Pharmacy closures are hitting rural Maine hard—and Aroostook County may be feeling it the most. Over the past decade, one in ten pharmacies in the state has closed, and in rural areas like Aroostook County, the figure climbs even higher. Independent pharmacies have borne the brunt, with a third shuttering statewide since 2013. As a result, many towns across The County now lack a full-service pharmacy, forcing residents — especially older adults — to drive 10  miles or more just to fill a prescription.  That's the definition of a "pharmacy desert."

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Nearly 90% of Mainers over 65 fill at least one prescription annually, and most take multiple medications to manage chronic conditions. Inaccessibility can lead to challenges with medication compliance and dangerous lapses in care. “It’s not just an inconvenience,” said one Aroostook caregiver. “It’s a health crisis waiting to happen.”

Local pharmacies have been innovating in order to meet the needs of The County.

One of the most visible closures occurred in Fort Fairfield, where Walgreens shut its pharmacy, leaving residents scrambling. Many older adults in Aroostook lack reliable transportation or internet access, compounding the isolation and risk they already face.  A second Walgreens, located in Houlton, is closing later this summer, part of a nationwide downsizing expected to affect more than 1200 locations.

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Earlier this year, state lawmakers responded to these challenges by passing L.D. 239, which allows for the creation of remote dispensing sites staffed by pharmacy technicians and supervised by pharmacists via telehealth. These sites, which are also authorized in 27 other states, could begin filling prescriptions in underserved areas by 2026.

But many of these challenges aren't new to The County — and it's clear that several local pharmacies have been innovating to meet the needs of their northern Maine clients for many years.

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At Mars Hill Pharmacy, Jacob Robertson says their Dis-Pel pill pack service — which organizes medications into daily doses and delivers them directly to clients’ homes — has surged in popularity. “Our pill pack service has become increasingly popular as it becomes more challenging for folks throughout the region to access pharmacies close to home,” said Robertson. “We often hear how much of a relief it is for our clients to know that getting their medications won't be a hassle — they show up right at their doorstep, right on time.”

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In Fort Kent, St. John Valley Pharmacy has been delivering prescriptions to rural clients for decades — free within a 30-mile radius. On any given day, they make over 100 deliveries to towns like Allagash, Madawaska, Grand Isle, and Eagle Lake. “We’ve been instrumental in caring for the health of the Valley with our medication regimen for more than 20 years,” said Charlie Ouellette, Director of Outpatient Pharmacy Services and former owner of the pharmacy. “We strive to be the one-stop location for all of their prescription needs, even if they can't stop in."

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Ouellette and his team also offer Dis-Pel pill packs, administer vaccinations in long-term care facilities and public clinics, and provide online ordering — all essential services in a sprawling rural region like ours.  Their work will continue under the new ownership of Northern Maine Medical Center, which acquired the pharmacy in December 2024. “Bringing together services under one roof creates synergy, efficiency, and eliminates duplication of services, allowing us to continue to focus on ways to better meet our customers' needs,” Ouellette added.

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Sustaining these local innovations requires policy support, including reforming pharmacy benefit manager (PBM) practices.  Too often, small local pharmacies are harmed by lack of equity and transparency in drug pricing and reimbursement.  PBM reform levels the playing field for independent pharmacies, protecting access to care and giving them the chance to do what they do best: serve their communities with personalized, accessible healthcare. Funding mobile delivery models throughout The County and scaling up telehealth dispensing will also be essential.

Aroostook County’s older adults deserve dependable access to life-sustaining medications — without the barrier of distance to services standing in the way.​​