WRITER: AMY LILLARD
CONTACT: DAVE PEDERSEN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-8032; fax (319) 335-8034
Release: Sept. 21, 1999
UI study looks at pharmacy availability
IOWA CITY, Iowa -- Independently owned pharmacies
are more prevalent in rural areas and areas with large populations under the
poverty line. But the recent trend of independent pharmacies closing and chain
store pharmacies expanding may result in shortages and less access to health
care for some segments of the population, according to a University of Iowa
William R. Doucette, Ph.D., assistant professor in
the UI College of Pharmacy and lead author of the study, said the availability
of pharmacies in the United States is an area often overlooked by other researchers.
"There has been a lot of research interest in access
to health care, but the majority focuses on hospital and physician availability,"
he said. "Not much has been done on access to pharmacies."
The study analyzed approximately 3,000 counties in
the United States for the number of community (non-hospital) pharmacies per
10,000 people, as well as the proportion of these pharmacies that are independently
owned. The researchers also looked at potential factors influencing the number
and kinds of pharmacies found, including location (rural or urban), income,
age and competition.
The researchers found evidence of small numbers of
pharmacies in areas that have large elderly populations, areas that are either
highly rural or largely urban, regions with high percentages of people below
the poverty line, and areas with a large HMO presence. The researchers also
pinpointed areas with large numbers of independent pharmacies, including highly
rural or highly urban areas as well as those with large numbers of people
below the poverty line and/or receiving public assistance.
The article noted the increasing number of prescription
drugs and the reliance upon prescriptions as a form of health care as the
reason that pharmacy access is important.
"As the older population increases, drug use is also
up," Doucette said. "Prescriptions are a more cost-effective method of health
care than hospitals and, proportionally, more is spent on them. Thus, pharmacy
availability becomes essential."
The dominance of independently owned pharmacies in
highly rural areas and where there are many people under the poverty level
can give pharmacists especially important roles in their communities' health
care. Often these pharmacies are managed and owned by actual pharmacists,
who are more in tune with innovations and willing to try new practices, Doucette
said. Pharmacy managers in retail chain stores must often concentrate on the
business aspects of running many stores.
An increasing number of independent pharmacies, however,
have been closing. This might suggest the expansion of retail store pharmacies,
but these outlets are reluctant to expand to areas where it might be difficult
to maintain their business.
Doucette acknowledged this as an area in need of future
"There is a lot of interest right now in the rural
situation with pharmacies and health care. Many people are concerned that
10 years from now the remaining independent pharmacies, owned by those in
retirement age, will close down. Then shortages may be severe," he said.
Doucette plans to follow up on some of the lingering
questions from his research with updated statistics. He suggested possible
study of the shortages of pharmacists as well as pharmacies.
Before joining the UI faculty and conducting other
research, Doucette co-owned an independent pharmacy in Evansville, Wis.
The study was published in the July 1999 issue of
the Journal of Clinical Therapeutics.