The nation’s three largest pharmacy chains have been shrinking for years. Rite Aid filed for bankruptcy and shuttered about 800 stores, CVS has closed 900 locations while Walgreens announced plans to close 1,200 more.
The cumulative effect: in 46% of U.S. counties — 1,447 out of 3,141 — there are no drugstores within 10 miles, and counties with high social vulnerability scores and few primary care practitioners were between 30% and 40% more likely to be designated pharmacy deserts. The communities losing access fastest are disproportionately low-income, older and minority. Moreover, the loss of retail pharmacies in rural or underserved areas risks exacerbating existing healthcare disparities within communities that health systems serve.
A survey of 100 health system executives and pharmacy leaders found that nearly three-quarters say the urgency to address community gaps in pharmacy access has increased and will continue to rise over the next three years, with leaders citing chronic disease adherence, transitions of care and 340B optimization as primary drivers.
Health systems across the country have been responding with a range of strategies — acquisitions, new openings, expanded delivery and centralized fulfillment. Here is what that response has looked like:
- Richmond, Va.-based VCU Health acquired Hope Pharmacy in Richmond’s East End in February when the independently owned pharmacy faced the risk of closing. Roughly 7% of the system’s patients reside in the ZIP code the pharmacy serves — the single largest concentration from any ZIP code in its patient base. Vice President and Chief Pharmacy Officer Matthew Jenkins, PharmD, said “the heart of this truly was meeting our patients where they’re at.” VCU also expanded free home delivery to all of its pharmacies in November 2025.
- Northern Inyo Healthcare District opened a pharmacy and updated infusion center in Bishop, Calif., in January, marking what the district called a milestone in efforts to expand access and modernize services in a rural Eastern Sierra market.
- Saltville-based Southwest Virginia Community Health Systems plans to open a pharmacy in its Tazewell Community Health Center in early 2026, offering a $4 prescription club plan, a sliding-fee patient assistance program, and delivery to local residents.
- In September 2025, Middlesex Health opened its first retail and specialty pharmacy in Middletown, Conn., and Cleveland Clinic opened a pharmacy at its South Pointe Medical Office specifically to address pharmacy deserts in Cuyahoga County’s eastern suburbs.
- Iowa Methodist Medical Center in Des Moines opened a retail pharmacy in June 2026, supporting Meds to Beds and breast milk donation programs alongside community dispensing.
- Catawba Valley Health System opened a community pharmacy in Hickory, N.C., in May, expanding services beyond health system employees to the broader community.
- Rockford, Ill.-based Mercyhealth opened a community pharmacy in Wisconsin in June as part of a growing footprint of health system-owned retail locations in the state
- Ascension Wisconsin plans to open two community pharmacies in summer 2026.
- MetroHealth System opened its 12th retail pharmacy in Cleveland’s Brooklyn Health Center in March.
- Hartford Healthcare opened a retail pharmacy at Backus Hospital in Norwich, Conn., in January, and Yale New Haven (Conn.) Health opened its sixth retail pharmacy at Bridgeport Hospital in April.
- Bend, Ore.-based St. Charles Health System opened a community pharmacy in Madras, Ore., in May — a rural Oregon market with limited remaining retail pharmacy options.
- Eskenazi Health opened a $10 million pharmacy central fulfillment center in Indianapolis in early March, centralizing capacity to serve a growing ambulatory network.
However, the financial reality of entering community pharmacy is complicated. Louisville, Ky.-based Baptist Health’s CPO, Nilesh Desai, told Becker’s the system is exploring alternative models for post-discharge and ED medication access as closures continue.
“As a lot of these pharmacies are closing and are going to close depending on how the financial viability turns out, at the end of the day we still have to figure out a way to provide patients with access to medications,” Mr. Desai said.
Boston-based Beth Israel Lahey CPO Jess de Jesus, PharmD, told Becker’s the biggest impact will be on access to acute medications like antibiotics — and that the closures also present a workforce pipeline opportunity, as pharmacists historically in retail shift toward health system outpatient settings. A 144% increase in demand for pharmacy technicians and a 14% increase for pharmacy directors in 2024, according to the American Association of Colleges of Pharmacy, reflects how quickly that workforce shift is moving.
CVS plans to open more pharmacies than it closes in 2026, including nearly 20 smaller pharmacy-only locations, averaging under 5,000 square feet and designed for underserved markets. But with Walgreens restructuring into five standalone companies following multibillion-dollar operating losses and Rite Aid’s footprint largely gone, the net loss of retail pharmacy access in vulnerable communities shows no sign of reversing.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.