules for pharmacies have changed slightly so medications can be refilled without seeing a provider, and some medications can be mailed that couldn’t have been mailed before.

Christensen said it can be difficult for pharmacies, as businesses, to make a profit in a rural area. 

Peters said the COVID-19 vaccine rollout is going well in Alger County because of the health department and the hospital in Munising. 

Most county residents who want a vaccine have gotten it, she said, and the county has been able to vaccinate homebound individuals and prisoners. 

Christensen said that although there are many pharmacies in cities such as Grand Rapids and Detroit, urban areas also can have a pharmacy desert without a drug store within a one-mile walking distance.

Pharmacies can be reimbursed for a portion of the medicine they sell by a pharmacy benefit manager, a group that handles prescription drug benefits on behalf of health insurance companies.

That occurs to keep medicines affordable for patients.

However, Christensen said pharmacy benefit managers are making pharmacy deserts worse.

Because of lower reimbursements from benefit managers, many smaller pharmacies don’t break even some of the time and then can’t afford to stay open. 

Christensen gave this example: If a pharmacy pays $10 for a drug, the customer pays $8 and the pharmacy benefit manager pays 70 cents, then the pharmacy loses more than $1in the transaction.

One solution to pharmacy deserts is to build more physical stores, Christensen said.

However, because of the expense to build a pharmacy, some in the field are advocating for telepharmacies.

Telepharmacies are legal in Michigan but not widely developed.

In a telepharmacy, a pharmacist oversees multiple stores and the only person present in the physical pharmacy is a technician to fill the prescriptions.