Pharmacy closures can have a ripple effect throughout the healthcare supply chain, resulting in medication shortages, distribution challenges, increased costs, and potential health disparities. It is crucial for stakeholders to adapt and plan for these disruptions to maintain a resilient supply chain. Potential impacts include: 

• Increasing Health Disparities: Current and anticipated closures disproportionately affect already disadvantaged communities, including communities with higher rates of chronic conditions, and where people must travel further to get to their nearest pharmacy.  Closures and other operational impacts may lead to reduced medication adherence, increasing health disparities as these populations face greater challenges in accessing essential medications. 
• Medication Shortages: Pharmacy closures can lead to local or regional shortages of essential medications, which can disrupt the supply chain and affect patient access to necessary drugs. Patients have already reported challenges in locating the most recent COVID-19 vaccine in their local area. Long-term closures may pose risk in patients’ ability to access supplies for the upcoming flu seasons. 
• Increased Workload: When pharmacies close, the remaining ones in the area may experience increased demand, leading to potential delays in medication dispensing and heightened stress on staff. 
• Cost Increases: Supply chain disruptions caused by pharmacy closures can lead to increased costs for healthcare providers, payers, and patients due to the need for alternative distribution methods and transportation of medications. 
• Inventory Management: Supply chain stakeholders, including wholesalers and pharmacies, must manage their inventory differently to accommodate the closures, which can lead to inefficiencies and added expenses.