Pharmacy and prescription drugs: Rural Health Research Products & Journal Articles

2024

Changes in Rural Pharmacy Presence 2023
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 08/2024
This data brief continues the RUPRI Center's series of reports exploring the availability of retail pharmacy services in rural areas of the U.S. It provides information on rural communities that have kept, lost, or gained a retail pharmacy between 2018 and 2023.

2022

Medicaid Expansion and Access to Naloxone in Metropolitan and Nonmetropolitan Areas
Journal Article
Rural and Underserved Health Research Center
Date: 11/2022
This study evaluated the association of Medicaid expansion at the state level on the number of naloxone prescriptions dispensed and the percentage paid by Medicaid. Increasing the percentage of Medicaid-paid naloxone prescriptions improved access in metro areas.
Medicare Beneficiary Access to Prescription Drugs in Rural Areas
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2022
Declines in the number of retail pharmacies in rural areas have raised concerns about beneficiary access to prescription medications when their local pharmacy closes. The purpose of this policy brief is to identify the types of pharmacies used by beneficiaries in rural areas with limited or no access to local pharmacies.
Rural and Urban Pharmacy Presence – Pharmacy Deserts
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 08/2022
This policy brief continues the RUPRI Center's ongoing examination of the availability of community pharmacies and their provided services in rural areas of the U.S. The brief also provides a deeper analysis of counties with no retail pharmacies (i.e. pharmacy deserts) based on metropolitan/nonmetropolitan locations.
Update on Rural Independently Owned Pharmacy Closures in the United States, 2003-2021
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 08/2022
Independently owned retail pharmacies in rural areas experienced a higher rate of closure than micropolitan and metropolitan areas. Closures have raised concerns about access to prescription medications as well as pharmacist-provided primary care services, which are often the sole source in rural areas for obtaining health services.

2021

Voices From the Field: A Qualitative Study of the Challenges and Promising Practices of Rural Public Health in Addressing HIV and Hepatitis C
Journal Article
Maine Rural Health Research Center
Date: 05/2021
Interviewing public health professionals from six rural states, researchers examined the challenges involving HIV, HCV, and serving rural people who inject drugs and determined strategies to address those challenges.
Capacity of Rural Counties to Address an HIV or Hepatitis C Outbreak
Policy Brief
Maine Rural Health Research Center
Date: 02/2021
This study examines rural-urban differences in state and local health department capacity to prevent, prepare for, and respond to an HIV or hepatitis C outbreak.
Opioid-Related Visits to Rural Emergency Departments
Policy Brief
Maine Rural Health Research Center
Date: 02/2021
The purpose of this project was to compare rural and urban opioid-related emergency department visits. Data from the Nationwide Emergency Department Sample were used to examine rural and urban opioid-related visits over time and to compare the outcomes of these visits.

2020

Telepharmacy Rules and Statutes: A 3-Year Update for All 50 States
Policy Brief
RUPRI Center for Rural Health Policy Analysis, Rapid Response to Requests for Rural Data Analysis
Date: 07/2020
This policy brief analyzed administrative rules and legislative statutes governing each state's pharmacy practice. Key features of telepharmacy regulations were investigated for comparative analysis. Twenty-one states currently authorize retail telepharmacy, but between these states the regulatory activity varies considerably.
Early-Career and Graduating Physicians More Likely to Prescribe Buprenorphine
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Only a small percentage of people who need treatment for opioid use disorder receive it, including buprenorphine. This paper shows differences in rates of prescribing buprenorphine and intentions to prescribe buprenorphine between early- and mid-to-late career family physicians, based on a survey of physicians taking a certification examination.
Practice Predictors of Buprenorphine Prescribing by Family Physicians
Journal Article
Rural and Underserved Health Research Center
Date: 01/2020
Physicians may prescribe buprenorphine if they obtain a waiver, but relatively few family physicians do so. This paper examines the association between practice characteristics and the likelihood that a family physician will prescribe buprenorphine, based on a survey of physicians seeking board certification in family medicine.

2018

Update: Independently Owned Pharmacy Closures in Rural America, 2003-2018
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 07/2018
Rural pharmacies play an important role in health service delivery to rural populations. This RUPRI Center brief updates previous findings on the continued decline in the number of independently owned rural pharmacies since the implementation of Medicare Part D. This brief provides follow-up data on rural pharmacy closures through March 2018.
Telepharmacy Rules and Statutes: A 50-State Survey (Journal Article)
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 05/2018
Peer-reviewed paper identifying state-enacted regulations and legislation authorizing use of community telepharmacy initiatives and describing implications for patients in underserved rural communities. Also provides a table listing states that permit telepharmacy, and pilot programs and waivers that enable telepharmacy initiatives.

2017

Financial Issues Challenging Sustainability of Rural Pharmacies
Journal Article
RUPRI Center for Rural Health Policy Analysis
Date: 08/2017
Findings from a survey of rural lone community retail pharmacies about issues perceived as a threat to their sustainability. Reimbursement issues were cited as being most immediate and of highest magnitude.
Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 07/2017
Opioid use disorder is a serious public health problem. Management with buprenorphine is an effective medication-assisted treatment, but 60.1% of rural counties lack a physician with a Drug Enforcement Agency waiver to prescribe buprenorphine. This national study surveyed all rural physicians who have received a waiver in the United States.
Issues Confronting Rural Pharmacies After a Decade of Medicare Part D
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2017
This brief reports on a survey of very rural independent pharmacies designed to assess threats to their sustainability. Major, immediate issues included delays in updates to maximum allowable costs (MACS), charges for remuneration fees, competition from mail order pharmacies; and, status as a "non-preferred pharmacy" for Medicare Part D plans.
Telepharmacy Rules and Statutes: A 50-State Survey
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 04/2017
This is summary analysis reviews administrative rules and legislative statutes governing the practice of telepharmacy in all 50 states. Telepharmacy is specifically authorized in 23 states and 16 states have no rules or legislation authorizing telepharmacy. Other states have pilot programs or waivers that would enable telepharmacy.

2015

Characteristics of Rural Communities With a Sole, Independently Owned Pharmacy
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 05/2015
This brief describes the populations of rural communities with single independently owned pharmacies. About 2.7 million people, more than 25% of whom live below the poverty level, live in 663 rural communities with sole independently owned pharmacies. For about 70% of these rural communities, the next closest pharmacy is more than 10 miles away.
Geographic and Specialty Distribution of U.S. Physicians Trained to Treat Opioid Use Disorder
Journal Article
WWAMI Rural Health Research Center
Date: 01/2015
Examines the distribution of physicians authorized to treat opioid use disorder in the United States, and proposes increasing access to office-based treatment as a promising strategy to address rising rates of opioid use disorder in rural areas.

2014

Update: Independently Owned Pharmacy Closures in Rural America
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 06/2014
This brief examines the closure of independently owned rural pharmacies in the United States from 2003 to 2013 and its effects on rural Americans' access to medications and other pharmacy services. This report is an update to past publications from RUPRI.

2013

Demographic and Economic Characteristics Associated With Sole County Pharmacy Closures, 2006-2010
RUPRI Center for Rural Health Policy Analysis
Date: 11/2013
This policy brief describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy.
Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study
RUPRI Center for Rural Health Policy Analysis
Date: 08/2013
This policy brief identifies factors that contributed to the closing of six rural pharmacies in various states and describes how the affected communities adapted to losing locally based services.
Rural Pharmacy Closures: Implications for Rural Communities
RUPRI Center for Rural Health Policy Analysis
Date: 01/2013
This study documents the closure of local retail pharmacies in which the pharmacist was the only clinical provider available in the community at the time the pharmacy closed. This brief describes the characteristics of the communities and retail pharmacies in question.

2012

Stand-Alone Prescription Drug Plans Dominated the Rural Market in 2011
RUPRI Center for Rural Health Policy Analysis
Date: 09/2012
This report shows that as of May 2011, 59.1% of rural Medicare beneficiaries were enrolled in Medicare Part D through insurance plans that provide coverage for prescription medications. It also provides further detail, including urban and rural enrollment by type of plan and by state.

2011

Independently Owned Pharmacy Closures in Rural America, 2003-2010
RUPRI Center for Rural Health Policy Analysis
Date: 06/2011
This policy brief provides information about the closure of rural, independently owned pharmacies, including pharmacies that are the sole source of access to local pharmacy services, from 2003 through 2010.

2010

February 2010: A Dramatic Shift Away From Private Fee-for-Service Plans in Rural Medicare Advantage Enrollment
RUPRI Center for Rural Health Policy Analysis
Date: 03/2010
Private fee-for-service (PFFS) enrollment fell in rural areas in early 2010. As a result, Medicare Advantage (MA) enrollment in rural areas fell. Nationwide, enrollment in preferred provider organization and health maintenance organization plans grew, offsetting the decline in PFFS enrollment and contributing to growth in total MA enrollment.

2009

Differences in Prescribing Patterns of Psychotropic Medication for Children and Adolescents Between Rural and Urban Prescribers
WICHE Center for Rural Mental Health Research
Date: 10/2009
This study reports that prescriptions of all psychotropic drug categories increased for urban and rural populations during the 10-year study period. Urban youth were more likely to be prescribed psychotropic medications by psychiatrists. In contrast, rural youth were more likely to have psychotropics prescribed by generalists or other prescribers.
Profile of Sole Community Pharmacists' Prescription Sales and Overall Financial Position
Rapid Response to Requests for Rural Data Analysis
Date: 08/2009
We conducted a survey of community pharmacists who owned the only retail outlets in their communities. Pharmacist-owners in independent pharmacies located at least 10 miles from the next closest retail pharmacy were interviewed to determine their reliance on prescription sales and to understand their stores' current financial positions.
Loss of Community Pharmacies Since 2006: State Experiences
RUPRI Center for Rural Health Policy Analysis
Date: 04/2009
This brief presents the latest data from a continuous monitoring of the status of rural pharmacies by the RUPRI Center. The brief includes a table showing the data by state.
Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety
Policy Brief
Upper Midwest Rural Health Research Center
Date: 03/2009
This policy brief describes successful telepharmacy activities being implemented in rural hospitals and analyzes policy issues related to the implementation of telepharmacy projects in rural hospitals.

2008

Implementation of Telepharmacy in Rural Hospitals: Potential for Improving Medication Safety (Final Report)
Upper Midwest Rural Health Research Center
Date: 12/2008
Findings from this report describe successful telepharmacy activities being implemented in rural hospitals and analyze policy issues related to the implementation of telepharmacy projects in rural hospitals.
Independently Owned Pharmacy Closures in Rural America
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 07/2008
This brief focuses on rural pharmacy closure because of the potential threat such closures present to access to any local pharmacy services in a community.
Prevalence of Evidence-Based Safe Medication Practices in Small Rural Hospitals
RUPRI Center for Rural Health Policy Analysis
Date: 04/2008
This issue brief presents the findings of a national survey whose purpose was to describe the prevalence of evidence-based, safe medication practices, including the use of voluntary medication error reporting, in the nation's smallest hospitals.

2007

Reliance on Independently Owned Pharmacies in Rural America
Policy Brief
RUPRI Center for Rural Health Policy Analysis
Date: 11/2007
This policy brief provides locations of independently owned pharmacies in rural America that are the sole sources of access to local pharmaceutical services. In more than 2,000 rural communities, the only local pharmacy is independently owned, and in 1,044 of those communities, there is no other pharmacy within 10 miles.
The Experience of Rural Independent Pharmacies With Medicare Part D: Reports From the Field
Journal Article
North Carolina Rural Health Research and Policy Analysis Center, RUPRI Center for Rural Health Policy Analysis
Date: 2007
Describes first-hand reports from rural pharmacist-owners about their experiences with Medicare Part D plans in the first 7 months of 2006 in order to gain a more thorough understanding of the challenges faced by rural independent pharmacies as a result of program implementation.

2006

Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety (Brief)
Policy Brief
Upper Midwest Rural Health Research Center
Date: 01/2006
This study's results indicate that many small rural hospitals have limited hours of onsite pharmacist coverage and many either don't have a pharmacy computer or don't use it for clinical purposes. Implementation of protocols related to medication use and key medication safety practices are areas where small rural hospitals could improve.
Pharmacist Staffing, Technology Use and Implementation of Medication Safety Practices in Rural Hospitals
Journal Article
Upper Midwest Rural Health Research Center
Date: 2006
Reports the capacity of small rural hospitals to implement medication safety practices, with a focus on pharmacist staffing and the availability of technology.

2005

Pharmacist Staffing and the Use of Technology in Small Rural Hospitals: Implications for Medication Safety (Full Report)
Upper Midwest Rural Health Research Center
Date: 12/2005
This study's results show that many small rural hospitals have limited hours of onsite pharmacist coverage and a significant number don't have a pharmacy computer or don't use one for clinical purposes. Implementation of protocols related to medication use and key medication safety practices are areas where small rural hospitals could improve.
How Might the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 Affect the Financial Viability of Rural Pharmacies? An Analysis of Preimplementation Prescription Volume and Payment Sources in Rural and Urban Areas
Journal Article
North Carolina Rural Health Research and Policy Analysis Center
Date: 2005
Presents descriptive information on mail-order prescriptions, volume, and payer type of retail prescriptions in rural vs. urban areas. Together, these data provide a baseline for evaluating how implementation of the Medicare Prescription Drug, Improvement, and Modernization Act may affect the financial viability of rural independent pharmacies.
Understanding the Impacts of the Medicare Modernization Act: Concerns of Congressional Staff
Journal Article
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis, Upper Midwest Rural Health Research Center
Date: 2005
The most efficient mechanism for research to affect policy is to provide policy makers with information on issues about which they have voiced concern. The Rural Policy Research Institute's Health Panel conducted 2 focus groups with 16 congressional staff in 2004 to identify a set of researchable questions concerning rural healthcare.

2003

An Assessment of Proposals for a Medicare Outpatient Prescription Drug Benefit: The Rural Perspective
RUPRI Center for Rural Health Policy Analysis
Date: 01/2003
This policy paper assesses legislative proposals to add an outpatient prescription drug benefit to the Medicare program and their implications for the delivery of services and the welfare of beneficiaries in rural areas.

2000

Designing a Prescription Drug Benefit for Rural Medicare Beneficiaries: Principles, Criteria, and Assessment
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 08/2000
This paper offers a rural perspective on the debate about the design/implementation of a Medicare prescription drug benefit. Background information on rural Medicare beneficiaries' need for, and access to, prescription drugs is provided, along with a set of rural-oriented principles for use in evaluating how various proposals may meet rural needs.
Improving Prescription Drug Coverage for Rural Medicare Beneficiaries: Key Rural Considerations and Objectives for Legislative Proposals
Maine Rural Health Research Center, RUPRI Center for Rural Health Policy Analysis
Date: 06/2000
This policy paper combines the work from current projects of the Maine Rural Health Research Center and the Rural Health Panel of the Rural Policy Research Institute to provide a statement of specific rural considerations and objectives for any proposal that would add a prescription drug benefit to the Medicare program.
Medicare Reforms: The Rural Perspective
NORC Walsh Center for Rural Health Analysis
Date: 04/2000
This policy analysis brief discusses Medicare reforms considered by the National Bipartisan Commission on the Future of Medicare (created by the Balanced Budget Act of 1997), including prescription drug coverage, funding graduate medical education, and increasing the eligibility age.