New data shows local pharmacy shortages

A new mapping tool from the National Community Pharmacists Association and University of Southern California shows a number of pharmacy shortage areas in the Tri-Cities. At least three suburban and five rural neighborhoods are considered lacking across Carter, Hawkins, Johnson, Sullivan, Unicoi and Washington counties. Southwest Virginia also has three shortage areas between Bristol and Abingdon. These regions are defined by how far people need to travel to reach the nearest pharmacy: more than 10 miles in rural areas, two miles in suburbs and one mile in urban neighborhoods. Community pharmacies are critical access points in their communities, said Dr. Ronna Hauser, senior vice president of policy and pharmacy affairs for the NCPA. "Patients see their pharmacists a lot more frequently than they do their primary care providers," she said. "Our [pharmacists] are there morning, noon and night to offer services." In addition to existing shortage areas, the data notes 25 pharmacies across the region that could cause or worsen a shortage if they closed. "These trusted health care destinations are at risk of closing," Hauser said. "What that does when they close, it leaves a gap in care." More than a third of those pharmacies are in rural areas. Rural facilities get a lot of attention, Hauser said, because many operate independently from chains like CVS, Walmart, Walgreens or Food City. In Northeast Tennessee, rural Johnson County is arguably the most affected by pharmacy shortages. Up to half of its population is in a shortage area, with the entirety of Mountain City in a rural shortage. All of the town's pharmacies are considered critical. Local data also mirrors an increasing trend of independent pharmacy closures. About 40 pharmacies in the region have closed over the past two decades. Nearly half of those (19) were independent. Of the more than two dozen identified critical pharmacies remaining, eight are independent. Hauser said the practices of large health care companies and pharmacy benefit managers — which act as middlemen between drug manufacturers, insurers and pharmacies — make it difficult for independent facilities to survive. "If you want to keep caring for your patients and your community that are covered by those big PBMs, you're really forced to take these egregious contract terms," she said. Federal and state legislatures have increasingly focused on PBM reform over the past decade. Tennessee has increased its enforcement power against the companies and is looking to crack down harder. An upcoming bill from Sen. Bobby Harshbarger, R-Kingsport, aims to eliminate PBM-owned and operated retail pharmacies — although a similar law in Arkansas has been blocked by a federal judge. Congress has attempted to implement PBM regulation for years, but hasn't yet passed any substantial legislation. Hauser said the NCPA wants to use its tool results to bring more attention to the issue. "We have had some longstanding, really significant legislation in Congress that is just so close to the finish line," Hauser said. "Congress must do their job and pass federal PBM reform to provide these pharmacies some relief and to keep patients' access points intact."