Pharmacy accessibility is key for the emerging role of community pharmacists as providers of patient-centered, medication management services in addition to traditional dispensing roles. To quantify population access to community pharmacies across the United States. We obtained addresses for pharmacy locations in the United States from the National Council for Prescription Drug Programs and geocoded each. For a 1% sample of a U.S. synthetic population, we calculated the driving distance to the closest pharmacy using ArcGIS. We estimated the proportion of population living within 1, 2, 5, and 10 miles of a community pharmacy. We quantified the role of chain vs regional franchises or independently owned pharmacies in providing access across degrees of urbanicity. We identified 61,715 pharmacies, including 37,954 (61.5%) chains, 23,521 (38.1%) regional franchises or independently owned pharmacies, and 240 (0.4%) government pharmacies. In large metropolitan areas, 62.8% of the pharmacies were chains; however, in rural areas, 76.5% of pharmacies were franchises or independent pharmacies. Across the overall U.S. population, 48.1% lived within 1 mile of any pharmacy, 73.1% within 2 miles, 88.9% within 5 miles, and 96.5% within 10 miles. Across the United States, 8.3% of counties had at least 50% of residents with a distance greater than 10 miles. These low-access counties were concentrated in Alaska, South Dakota, North Dakota, and Montana. Community pharmacies may serve as accessible locations for patient-centered, medication management services that enhance the health and wellness of communities. Although chain pharmacies represent the majority of pharmacy locations across the country, access to community pharmacies in rural areas predominantly relies on regional franchises and independently owned pharmacies.

The Food and Drug Administration (FDA) approved dabigatran etexilate mesylate for the prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation (AF) in October 2010¹ based on the results of the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial.² Quiz Ref ID The RE-LY trial did not find differences in the rates of major bleeding between treatments; however, dabigatran was superior to warfarin sodium in the prevention of stroke. In addition, dabigatran etexilate mesylate, 150 mg, was associated with a higher risk of gastrointestinal bleeding but a lower rate of intracranial hemorrhage compared with warfarin.

The shift toward value-based care has placed emphasis on preventive care and chronic disease management services delivered by multidisciplinary health care teams. However, some patients continue to have difficulty accessing affordable quality care. Pharmacists are accessible and trusted members of the health care team and routinely encounter patients at their community pharmacies. Patient-pharmacist encounters have traditionally focused on the provision of medications. More recently, community pharmacists have transformed and optimized their roles from product-centered services (ie, medication dispensing and sale of over-the-counter medications) to patient-centered services (ie, medication therapy management). The goal of medication therapy management is to optimize medication use, reduce the risk of adverse events, and improve medication adherence.¹

From 2008 to 2016, increases in medication list prices considerably exceeded inflation,¹ leading to concerns about affordability and access for patients.² Trends in list prices, however, do not reflect changes in manufacturer discounts to payers (rebates) and other concessions that have contributed to lower net prices of drugs. The lack of discount data in most prior drug pricing research constitutes a critical limitation because rebates and other manufacturer discounts have increased over time.^3,4 Thus, increases in list prices could reflect rising discounts rather than a change in actual net price. The lack of discount data limits drug pricing policy discussions, particularly because pharmaceutical manufacturers have recently argued that, after accounting for rebates, net prices have increased at the rate of inflation.⁵ This is especially relevant in the current legislative environment, when changes to the pharmaceutical reimbursement structure for major public payers are discussed.

This study estimates the total costs associated with administering chimeric antigen receptor T-cell treatment.