Viewpoint: 'Pharmacy desert' definition is ripe for revision

Time traveled is a better indicator than distance traveled in determining what constitutes a pharmacy desert, Yale and Weill Cornell researchers argue in a July 29 opinion piece in The Hill.

Research that tracks the availability of pharmacies in relation to population data usually measures distance from the patient's home to the pharmacy, but this metric obscures the more important data point of travel time, which can depend on a person's access to a car or public transportation, the researchers stated. 

The opinion's authors are Peter Kahn, MD, a fellow at the Yale School of Medicine in the section of pulmonary, critical care and sleep medicine; Xiaohan Ying, MD, a resident in the internal medicine department at NewYork-Presbyterian Hospital/Weill Cornell; and Stan Mathis, MD, medical director of the Assertive Community Treatment team and a psychiatry professor at Yale. 

"Although important, thinking about distance from point A to B only provides a part of the story," the authors wrote. 

In a paper published July 5 in the Journal of the American Pharmacists Association, the researchers found that, among the four largest U.S. cities, about 500,000 people lived in pharmacy deserts when travel time was considered. The results also found more pharmacy closures among predominantly Black and Hispanic neighborhoods, and car pharmacy deserts are more common than public transportation pharmacy deserts. 

Recent national research indicates about 9 in 10 people live within 5 miles of a pharmacy, but the leading author of that study, Lucas Berenbrok, PharmD, also highlighted the same issue: "not all 5 miles are created equal."

"The notion of an access 'desert' — used by various governmental agencies — is ripe for revision," The Hill column states. "While absolute distance to a location can be a helpful way of starting a conversation about access, we believe that these definitions are incomplete if they do not include real world measures like travel time as a criterium."

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