Pharmacy Access in Rural Areas
A youthful family member depends on prescriptions to control his seizures. The family lives in Walden, Colorado, an hour's drive over tricky mountain passes to Laramie, Wyoming, where they obtain food and their son's medications. Sometimes they need refills before making those trips and rely on help from neighbors.
Swim was fortunate to avoid complications. However, using a neighborhood pharmacy for mail orders comes with added costs—$26 for a prescription last month, which is an additional expense for those who can't easily access a pharmacy. Mail-order pharmacies typically don't charge for delivery, but obstacles can arise. Last year, some of Wade's prescriptions were stuck in a Denver processing facility for three weeks, forcing the family to pay $1,600 out-of-pocket for replacements.
Walden has no hospital, just a small clinic staffed by an advanced practice nurse. The clinic stocks some essential medications to manage routine acute needs, such as antibiotics for strep throat and inhalers for asthma, and can prepare liquid suspensions for those who can't swallow pills.
Studies show that without a pharmacy nearby, patients are less likely to adhere to their prescriptions, leading to deteriorating health conditions. Without readily available medications, patients may end up needing emergency transport to a trauma center.
Walden promotes itself as the moose-viewing capital of Colorado and is a hub for hunting, fishing, and snowmobiling. However, attracting a pharmacist can be challenging due to the town's lack of amenities like cinemas and shopping malls.
Center Park Health, the Granby-based hospital system operating the Walden clinic, has explored the idea of establishing a more comprehensive pharmacy within the clinic but has been unable to find a pharmacist to staff it. In towns without an ER or late-night clinics, pharmacists often become primary healthcare providers, advising patients on whether to make the long trip to a hospital late at night or wait until morning.
Pharmacies often serve as the first point of access for healthcare. Pharmacists are trained to assess what can be self-treated with over-the-counter medications and when to seek higher-level care.
Experts from the Rural Policy Research Institute at the University of Iowa have reported that the survival of community pharmacies is increasingly at risk. In 2013, they found that new Medicare Part D medication plans resulted in low and delayed reimbursements, replacing direct out-of-pocket payments from patients. By 2018, studies indicated that pharmacies struggled with the narrowing margin between medication costs and insurance reimbursements.
Towns with populations over 10,000 typically have at least one pharmacy, often found in Walmart or grocery stores. However, smaller communities have largely relied on independent pharmacies. There’s no substitution for these local businesses, as chain pharmacies cannot replace the personalized care provided by independent ones.
The young patient has considered moving closer to family in Wyoming to be nearer to a hospital and pharmacy. "When you can't get to a pharmacy, it's terrifying because things can happen so quickly," the patient said. "People just have no understanding of what it's like over here."
No comments:
Post a Comment