DES MOINES, Iowa- A Drake University professor found that the total number of pharmacies in Iowa has decreased and more pharmacies are projected to close.

Dr. Michael Andreski is a professor of pharmacy at Drake who tracked open pharmacies in the state between 2008 and 2022. He found that in 2008, 38 of Iowa’s 99 counties had only 1, 2, or 3 pharmacies. In 2022, that number jumped to 52 counties.

While his research showed that rural areas and independent pharmacies have been hit the hardest, he said that this is seen across the board. In urban areas, there was an 8% decrease in the number of pharmacies, despite population increases in these areas. Chain pharmacies also aren’t immune to this as there was a 3% decrease among them.

The only solution, according to Andreski, is payment reforms. Pharmacy Benefit Managers (PBMs) are companies that are the intermediary between insurance companies and pharmacies. According to Andreski, reform is needed.

“[PBMs] got involved with rebates, deals, and they’ve basically taken the money that was going to the pharmacies for providing services and they’ve taken that and used that for their own purposes,” Andreski said, “The three largest PBMs in the country, which they control over 75% of the prescriptions filled in the United States, and their profits last year were in the Fortune 15. So, basically, pharmacies are being slowly strangled so these companies can have huge profits.”

Andreski said that until there are payment reforms, pharmacies will continue to close, and this can cause major problems for people.

“If you’re living in a very rural Iowa county and the only pharmacy in your county closes, so, if your child has an inner ear infection, and needs to get to a pharmacy to get those antibiotics, parents might be looking at a 40-mile drive to get that. While on a beautiful fall day like today, that’s not a problem, but in the middle of February when we have an ice storm or blizzard, that could be a serious problem,” said Andreski.

His research has shown that independent pharmacies in rural areas may be more likely to close first, and chain pharmacies won’t be able to provide relief.

“There isn’t excess capacity in the chains to pick up for a lot of these places. There were issues during the pandemic with getting prescriptions filled [and] having long waits. And that can become endemic if most of the rural areas, if the pharmacies close in those areas.”

Andreski said that if there isn’t payment reform, the first quarter of 2024 can see a dramatic amount of Iowa pharmacies close. He suggests that people reach out to their state senators and representatives to voice their concerns to help push legislation forward that may help.