For residents of Manchester, Fulton and Highland Park, pharmacies are increasingly hard to reach

Once upon a time, pharmacies were neighborhood institutions, places where prescriptions could be filled and medical advice dispensed by familiar faces.

“There's no other health professional that a patient has as much access to than pharmacists,” said Shantelle Brown, founder and lead pharmacist at HOPE Pharmacy in Church Hill. 

But that situation is increasingly a relic of the past. Between 2011 and 2021, almost a third of U.S. pharmacies closed. And in Richmond, according to new research from VCU and the Virginia Board of Pharmacy published this February, closures have led to “pharmacy deserts” in neighborhoods including Manchester, Fulton and Highland Park. 

“When a pharmacy closes, it’s not just your ability to fill your prescriptions that goes away,” said Dr. Teresa Salgado, an associate professor at VCU’s School of Pharmacy who served as lead author of the February study.

Besides offering vaccinations, she noted that pharmacists provide patients with medical expertise and counseling, critical testing for illnesses like strep throat and even the ability to prescribe medications like contraceptives and naloxone. “Pharmacies are the front door to health care.” 

Experts say the disappearance of pharmacies is due to a number of factors, including market consolidation, rising operational costs and fees that have to be paid to market middlemen known as pharmacy benefit managers, or PBMs. But Salgado said the biggest driver is the low reimbursement rates that pharmacies receive from insurance companies. 

“You could be dispensing a medication or filling a script and losing money on that medication. You paid more for the medication than you’re actually getting reimbursed for,” she said. “That really compromises the financial viability of a pharmacy.” 

Whatever the reason behind it, the shrinking footprint of pharmacies in Richmond has been readily apparent for some time. Grove Avenue Pharmacy in the West End closed in 2019. CVS closed its downtown store on East Main in 2021. And most recently, a Rite Aid at the corner of Hull Street and Cowardin Avenue closed in May 2024 as part of the company’s bankruptcy restructuring. 

Nor does the trend appear likely to be over soon. Both CVS and Walgreens have announced plans to majorly reduce the number of stores they are operating in 2025. 

The VCU study, which was published Feb. 10 in the Journal of the American Pharmacists Association, sought to put hard numbers behind the apparent trends and delineate what Salgado called “the landscape of pharmacy deserts in Virginia.”

In urban environments like Richmond, pharmacy deserts were defined as census tracts that had more than 20% of residents living below the federal poverty line and were 1 or more miles from an available pharmacy. (Suburban deserts were those located 5 or more miles from a pharmacy, while urban deserts were those located 10 or more miles away.) 

Researchers identified 51 such deserts in Virginia, most of which were urban. Five were located in Richmond, and pharmacy desert status “was associated with a lower proportion of residents under 18 years old, greater proportion of Black and uninsured/publicly insured residents, and high poverty level.” 

Salgado flagged the Manchester area as a particularly notable desert, observing that residents must travel to the Forest Hill area to access a pharmacy because of recent closures. 

Those distances can have a significant impact on residents who lack a vehicle of their own. 

Katherine Furbush, a veteran who lives in Church Hill and was visiting HOPE Pharmacy in her motorized wheelchair last week, said that before that store opened, she had to go all the way across town to the VA hospital to get her prescriptions. 

“It’s just so convenient to have it right here, so I can scooter on over,” she said. 

In addition to identifying existing pharmacy deserts, the VCU study also pinpointed 44 locations where placement of a pharmacy could benefit the greatest number of residents. One such site “prevented over 15,000 residents and 4 census tracts from desert status,” the study found. 

“Our findings provide grounds for action,” said Salgado. “We’re ready to roll up our sleeves.” 

Editor Michael Phillips and Reporter Victoria Ifatusin contributed to this story.