Filling a prescription in the Seattle area? Put on comfortable shoes and be ready to wait

K. Alvason trudges about a mile uphill to the CVS store inside Target on Second Avenue, one of the few pharmacies left in downtown Seattle.  

Alvason, who lives near Lumen Field, finds the neighborhood’s pharmacies options hard to get to; they are either a difficult walk or require a car or bus ride. 

“It is kind of ridiculous that people have to get on public transportation to get something as basic as a prescription filled,” Alvason said.

Seattle’s downtown, which has seen six Bartell Drugs stores close since 2020, is one of the most noticeable areas in the Seattle area where easy access to a pharmacy has deteriorated. Plagued by broader industry woes, several drugstore chains, including Rite Aid, owner of Bartell Drugs, CVS and Walgreens closed stores across the nation and in Washington. 

Without easy access to a pharmacy, people are more likely to skip prescriptions and services that are usually only provided by a pharmacist in person, such as vaccinations and counseling on a medicine’s side effects and interactions with other medicines. 

But a lack of access to pharmacies is not a new problem in Washington. 

As many as 1.2 million Washingtonians lived in areas of low access to pharmacies as of 2022, according to a University of Washington-led study that mapped low-access areas as well as “pharmacy deserts” across the country in the wake of COVID. 

“I expect the number of areas with poor access to pharmacies to increase, especially in low-income areas of Seattle and rural areas throughout the rest of the state,” Rachel Wittenauer, one of the authors of the UW-led study, wrote in an email.  

Between January 2023 and last March, there were 81 pharmacy closures statewide, according to the Washington State Pharmacy Association. 

These closures included 26 Bartell Drugs stores, 25 Rite Aid locations, three PharMerica, two Walgreens, one Safeway pharmacy, 14 independent pharmacies; and 10 pharmacies at hospital or behavioral health facilities.  

CVS also closed two sites in Seattle Target stores, at 4313 University Way N.E. in 2022 and on Fourth Avenue last April, a company spokesperson said. 

Seattle struggles 

Although Seattle downtown and the Chinatown-International District were not identified in the UW mapping study as low-access areas in 2022, residents have struggled with accessing basic pharmacy services, like filling prescriptions, after recent closures.  

The CID lost Bartell Drugs at Fourth Avenue South and South Jackson Street in September 2022 and Luke’s Pharmacy, the neighborhood’s last independent pharmacy, in 2023. 

Many CID residents now get prescriptions at the International District Community Health Services on Eighth Avenue; however, that pharmacy is only open to patients of the clinic.  

Jeffrey Liang, interim executive director of the CID Business Improvement Area, said the loss of Luke’s was particularly a blow to the area’s large Asian community. The pharmacy staff could speak several Asian languages. Mail-in options aren’t really a practical option for many of the CID’s older adults, he said. 

“We have a population of residents here who are elderly and a lot of them just aren’t good with the internet, using the online pharmacies,” Liang said. “And so, not having an accessible, meaning a walkable pharmacy, is a challenge.”  

When the pharmacies closed, the CID also lost convenience stores where people could buy household items, like snacks, razors and shampoo, Liang said. The pharmacies also tied the neighborhood together by providing an essential service. 

“If it’s a Bartell’s or a neighborhood pharmacy, the pharmacists, the staff there, they get to know people in the neighborhood,” Liang said. “So, it’s like you lose that community connection, too.” 

The Fourth Avenue Bartell Drugs that closed in the CID was about a five-minute walk for residents who live near Lumen Field. Now residents have about a 20-minute walk to the closest retail pharmacies at the CVS on Second Avenue and Walgreens at Third and Pike.   

Alvason, a 59-year-old technical editor, noted the city has been debating a proposal to add homes near the stadiums on land zoned for industrial use. But, they said, “there is nothing down here to support residents.”  

“We don’t have drugstores, we don’t have corner stores, we don’t have a Safeway,” they said. “We have a Uwajimaya, but that’s very limited and more expensive option for most people.” 

What are low-access tracts?  

 The UW study identified more than 90 census tracts in King County with low access to pharmacies. Some were classified as “pharmacy deserts,” which are also low-income areas.   

Low access is defined as tracts where at least 33% of the population lives outside a certain distance from a pharmacy: 1 mile or farther in urban census tracts, 5 miles for suburban tracts and 10 miles for rural areas. For census tracts where fewer than 100 individuals own a car, the distance is 0.5 miles. 

Wittenauer said low-income tracts tend to have low access to many types of commercial businesses. These tend to be neighborhoods that have historically been subjected to “redlining,” the practice of denying loans and investment in areas with large minority or low-income populations. 

“There are several areas that stand out as having worse access to pharmacies, in particular Central and South Seattle, White Center and Federal Way,” said Wittenauer, who is now a postdoctoral research scientist with the World Health Organization based in France.  

 “These neighborhoods are also areas with a high proportion of racial minorities and low-income households,” she said.  

An estimated 600,000 people lived in pharmacy deserts in Washington at the time of the study, and another 600,000 or so lived in low-access areas.  

Measuring the extent of the problem is challenging.  

Many insurance plans, for example, have a mail-in option where a person can opt to get prescriptions delivered to them. 

 On the other hand, people who might live near a pharmacy may have restrictions on their insurance that require them to travel to an in-network pharmacy. 

Access has been limited in other ways as well. Pharmacies have been cutting back hours, particularly on weekends, and the state has few retail pharmacies open 24 hours, said Jenny Arnold, chief executive officer of the Washington State Pharmacy Association.  

“When I talk to colleagues who work within health systems discharging patients gets to be difficult, especially on weekends or later in the evening because the patients will struggle to get doses that they need to be able to go home safely because of the pharmacy closures,” Arnold said. 

Additional challenges 

The pharmacy closures have also caused long lines at nearby pharmacies.  

Margrit Lindal, 80, said Lindeman Pharmacy on the Virginia Mason Medical Center campus has gotten busy since Buck’s pharmacy on the same campus closed in 2023. Lindal lives on First Hill in the retirement community Horizon House on University Street, a short walk to the pharmacy.  

“Sometimes I go over there three times a day, and I can’t get in line because 30, 40 people are waiting,” Lindal said.    

She believes other recent closings increased traffic at her pharmacy. Within a mile of Horizon, Bartell Drugs on Broadway and Pike closed in 2023. The Bartell Drugs on Third and Union shuttered in early 2020.  

Lindal said her closest alternatives to Lindeman Pharmacy are the Walgreens stores on Pine and Broadway and Third and Pike. Both are less than a mile away from Horizon House, but she doesn’t feel safe walking there alone, particularly around Third and Pike where there’s been reported drug activity.  

“They are surrounded by security,” she said. “In the store, I feel safe, and that is a viable option for people downtown to get their medication.” 

Ryan Oftebro, chief executive officer of the Kelley-Ross Pharmacy Group, said his group’s pharmacies near downtown are busier since Rite Aid closed the downtown Bartell Drugs stores.   

Kelley-Ross has four pharmacy locations in Seattle, including at Seventh and Madison Avenue near downtown’s financial district and one in Capitol Hill.  

“We initially noticed the wave from the Bartell’s closures from the locations that are near us,” Oftebro said. “And so, we are busier than we’ve ever been, and we definitely are noticing that the patients are feeling it when they are trying to find a pharmacy location.” 

The pharmacy association’s Arnold said she’s not surprised to hear reports of long lines at pharmacies near ones that have closed.  

“When one pharmacy closes, oftentimes there’s very little notice given,” Arnold said. “What you see is that the pharmacies next door or the pharmacies where the scripts are sent suddenly are overwhelmed and hadn’t had time to staff appropriately.” 

That’s what has happened on South Whidbey Island, where residents are reporting routine waits of 40 minutes or more to get to the counter at the Rite Aid in Freeland. It is now the only pharmacy serving about the lower third of the 37-mile-long island.  

“You really don’t have a clue as to what the wait time is, you don’t get to take a number,” said Gary Hattal, a retiree who lives near Freeland. 

South Whidbey, another area that wasn’t flagged as low access in the UW study as of 2022, lost its only other pharmacy in July when Island Drug in Clinton closed. Two other independent pharmacies in the chain also closed in Oak Harbor in north Whidbey Island and La Conner, a community near Skagit Bay.  

The next closest pharmacy to Freeland is about a 24-minute drive away in Coupeville run by the WhidbeyHealth Medical Center. WhidbeyHealth, however, recently started a home-delivery service to the south portion of the island, serving Greenbank, Freeland, Langley and Clinton.  

There are pharmacies at the north end of the island in Oak Harbor; however, the UW study did mark some census tracts in north Whidbey as low access in the 2022 study.  

Hattal doesn’t blame the pharmacists or counter staff who are “overworked.” The staff now walk out into the line and take down information on clipboards. There’s a second window open, like a fast lane, for people who pay ahead online.  

“It has gotten a little bit quicker, but there are still people almost out the door all the time,” said Whidbey resident Candace Jordan, 74, who lives in Langley about 8 miles from Freeland’s Rite Aid.  

Expecting a long wait, Hattal said he makes sure to put on comfortable shoes and charge his cellphone on days he plans to pick up prescriptions. He’ll check if any games or programs are on that he can watch as the line inches closer to the counter.  

If he sees a friend, they might take turns holding each other’s place in line, and one will run off to the hardware store or go grocery shopping in town.   

“You better have something to do,” Hattal said.