Large chain pharmacies have closed nearly half of their retail stores in New York City since 2019, leaving a million square feet of empty retail space and blighted storefronts while leaving New Yorkers with fewer options, higher prices, and less access to healthcare services. A new report published by the Vanderbilt Policy Accelerator (VPA) proposes “CityRx,” a system of public pharmacies for New York City, which would combine a “public option” for pharmacies with support for independent pharmacies to restore and improve access to pharmacy services for all New Yorkers.
The report from VPA’s director of industrial policy and economic security Joel Dodge and researcher Dana Brown outlines the CityRx proposal. An initial phase would focus on new City-owned delivery and mobile pharmacy options, followed by an expansion of the City’s existing public pharmacy network and a new alliance of City-certified and -supported independent pharmacies.
“Even in a city as densely populated and well-connected as New York, many neighborhoods still suffer from lack of access to healthcare, including pharmacies,” said Dodge. “Public pharmacies could play an important role in ensuring that all New Yorkers can get access to critical medications and basic healthcare services.”
“Healthcare public options help bring essential services to all Americans while keeping costs and prices in check. New York City has a real need for better pharmacy access, and CityRx would gradually expand public pharmacy services to all New Yorkers,” said Brown.
The CityRx plan builds on existing municipal programs and recent innovations.
Earlier this year, NYC Health and Hospitals (H+H) and Gotham Health launched a pharmacy home delivery program, which could be expanded to improve access for all New Yorkers, regardless of their healthcare provider.
Similarly, the former “Test to Treat” program that originated during the Covid-19 pandemic could serve as the basis for expanding mobile pharmacy options to residents who lack care in their neighborhoods. New York could then strengthen its existing public pharmacy footprint to serve more city residents; H+H’s existing in-hospital pharmacies, which currently serve Medicaid patients and uninsured patients, provide a foundation for the City to expand upon and could serve additional patients, including those on Medicare or with private insurance.
Finally, the City could boost independent pharmacies by creating a government-coordinated alliance of qualifying pharmacies and providing those pharmacies with support to promote their growth and ability to serve New Yorkers. For instance, this alliance could help members gain better terms from their suppliers and payers, demand stronger reimbursement from pharmacy benefit managers, and preferential–or at least neutral– treatment from insurers on behalf of member pharmacies.
Eventually, CityRx could become a foundation for even bolder policy actions to use public power to improve the health of New Yorkers, such as direct drug procurement or public drug production, as is already the case in California with CalRx. By leveraging, expanding, and strengthening the City’s existing public and private pharmaceutical infrastructure, CityRx can maximize the potential of both H+H pharmacies and high-quality independent pharmacies, ultimately improving medicine access and health outcomes for New Yorkers.
Read the full report here, or check out VPA’s Substack here.
About the VPA
The Vanderbilt Policy Accelerator for Political Economy and Regulation (VPA) focuses on cutting-edge topics in political economy and regulation to swiftly bring research, education, and policy proposals from infancy to maturity. To learn more about our work, visit vu.edu/vpa.
