How Hospital Specialty Pharmacies Are Closing the Pharmacy Desert Gap

Pharmacy deserts, or areas where people must travel beyond a reasonable distance to access a pharmacy, continue to persist across the US, negatively impacting access to medications and care and leaving 1 in 7 Americans without easy access to a pharmacy. According to research by GoodRX, 48.4 million people now live in an area where filling a prescription requires a lengthy drive.¹ In the U.S., 46% of U.S. counties have at least one pharmacy desert, and these were found to be significantly more common in disadvantaged communities.²

Pharmacies serve as a critical point of access to health care, and when chain and independent pharmacies close, the resulting pharmacy deserts can limit care access and deepen existing health disparities. A gap in access often creates a gap in care that can have a compounding impact on community health and patient care and create incremental burdens on the local care teams and health systems.

In Chicago, for example, there is a 20-year life expectancy gap between affluent neighborhoods and those on the West side of the city due to health disparities and access to care.³ Residents living in Chicago’s Loop have a life expectancy of 87 years, while West Garfield Park residents have a 67-year life expectancy. Chicago represents the widest disparity in any major US city; however, this city clearly illustrates how a person’s zip code can significantly impact a person’s health outcomes and life expectancy. In fact, a person’s zip code can determine health outcomes and life expectancy by up to 60%.⁴ The location of where a person lives determines their pathway to healthy food, safe housing, quality education, reliable transportation, and access to health care and lifesaving medication therapies.

Hospital- or health system–owned pharmacies and specialty pharmacies are a critical, longstanding lifeline to care for all communities. The American Hospital Association found that the average age of hospitals in the U.S. was 11.5 years in 2015,⁵ with many community hospitals serving communities for decades. When chain or independent pharmacies close, hospitals often remain the last stable and trusted health care presence amidst the changing landscape around them in a community. Hospitals don’t leave when margins shrink—retail pharmacies sometimes do. Yet, many hospitals hesitate to pursue an outpatient pharmacy or specialty pharmacy service line due to common misconceptions, including:

• The belief that launching a specialty pharmacy is too costly, complex, or risky given perceived regulatory limitations.
• The assumption that a hospital must meet a minimum pharmacy spend threshold.
• The idea that specialty pharmacy programs only succeed with large patient populations in areas such as oncology.

In many cases, however, establishing an in-house specialty pharmacy can strengthen clinical care, create new revenue stream opportunities, and expand support for underserved communities within hospitals. Here are 5 ways hospital or system-owned specialty pharmacies can bridge the pharmacy desert gap and improve the standard of care for patients while also remaining financially stable.

1. Convenient, reliable, and affordable medication access: From meds-to-beds pharmacy programs to retail pharmacies, pharmacy consultations, specialty pharmacy services to mail-order or courier services, these hospital-owned outpatient pharmacies are best equipped to care for patients, anchoring access to pharmacy services in a familiar care setting, under the supervision of the patient’s care team and in a location that is close to home. A hospital pharmacy team also excels in helping to find internal funding for patients who cannot afford their medications.
2. Coordinated and comprehensive care improves patient experience and adherence and reduces care fragmentation: Health systems that operate an owned specialty pharmacy can manage a patient’s long-term care in a more coordinated and comprehensive way. When patients receive both their clinical care and specialty medications through the same health system, care teams can oversee treatment across the full continuum—from prescribing and dispensing medications to monitoring adherence and outcomes. This integrated approach reduces care fragmentation, streamlines the patients’ experience, and enables providers to intervene more quickly when issues arise. This model allows clinicians to collaborate more effectively and avoid duplicative services.
3. Experts overseeing complex medication management: Medications, particularly specialty medications, have become very complex. Patients need experts who can help them through this journey. By helping patients understand and navigate their medications and treatment regimens, a pharmacy team can often mitigate emergency department visits and inpatient stays and reduce unnecessary adverse events and readmissions. Further, they seamlessly provide follow-up care to ensure patients are monitored for symptoms and take their medications on time. When patients stay adherent to treatments, clinical outcomes improve.
4. Reduced burden on clinical staff so they can focus more time on patients: Integrating pharmacists, pharmacy liaisons, and technicians into clinical teams expands clinical expertise while allowing other health care professionals to focus on responsibilities that align with the highest level of their licensure and patient care. Pharmacy liaisons play a critical role in helping patients access medications by navigating insurance approvals, financial assistance programs, and therapy access barriers. By taking on these responsibilities, they reduce administrative strain on medical staff, improve workflow efficiency, and help mitigate provider burnout.
5. Creating an asset that continues to give back to patients and communities well into the future: A well-designed in-house specialty pharmacy program that leverages savings from the 340B Drug Pricing Program expands access, services, and programs that are critical to the needs of patients and the communities. While the 340B program has faced scrutiny over whether savings are consistently directed toward safety-net patients as intended,^6-9 hospitals that deliberately reinvest those savings into patient care and community services demonstrate the program’s core purpose.¹⁰ It stabilizes hospital finances, reduces patient out-of-pocket costs, and strengthens community-wide resources to build long-term sustainability for the health care organization and community for years to come.

When specialty pharmacy services are integrated into a hospital or health system and paired with 340B savings, it can have an enormous impact on patient access to lifesaving medications and improved care and can be a solution to filling the gaps that pharmacy deserts have created. Realizing that full impact depends on how health systems choose to deploy those savings and is a question that sits at the center of ongoing 340B policy debates.

Allison Arant is the senior vice president of client development and marketing for Clearway Health.

References

1. Marsh T, Cisneros T. 48.4 million Americans lack adequate access to a pharmacy. GoodRx. March 20, 2025. Accessed June 10, 2026. https://www.goodrx.com/healthcare-access/research/many-americans-lack-convenient-access-to-pharmacies

2. Catalano G, Khan MMM, Chatzipanagiotou OP, Pawlik TM. Pharmacy accessibility and social vulnerability. JAMA Netw Open. 2024;7(8):e2429755. doi:10.1001/jamanetworkopen.2024.29755

3. Schorsch K. There’s a 20-year life expectancy gap in Chicago. Many of these deaths are preventable. Chicago Sun Times. November 20, 2025. Accessed June 10, 2026. https://chicago.suntimes.com/health/2025/11/20/death-gap-racial-life-expectancy-gap-west-garfield-park-heart-disease-cancer-homicide-opioid-overdose-chicago-west-side-loop

4. Koenigshausen K. Forget genes: it’s your zip code that influences your health. World Economic Forum. June 30, 2016. Accessed June 10, 2026. https://www.weforum.org/stories/2016/06/transforming-healthcare-for-the-low-income/

5. King DD, Beebe C, Suchomel J, Bardwell P, Della Donna V, Walt L. State of U.S. Health Care Facility Infrastructure. American Society for Health Care Engineering; 2017. Accessed June 10, 2026. https://www.ashe.org/facilityinfrastructure

6. Chair Cassidy releases report on 340B reform, calls for Congressional action. News Release. US Senate Committee on Health, Education, Labor & Pensions. April 24, 2025. Accessed June 9, 2026. https://www.help.senate.gov/rep/newsroom/press/chair-cassidy-releases-report-on-340b-reform-calls-for-congressional-action

7. Thomas K, Silver-Greenberg J. How a hospital chain used a poor neighborhood to turn huge profits. New York Times. September 24, 2022. Accessed June 9, 2026. https://www.nytimes.com/2022/09/24/health/bon-secours-mercy-health-profit-poor-neighborhood.html

8. Smith K, Padmanabchan P, Chen A, Glied S, Desai S. The impacts of the 340B Program on health care quality for low‐income patients. Health Serv Res. 2023;58(5):1089-1097. doi:10.1111/1475-6773.14204

9. Knox RP, Wang J, Feldman WB, Kesselheim AS, Sarpatwari A. Outcomes of the 340B Drug Pricing Program: a scoping review. JAMA Health Forum. 2023;4(11):e233716. doi:10.1001/jamahealthforum.2023.3716

10. Watts E, McGlave C, Quinones N, Bruno JP, Nikpay S. 340B participation and safety net engagement among federally qualified health centers. JAMA Health Forum. 2024;5(10):e243360. doi:10.1001/jamahealthforum.2024.3360