Lynne Vezina of the Vermont Family Pharmacy in Burlington on Dec. 30, 2021. File photo by Glenn Russell/VTDigger
Hardwick’s sole pharmacy — a Walgreens that had twice been hit by Vermont’s recent summer floods — closed for good at the end of September. Since then, residents have had to drive 25 minutes to access a pharmacy in Morrisville or 40 minutes to the closest Walgreens in Lyndon, leaving Hardwick squarely in a “pharmacy desert.”
Pharmacy deserts are generally defined as places where there is no or limited access to a pharmacy. In rural areas, this means the closest is over 10 miles away, while in urban areas, the closest is over one mile away.
Hardwick is hardly the only pharmacy desert in the state. According to a recent analysis of pharmacy locations across the country, 41 of Vermont’s 193 census tracts (21%) had low access to a pharmacy in 2022. The analysis, published by the academic journal Health Affairs Scholar, defined low access as at least one-third of the tract’s population living within a pharmacy desert. Between closures of independent pharmacies and national chains continuing to scale back back “less profitable” operations, the number of pharmacy deserts is only increasing.
Mike Fisher, Vermont’s chief health care advocate, said that pharmacy closures across the state are an ongoing and “very serious” trend.
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“I live in Addison County,” he said. “When the local Marble Works Pharmacy closed, I remember just how upsetting and difficult that was for so many people.”
According to the state’s Board of Pharmacy, 28 Vermont pharmacies have closed permanently over the past five years, leaving 126 currently operating in the state. A nationwide study has linked such closures to a decline in older Americans taking their prescription cardiovascular medications.
Often, Fisher said, there’s another pharmacy in town, as in Middlebury. But in a growing number of towns, there isn’t.
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” data-medium-file=”https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-300×225.jpeg” data-large-file=”https://i1.wp.com/vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-1200×900.jpeg?crop=1&ssl=1″ fifu-data-src=”https://i1.wp.com/vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-1200×900.jpeg?crop=1&ssl=1″ alt=”” class=”wp-image-537566″ srcset=”https://i1.wp.com/vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-1200×900.jpeg?crop=1&ssl=1 1200w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-300×225.jpeg 300w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-125×94.jpeg 125w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-768×576.jpeg 768w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-1536×1152.jpeg 1536w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-2048×1536.jpeg 2048w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-800×600.jpeg?crop=1 800w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-600×450.jpeg?crop=1 600w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-400×300.jpeg?crop=1 400w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-200×150.jpeg?crop=1 200w, https://vtdigger.org/wp-content/uploads/2023/01/VTD-Hotel-Pharmacy-2-1568×1176.jpeg 1568w” sizes=”(max-width: 1200px) 100vw, 1200px”>Brattleboro’s Hotel Pharmacy has operated out of the town’s former Methodist church since 1993. Photo by Kevin O’Connor/VTDigger
According to a study published this month in the journal Health Affairs, more pharmacies closed than opened between 2018 and 2021 both nationally and in Vermont, with independent pharmacies and those located in Black and Latinx communities a higher risk for closure.
Options for those living in a pharmacy desert do exist. In Hardwick, area residents can utilize mail-order pharmacies for their prescriptions and Kinney Drugs offers weekly deliveries. However, Fisher notes, pharmacies don’t solely dispense medications, but also vaccines and advice.
“The pharmacist at the local pharmacy counter is an accessible, front-line healthcare professional that many people depend on,” he said. “You lose something really important when you lose your community pharmacist.”
Marty Irons, a full-time Vermont pharmacist for almost two decades and a member of the Vermont Pharmacists Association’s board, said in an email that the organization is very aware of pharmacy closures and expects them to continue to impact Vermont.
Pharmacists largely attribute closures to pharmacy benefit managers: companies that act as intermediaries between drug manufacturers and insurance companies. In Vermont, two pharmacy benefit managers — CVS Caremark and Express Scripts — account for 95% of Vermont’s drug market for commercial health insurance plans, according to the state Attorney General’s Office.
Pharmacy benefit managers, often abbreviated as PBMs, are known to under-reimburse pharmacies for the costs of filling prescriptions. According to Irons, this loss of income often requires pharmacies to pull back on services — such as the number of hours they’re open — and, in some cases, close.
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“Negative, or below cost, reimbursement is no longer the exception,” Mike Duteau, president of the Vermont Association of Chain Drug Stores, said in an email. “The growing impact is so substantial that pharmacies are closing in larger numbers and more quickly.”
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In addition, Irons and Duteau point to staffing challenges only exacerbated by the closure of Vermont’s only pharmacy school three years ago.
The Legislature passed a bill this year to regulate PBMs, the system for which is currently being set up at the Department of Financial Regulation, Fisher said. The bill requires PBMs to obtain a license from the department, strengthens its oversight and bans some of the companies’ practices.
In addition, Vermont Attorney General Charity Clark announced a lawsuit against PBMs earlier this year, alleging that the state’s two major PBMs skim money from drug transactions. However, it is unclear how — and how soon — these two state efforts might improve the situation for pharmacies and their customers.
“Our Vermont pharmacy infrastructure is so fragile,” said Irons. “Most people assume it will always be there; I hope so!”
A plan by Gov. Phil Scott’s administration to make all of the state’s lottery games, including scratch-off tickets, available on a person’s phone never got off the ground at the Statehouse this year.
Lottery Commissioner Wendy Knight told lawmakers in January that the plan was a way to modernize the lottery “because you need to keep pace with technology — you need to meet your players where they are.”
Fifteen states have created a “digital” lottery system, and many have discovered there’s a distinct market of people who don’t buy lottery tickets at retail outlets but will do so on their phones, according to Knight. “We’re trying to ensure the future of the Vermont Lottery, ” the commissioner said.
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But state lawmakers have not been persuaded.
Vergennes Rep. Matt Birong, the Democratic chair of the House government operations committee, said members of the panel felt this year was not the time to move forward with this plan, especially given the recent legalization of sports betting.
“It is digitizing a current system and after moving forward with the sports wagering — people just wanted to take their time with it — so my committee decided to tap the brakes on further testimony.”
The administration estimated that the plan would have raised roughly $5 million a year for the state’s education fund after two years of implementation.
The prospect of that additional revenue is appealing to lawmakers, and Birong said they may reconsider the plan next year.
Records: UAlbany (10-5, 5-1 America East) | Vermont (8-6, 4-1 America East)
Short Story: UAlbany women’s lacrosse fell to the Vermont Catamounts on Saturday afternoon.
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Key Stats
Grace Cincebox recorded a total of 14 saves with 13 goals allowed for a .565 save percentage.
Ravan Marsell led the Great Danes with two points on one goal and one assist.
Four different UAlbany players scored in the contest.
Reggie Williams was the team’s leader with three ground balls.
Delilah Mile caused a team high three turnovers.
How It Happened
The Catamounts came out of the gates hard and heavy, scoring all three goals between both sides in the first quarter.
Vermont would take an 8-0 lead in the second quarter before Amanda Williamson found the back of the net on a women-down goal to put the Great Danes on the board and make it 8-1.
The Great Danes would allow one more goal in the first half to trail 9-1 after 30-minutes of play.
Grace Cincebox would enter the half with 10 saves.
Riley Forthofer started the Great Danes off in the second half to make it a 9-2 game, before Vermont put up three more goals to take a 12-2 lead entering the final quarter of play.
Mya Carroll and Ravan Marsell both scored on back-to-back free-position goals to make it a 12-4 game.
The Catamounts finished the game with two more goals to take the win 14-4.
Up Next
The Great Danes will next have a bye week and wait to see the outcome of next week’s Vermont vs UMass Lowell game to see who will host the America East Tournament.
Social Central: Stay up to date with UAlbany women’s lacrosse by following the team on Instagram (@UAlbanyWLax), Facebook (UAlbany Women’s Lacrosse), and X (@UAlbanyWLax) for all of the latest news and highlights throughout the year.
