Richmond, Va.-based VCU Health’s acquisition of Hope Pharmacy in Richmond was not a growth play or a margin strategy but a decision rooted in access.
When the independently owned pharmacy faced the risk of closing, system leaders saw a potential pharmacy desert forming in one of the highest-need areas they serve.
“We are very concerned about the increase in pharmacy deserts that we’re seeing across the country,” Sheryl Garland, chief of health impact for VCU Health, told Becker’s. “Health is not just access to a doctor, it’s access to all services, and that includes your medications.”
For VCU Health, the geography made the decision clear. Roughly 7% of the system’s patients reside in ZIP code 23223 — the single largest concentration of patients from any ZIP code it serves. The east end of Richmond includes high numbers of low-income residents and older adults, many of whom rely on in-person pharmacy services.
“Had we not done this, our patients would have been suffering from a pharmacy desert,” Matthew Jenkins, PharmD, chief pharmacy officer, said. “Even a couple of miles of distance would have been the difference from patients being able to access medications and being adherent to their critical therapies.”
Nationally, pharmacy deserts are common. A 2024 study estimated that 15.8 million people in the U.S. live in low-income communities with limited access to a pharmacy, and nearly 95% of those areas contain no pharmacy at all. Researchers found those communities are more likely to include residents with lower incomes, lower insurance coverage and higher proportions of racial and ethnic minorities.
Leaders said the east end of Richmond, where Hope Pharmacy is located, reflects many of those dynamics.
While many health systems are investing in centralized fill models, mail order and digital pharmacy capabilities, Dr. Jenkins said those options do not work equally well for all populations.
“Home delivery mechanisms only work if our patients have stable homes and stable social determinants of health,” he said. “This isn’t a patient population that would be best served by locker systems or mail order.”
Maintaining a physical pharmacy presence was critical not only for dispensing medications but for vaccine administration, medication counseling and chronic disease education. The pharmacy sits inside a grocery store that was intentionally placed to mitigate a food desert and next to VCU Health’s Health Hub, a community-based wellness center focused on outreach and resource connection.
“We are part of an ecosystem that was intentionally built to connect people to resources,” Ms. Garland said. “That pharmacy is a critical component of that ecosystem.”
Unlike some retail pharmacy expansions tied to vertical integration or 340B strategy, VCU Health leaders emphasized that this acquisition was mission driven.
“This was not designed as some broad financial play,” Dr. Jenkins said. “The heart of this truly was meeting our patients where they’re at.”
For other systems evaluating similar moves, he said the operational mechanics — regulatory, financial and integration work — are manageable. The more important question is whether the community need warrants intervention.
Over the next one to three years, VCU Health plans to measure success less by retail capture rates and more by access and quality indicators, including medication adherence, vaccine utilization and use of financial assistance programs.
As independent pharmacy closures continue nationwide, some health systems may increasingly face similar decisions regarding whether to allow access gaps to widen or step in to preserve community infrastructure.
For VCU Health, leaders said the answer was clear.
“As the largest safety-net health system in Virginia, it’s part of our mission,” Ms. Garland said. “We were in a position where we could step in and make sure that we could maintain this wonderful resource.”
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