Research Reveals Toll of Pharmacy Closures, Prescription Transfers

Sai Veeramachaneni, a Ph.D. student in the Department of Pharmacy Administration, is the lead author of a new study published by JAMA Health Forum. The paper examines how bulk prescription transfers reshape patients’ access to care, and grew out of a broader project on pharmacists’ perspectives on patient care during pharmacy closures.

The research was prompted by the rapid contraction of the retail pharmacy industry. Nationwide, about 8,000 pharmacies have closed over the past five years, even as the number of prescriptions filled each year has continued to climb. That means fewer pharmacies are now serving more patients.

“Nobody had really tried to understand why patients were failing to refill prescriptions after their pharmacy closed,” Veeramachaneni said. “I decided to look for answers.”

To find out, Veeramachaneni interviewed pharmacists across several states, and multiple reasons for failure to refill prescriptions emerged. Many times, when a pharmacy closes, it sells its prescriptions in bulk to help recoup losses, without regard for how far patients will have to travel.

An opportunity to study this in real time when Rite Aid filed for bankruptcy and closed properties in 2025, publishing a list of its shuttered locations and the pharmacies that acquired its prescriptions. Using that list, Veeramachaneni and his co-authors mapped the transfers against pharmacy density and geographic access by ZIP code, and found that many new pharmacies were significantly farther away from the ones they replaced. In some cases, there were no nearby bus stops or other forms of public transportation.

"This was one of the shortest timeframes in my experience, from the beginning of the research to the publication of the findings,” said Sujith Ramachandran, associate professor of pharmacy administration, research associate professor in the Research Institute of Pharmaceutical Sciences, and assistant director of the Center for Pharmaceutical Marketing and Management. "We knew we had to move quickly because of the shifting market dynamics. If we waited too long, the information would no longer be relevant."

The team began the project in fall 2025, submitted its findings in February, and saw the paper published in July.

Ramachandran, who also worked with co-author Marie Barnard on the project, pointed to a landscape reshaped by market pressure, federal policy and a growing wave of pharmacy bankruptcies, from major chains bought out by private equity to independent pharmacies closing at increasing rates.

“There is growing public awareness, but research is often behind,” said Barnard, associate professor of pharmacy administration, research associate professor in the Research Institute of Pharmaceutical Sciences, and associate professor of public health. “We believe this could be helpful for pharmacies that are considering closing or consolidating locations, because they could consider the impact of bulk prescription transfers, and this could ultimately benefit patients.”

Currently, no regulations require that bulk-transferred prescriptions go to a nearby pharmacy. Chains typically transfer prescriptions to one of their own locations, while smaller pharmacies may sell to the highest bidder when they go bankrupt, regardless of proximity to patients. 

Veeramachaneni said the loss extends beyond convenience. Brick-and-mortar pharmacies provide community health services well beyond dispensing medication, and those services disappear along with the storefront. He and his collaborators plan further research into which patients are most affected, whether they ultimately refill at their new pharmacy, and how long that transition takes.

“When you're talking about patients who have limited ability to get to their pharmacy, several miles can create a hardship, and some will simply not go,” Veeramachaneni said. “More research is needed to understand what kinds of patients are affected and the costs, both financially and physically. This is about more than distributing medications, it’s about patient services being lost when brick and mortar pharmacies leave communities.”