Study finds pharmacy closures impact anticonvulsant medication refills

A new study, out today in the Journal of the American Medical Association, has found that pharmacy closures in communities around Colorado significantly impact patient access to anticonvulsant medications, typically used to treat epilepsy, neuropathic pain and psychiatric disorders. Missing doses of this class of medication can result in increased mortality, pain and emergency room visits.

Researchers, led by Kelly Anderson, Ph.D., MPP, assistant professor at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, sought to investigate how pharmacy closures impact usage for a Medicare protected class of medications, or medications that Medicare prescription drug plans must cover.

While access to these medications is critical, study results find pharmacy access disrupts medication refills. Researchers used Colorado all-payer claims data to define patients who were exposed to community pharmacy closures between January 2018 and June 2022, identifying 39 closures in that time. They found a15.6% reduction in fills and a 14.4% reduction in days supplied.

“Additionally, we found that the disruption in refilling anticonvulsant medications persists for up to 6 months after pharmacy closures,” says Anderson. “We also found that while mail-order pharmacies can be a helpful way for some patients to access medications, mail-order pharmacies did not meaningfully fill in the gap when patients were exposed to a pharmacy closure.”

This study builds on existing research surrounding cardiovascular medications, which also found a decrease in usage following pharmacy closures. Anderson says future studies could continue to examine other drug classes, but a pattern is emerging.

“These results tell us that the U.S. health system should consider measures to support patients affected by community pharmacy closures, whether that’s by providing 90-day medication supplies when a closure is imminent, providing financial support to pharmacies at risk of closure in underserved communities, or encouraging clinicians to be more proactive in assisting patients to transfer prescriptions,” says Anderson.