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Rural Pharmacy and Prescription Drugs Resources

Selected recent or important resources focusing on Rural Pharmacy and Prescription Drugs.

Drug Discount Program: Characteristics of Hospitals Participating and Not Participating in the 340B Program
Analyzes 2016 cost report data to describe and compare characteristics of 340B participating and non-participating hospitals, specifically examining three hospital types: Critical Access Hospitals (CAHs), Sole Community Hospitals (SCHs), and general acute care hospitals. Discusses trends related to decreased charity care and an increase in Medicaid expansion on 340B hospital participation.
Additional links: Full Report
Date: 07/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Drug Discount Program: Improvements Needed in Federal Oversight of Compliance at 340B Contract Pharmacies
Details an evaluation of HRSA's oversight of contract pharmacies participating in the 340B Drug Pricing Program. Discusses rates of compliance by contract pharmacies and HRSA's enforcement efforts.
Additional links: Full Report
Date: 07/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Drug Discount Program: Federal Oversight of Compliance at 340B Contract Pharmacies Needs Improvement
Focuses on the 340B Drug Pricing Program, which allows certain facilities such as Disproportionate Share Hospitals (DSHs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs) to purchase prescription and non-prescription medications at reduced cost. Describes financial arrangements participating facilities have with contract pharmacies, the extent to which they provide discounts on 340B drugs dispensed by contract pharmacies to low-income, uninsured patients, and examines the Health Resources and Services Administration's efforts to ensure compliance with 340B Program requirements at contract pharmacies.
Additional links: Full Report
Date: 06/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Drug Discount Program: Status of Agency Efforts to Improve 340B Program Oversight
Testimony before the Committee on Health, Education, Labor, and Pensions, U.S. Senate, describing the Health Resources and Services Administration's (HRSA) actions in response to the Government Accountability Office's (GAO) recommendations to improve the 340B program oversight. Covers GAO's ongoing work related to the 340B program and HRSA's efforts to implement the GAO's recommendations. includes information on 340B program participants, program structure, operation, and key requirements.
Additional links: Examining Oversight Reports on the 340B Drug Pricing Program, Full Report
Date: 05/2018
Type: Document
Sponsoring organization: Government Accountability Office
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Reforming Biopharmaceutical Pricing at Home and Abroad
Discusses federal policy changes within the Food and Drug Administration (FDA) and Medicare and Medicaid programs that could help lower domestic drug prices and encourage more robust price competition. Includes a discussion of potential changes to the 340B Drug Pricing Program and the resulting impacts for Critical Access Hospitals (CAHs), Disproportionate Shares Hospitals (DSHs), and other providers.
Date: 02/2018
Type: Document
Sponsoring organization: The Council of Economic Advisers
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2018 OPPS Medicare Part B Payment Impact Analysis
Examines how changes to the CY 2018 Medicare Outpatient Prospective Payment System (OPPS) will impact hospitals' net Part B payments. Discusses the payment reduction for drugs purchased through the 340B Program and how the reduction will affect rural and urban hospitals. Includes a state-by-state analysis of aggregate impacts.
Date: 01/2018
Type: Document
Sponsoring organization: Avalere
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Review of the 340B Drug Pricing Program
Provides extensive background information about the 340B Program, explains the Health Resources and Services Administration's (HRSA) oversight functions, and details requirements for the various covered entities, including rural hospitals and Federally Qualified Health Centers (FQHCs). Also makes recommendations for clarifying the 340B Program's scope and ensuring program integrity is maintained.
Date: 01/2018
Type: Document
Sponsoring organization: House Energy and Commerce Committee
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Rural-Urban Enrollment in Part D Prescription Drug Plans: June 2017 Update
Updates prior policy briefs and shows state-to-state variation in stand-alone prescription drug plans and Medicare Advantage with Prescription Drug plans. Features statistics with breakdowns by rural and urban enrollment in 2008 and 2017.
Author(s): Paula Weigel, Fred Ullrich, Keith Mueller
Date: 12/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Preventing Drug Abuse: Low Participation by Pharmacies and Other Entities as Voluntary Collectors of Unused Prescription Drugs
Report to Congress documenting low participation rates among pharmacies and other eligible entities in the Drug Enforcement Administration's (DEA) unused controlled substance collection and disposal program. Includes an outline of program requirements, a state-by-state overview of currently eligible and enrolled entities, and information about participation rates by rural and urban location.
Additional links: Full Report
Date: 10/2017
Type: Document
Sponsoring organization: Government Accountability Office
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Antibiotic Prescription Fill Rates Declining in the U.S.
Examines antibiotic prescriptions filled as a result of an outpatient visit by commercially insured members of Blue Cross Blue Shield from 2010 to 2016. Includes statistics on antibiotic prescription fill rates in urban and rural counties by antibiotic type.
Date: 08/2017
Type: Document
Sponsoring organization: Blue Cross Blue Shield
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Drug Discount Program: Update on Agency Efforts to Improve 340B Program Oversight
Testimony before the Subcommittee on Oversight and Investigations, Committee on Energy and Commerce, U.S. House of Representatives, describing the Health Resources and Services Administration's (HRSA) actions and plans for improving 340B program oversight. Also provides an update on the Government Accountability Office's work regarding the 340B program and HRSA oversight. Includes information on 340B program participants, background, structure, audit frequency, and more.
Additional links: Examining HRSA’s Oversight of the 340B Drug Pricing Program, Full Report
Date: 07/2017
Type: Document
Sponsoring organization: Government Accountability Office
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340B Hospitals Use Their Contract Pharmacy Benefit to Treat Low-Income and Rural Patients: Results from a Survey of 340B Health Members
Presents results from a survey of 340B Health member hospitals regarding the importance and financial benefit of the contract pharmacy arrangement. Primary focus is on understanding and explaining how the contract pharmacy arrangement benefits low-income and rural patients.
Additional links: Report Overview
Date: 07/2017
Type: Document
Sponsoring organization: 340B Health
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Identifying Adverse Drug Events in Rural Hospitals: An Eight-State Study
Analyzes adverse drug events (ADEs), or events involving patient injury resulting from medication use, and identifies ways to improve medication safety in rural hospitals. Uses 2013 data from eight states with significant rural populations, and examines ADE rates based on hospital characteristics and across four main categories: steroids, antibiotics, opiates/narcotics, and anticoagulants. Companion brief lists resources that can be used to reduce and prevent ADEs in rural hospitals, including rural prospective payment system (PPS) hospitals and Critical Access Hospitals (CAHs).
Additional links: Resources to Reduce Adverse Drug Events in Rural Hospitals
Author(s): Michelle Casey, Peiyin Hung, Emma Distel, Shailendra Prasad
Date: 05/2017
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Telepharmacy Rules and Statutes: A 50-State Survey
Policy brief identifying state-enacted regulations and legislation authorizing use of community telepharmacy initiatives, and describing implications for patients in underserved rural communities. Includes a table listing states with telepharmacy permitted in some capacity, pilot programs that enable telepharmacy initiatives, waivers enabling telepharmacy initiatives, or no rules or legislation authorizing telepharmacy use.
Additional links: Table Supplement
Author(s): George Tzanetakos, Fred Ullrich, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: Rural Policy Research Institute
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Issues Confronting Rural Pharmacies after a Decade of Medicare Part D
Discusses the major challenges facing rural independent pharmacies, focusing on delayed maximum allowable cost (MAC) adjustments, and direct and indirect remuneration (DIR) fees. Other challenges include competition from mail order pharmacies, being a non-preferred pharmacy, and orderly succession planning. Also examines the implications for rural communities when independent pharmacies close.
Author(s): Fred Ulrich, Abiodun Salako, Keith Mueller
Date: 04/2017
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Potentially Preventable Medication-Related Hospitalizations: A Clinical Pharmacist Approach to Assessment, Categorization, and Quality Improvement
Examines pharmacist-led quality improvement practices, implemented across rural and urban counties in Hawaii, to identify and categorize potentially preventable medication-related hospital admissions. Describes how data collected during the investigation is used to improve pharmacist interventions focused on reducing medicated-related readmissions.
Author(s): Karen L. Pellegrin, Elizabeth Lee, Reece Uyeno, Chris Ayson, Roy Goo
Citation: Journal of the American Pharmacies Association, 57(6), 711-716
Date: 2017
Type: Document
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Trends in Hospital Inpatient Drug Costs: Issues and Challenges
Examines recent increases in inpatient drug prices and presents trends in hospital inpatient drug prices and spending. Discusses how drug prices affect hospitals' ability to manage the overall cost of patient care. Analysis uses information from several types of hospitals, including rural hospitals, and focuses on price changes between fiscal years 2013-2015.
Date: 10/2016
Type: Document
Sponsoring organizations: American Hospital Association, Federation of American Hospitals, NORC at the University of Chicago
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Benefiting Hospitals, Not Patients: An Analysis of Charity Care Provided by Hospitals Enrolled in the 340B Discount Program
Examines charity care levels at 340B Disproportionate Share Hospitals (DSHs) to determine if eligibility criteria for DSH hospitals appropriately align with the 340B programs goal of supporting access to prescription drugs for uninsured and vulnerable populations. Appendix provides additional information and operating statistics specific to Critical Access Hospitals (CAHs).
Date: 2016
Type: Document
Sponsoring organization: Alliance for Integrity and Reform of 340B
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Rural and Urban Differences in Choice of and Satisfaction with Medicare Part D Plans
Examines how drug plan selection experiences and satisfaction levels differ for rural and urban Medicare beneficiaries. Includes breakdowns by three locations types, considerations in choosing plans, and percentage of people who felt satisfied and confident in their coverage.
Author(s): Carrie Henning-Smith, Heidi O’Connor, Michelle Casey, Ira Moscovice
Date: 07/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Differences in Part D Plans Offered to Rural and Urban Medicare Beneficiaries
Analyzes how Medicare Part D plan options differ for rural and urban residents in terms of premiums, deductibles, and copayments, as well as differences in plan options within more-densely and less-densely populated rural areas. Includes statistical breakdowns by three location types, number of available plans, average premiums, deductible amounts, and average co-pays.
Author(s): Heidi O’Connor, Carrie Henning-Smith, Michelle Casey, Ira Moscovice
Date: 07/2015
Type: Document
Sponsoring organization: University of Minnesota Rural Health Research Center
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Report to Congress: Overview of the 340B Drug Pricing Program
Provides a general overview of the 340B Drug Pricing Program, including eligibility criteria for hospitals and providers, analysis of the program's financial impact, and a summary of the current debate over the program's importance, especially to underserved communities.
Date: 05/2015
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Characteristics of Rural Communities with a Sole, Independently Owned Pharmacy
Characterizes the population of rural areas being served by a sole, independently owned pharmacy to better understand the role of rural pharmacies in providing broader healthcare services to underserved communities.
Author(s): Matthew Nattinger, Fred Ullrich, Keith Mueller
Date: 04/2015
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Growth of the 340B Program: Past Trends, Future Projections
Highlights an increase in the number of disproportionate share hospitals (DSH) that are eligible for, and then enroll in, the 340B discount drug program. Causes of the increase include hospital acquisitions and changes in the Affordable Care Act (ACA), among other things. The report projects continued, rapid growth of the 340B program over the next several years.
Author(s): Aaron Vandervelde
Date: 11/2014
Type: Document
Sponsoring organization: Alliance for Integrity and Reform of 340B
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Update: Independently Owned Pharmacy Closures in Rural America
Examines the closure of independently owned rural pharmacies in America from 2003-2013 and its effects on rural Americans’ access to medications and other pharmacy services. This report is an update to past publications from RUPRI.
Author(s): Fred Ullrich, Keith Mueller
Date: 06/2014
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Issue Brief: Medication Adherence and Health IT
Discusses how medication adherence and health information technology (HIT) can increase adherence rates to support wellness and population health. Highlights a project that facilitates coordination between hospital pharmacists and rural community pharmacists to provide patient medication management and consultation services pre- and post-discharge.
Author(s): Aja B. Williams
Date: 01/2014
Type: Document
Sponsoring organization: Office of the National Coordinator for Health Information Technology
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Demographic and Economic Characteristics Associated with Sole County Pharmacy Closures, 2006-2010
Describes demographic and economic characteristics associated with counties experiencing closure of their sole pharmacy which results in patients having reduced access to key health services like drug dispensing, immunizations, patient assessments, and medication therapy management services.
Author(s): Paula Weigel, Fred Ullrich, Keith Mueller
Date: 11/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Characteristics of Adverse Drug Events Originating During the Hospital Stay, 2011
Provides hospital inpatient data on the four most common adverse drug events (ADEs). Table 1 and Figure 4 list data on ADEs for rural compared to urban hospitals.
Author(s): Audrey J. Weiss, Anne Elixhauser
Date: 10/2013
Type: Document
Sponsoring organization: Agency for Healthcare Research and Quality
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Causes and Consequences of Rural Pharmacy Closures: A Multi-Case Study
Policy brief identifies factors that contributed to the closing of six rural pharmacies in different states and describes how the affected communities adapted to losing locally based services.
Author(s): Kelli Todd, Katie Westfall, Bill Doucette, Fred Ullrich, Keith Mueller
Date: 08/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Setting the Record Straight on 340B - A Response to Critics
Documents independent research and the congressional intent of the 340B program. Presents information on how providers are using their savings and how the program is saving money for federal, state, local governments and taxpayers. Highlights rural hospitals, community health centers, rural referral centers, and sole community hospitals.
Date: 07/2013
Type: Document
Sponsoring organization: 340B Health
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Rural Pharmacy Closures: Implications for Rural Communities
Documents the closure of local retail pharmacies in which the pharmacist was the community's only clinical provider at the time the pharmacy closed. Describes the characteristics of each community and retail pharmacy in question.
Author(s): Kelli Todd, Fred Ullrich, Keith Mueller
Date: 01/2013
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Rural Health in Pharmacy Curricula
Reports on the status of rural specialized education and training within colleges and schools of pharmacy as of December 2011.
Author(s): Kim Thrasher, Shanna K. O'Connor, Pamela U. Joyner
Citation: American Journal of Pharmaceutical Education
Date: 11/2012
Type: Document
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Main Challenges Facing the Pharmaceutical Sector in Buchanan County, Virginia: A Pilot Study
Discusses the challenges facing the pharmaceutical component of rural community health care. Provides suggestions for improving the sector in Buchanan County, a poor and marginalized county in Central Appalachia, Virginia.
Author(s): P. Gavaza, W. Yan, J. Campbell
Citation: Rural and Remote Health, 12, 2125
Date: 11/2012
Type: Document
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Stand-Alone Prescription Drug Plans Dominated the Rural Market in 2011
Examines the prevalence of Medicare Part D prescription drug coverage in rural and urban areas, and explains enrollment patterns based on rural/urban region. Also discusses the difference between stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug (MA-PD) plans, and how changes in the Affordable Care Act (ACA) may affect rural and urban Medicare Part D beneficiaries differently.
Author(s): Leah Kemper, Abigail Barker, Fred Ullrich, et al.
Date: 09/2012
Type: Document
Sponsoring organization: RUPRI Center for Rural Health Policy Analysis
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Perceptions of and Barriers to Use of Generic Medications in a Rural African American Population, Alabama, 2011
Explores beliefs about generic medication use among 30 chronically ill African Americans in the Black Belt, a region characterized by poverty and prevalence of chronic diseases. Includes statistical breakdowns by age, sex, employment status, level of education, insurance status, and number of medications taken daily.
Author(s): Keri Sewell, Susan Andreae, Elizabeth Luke, Monika M. Safford
Citation: Preventing Chronic Disease, 9
Date: 08/2012
Type: Document
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Prospective Student Pharmacist Interest in a Rural Pharmacy Curriculum
Seeks to determine prospective student pharmacists’ interest in a rural pharmacy health curriculum. Results are based on a survey of 250 applicants who were selected to interview for fall 2011 enrollment at the UNC Eshelman School of Pharmacy.
Author(s): Shanna K. O'Connor, Jeffrey S. Reichard, Kim A. Thrasher, Pamela U. Joyner
Citation: American Journal of Pharmaceutical Education, 76(6), 105
Date: 08/2012
Type: Document
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Impact of a Rural Interprofessional Experience in Rural Communities on Medical and Pharmacy Students
Examines the impact of a Rural Interprofessional Experience (RIE), based at the University of Minnesota Duluth campus, on the attitudes and knowledge of medical and pharmacy students in relation to rural practice.
Author(s): Debra C. Sisson, Ruth E. Westra
Citation: Family Medicine, 43(9), 653-658
Date: 10/2011
Type: Document
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e-Emergency Services Bring Specialists to Rural Patients with the Push of a Button
More and more specialists are available to small hospitals via telemedicine, benefiting patients—and doctors. Highlights Avera eEmergency Services, a hospital-based telemedicine emergency support service available in South Dakota, Iowa, Minnesota, and North Dakota.
Author(s): Candi Helseth
Citation: Rural Monitor, 2011(Summer)
Date: 08/2011
Type: Document
Sponsoring organization: Rural Health Information Hub
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Rural Pharmacies Struggle to Survive
Describes the North Dakota Telepharmacy Project that outreaches to rural communities.
Author(s): Candi Helseth
Citation: Rural Monitor, 2009(Fall)
Date: 11/2009
Type: Document
Sponsoring organization: Rural Health Information Hub
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Workforce Issues Among Sole Community Pharmacies
Explores the shared experiences of sole community pharmacist-owners regarding the challenges facing the pharmacy workforce in their communities and their concerns about their pharmacy's future.
Author(s): Donald Klepser, Michelle Lampman, Andrea Radford, Indira Richardson, Stephen Rutledge
Date: 07/2009
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Pharmacy
Discusses key policy issues impacting access to pharmacy services in rural areas including reimbursement, workforce, policy, and pharmacist services in Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs).
Date: 05/2009
Type: Document
Sponsoring organization: National Rural Health Association
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The Key Role of Sole Community Pharmacists in Their Local Healthcare Delivery Systems
Presents findings from a 2008 survey of 401 community pharmacists that are the only retail provider in their community to document their extended relationships with other health care providers.
Author(s): Andrea Radford, Indira Richardson, Michelle Mason, Stephen Rutledge
Date: 03/2009
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Sole Community Pharmacies and Part D Participation: Implications for Rural Residents (Findings Brief)
Describes the contracting rates of sole rural community pharmacies in 16 states to assess the extent to which each pharmacy contracts with the most commonly used Prescription Drug Plans (PDPs) available in their state.
Author(s): Victoria Freeman, Indira Richardson, Rebecca Slifkin
Date: 02/2009
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Medicare Beneficiaries’ Access to Pharmacy Services in Small Rural Towns: Implications of Contracting Patterns of Sole Community Pharmacies with Part D Plans
Describes pharmacy Prescription Drug Plan (PDP) contract patterns of sole rural pharmacies. Addresses PDP enrollment choices of Medicare Part D enrollees.
Author(s): Victoria A Freeman, Indira Richardson, Rebecca T. Slifkin
Date: 01/2009
Type: Document
Sponsoring organization: North Carolina Rural Health Research Program
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Case Study: Pharmacy Provides Critical Link in Rural Care Continuum
Follows the transition of pharmacy services in Pender, Nebraska to highlight the importance of pharmacy services in rural communities. Focuses on how Pender Community Hospital District Inc. partnered with Pender Care Centre District Inc. to purchase a local retail pharmacy, expand pharmacy access, increase revenue, and qualify for the 340B Program.
Type: Document
Sponsoring organization: Bryan Health
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PubMed Search: Rural Pharmacy Services
Searches PubMed's collection of journal article citations on pharmacy services in rural areas.
Type: Literature Search
Sponsoring organization: U.S. National Library of Medicine
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RxAssist: Patient Assistance Program Center
Provides a searchable database of patient assistance programs that provide free or low-cost prescription medications to people who cannot afford to buy their medicine. Includes information for patients and for healthcare providers.
Type: Directory
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The 340B Prime Vendor Program
Serves as the contractor for the Health Resources and Services Administration (HRSA)'s 340B Prime Vendor Program. Negotiates pharmaceutical pricing below the 340B price and establishes distribution solutions and networks that improve access to affordable medications for participants of the 340B Drug Pricing Program.
Type: Website
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340B Drug Pricing Program
Provides information and updates on the 340B Drug Pricing Program.
Type: Website
Sponsoring organization: Office of Pharmacy Affairs
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InsureKidsNow.gov
Supplies information on free and low-cost health insurance programs for children including Medicaid and CHIP (Children's Health Insurance Program).
Type: Website
Sponsoring organization: U.S. Department of Health and Human Services
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Last Updated: 7/20/2018