Introduction

Community pharmacies have long been fixtures in American life—familiar spaces that people visit to refill a prescription, stop into for advice, or rely on during moments of uncertainty. For much of the twentieth century, these pharmacies were neighborhood crossroads, places where clinical knowledge, everyday commerce, and personal relationships all intersected. The local pharmacist—at times, called a druggist—often knew a family’s health history, offered informal consultations, compounded medicines by hand, and provided a social anchor as much as a clinical one. But as the healthcare system expanded and rationalized, as insurance grew more complex, and as chain stores and corporate intermediaries reshaped the business of dispensing, the role of community pharmacy changed dramatically. What was once a highly localized craft evolved into a profession caught between clinical aspiration and commercial constraint.

This special issue examines the history of community pharmacy specifically in the United States, where retail practice, regulatory structures, and corporate consolidation have followed distinctive paths. The last century has been, in this sense, a story of constant renegotiation. Pharmacies transformed from soda‑fountain social hubs into standardized retail spaces; from compounding workshops into high‑volume dispensing centers; from locally owned institutions into nodes within vertically integrated corporate networks. Regulatory changes, reimbursement models, urban redevelopment, and professional shifts all shaped how pharmacists understood their work and how communities experienced pharmacy access. For the purposes of this issue, “community pharmacy” refers to the network of publicly accessible pharmacies—whether independent drugstores, cooperatives, or later chain and big‐box retailers—where pharmacists have long dispensed medications, offered advice, created preparations, and served as everyday health counselors. The following pages bring together five contributions that help track layered transformations—across geographies, decades, policy landscapes, and professional debates—to illuminate both the persistence and the precarity of community pharmacy in American life. For greater context, this issue of Pharmacy and Pharmaceuticals was developed as both a labor of love and an effort to spotlight what we feel is an understudied area of pharmacy history.

The American Institute of the History of Pharmacy has long recognized that community pharmacy is not only a subject of historical inquiry, but also a living practice shaped by the people who inhabit it. Over the years, AIHP’s publications have traditionally welcomed the perspectives of practicing pharmacists, and this special issue extends that commitment by featuring work from pharmacist‐historians and scholars trained within the profession. Their contributions underscore our conviction that the history of pharmacy is strongest when it engages those who know its everyday realities firsthand. We are proud to support and expand this inclusive ethos—one that invites collaboration across professional identities, encourages methodological and thematic experimentation, and positions community pharmacy as a space where scholarly and practitioner voices can meet. This issue reflects that spirit, and it signals our intention to cultivate even more opportunities for pharmacists to participate in, shape, and deepen historical scholarship.

Scholarship on community pharmacy has slowly developed along several intersecting paths, ranging from broad institutional histories to focused examinations of professional identity, policy, and place. Foundational syntheses such as Kremers and Urdang’s History of Pharmacy established the economic and structural contours of retail pharmacy across the twentieth century, providing a durable baseline for understanding community practice.¹ Building on this foundation, Higby’s account of the “continuing evolution” of American pharmacy practice traced the mid‐century shift from compounding and soda fountains to standardized dispensing and emerging clinical roles, positioning community pharmacy as a site of ongoing professional renegotiation.² Professional literature also contributed significantly to this historiography. Hepler and Strand’s landmark articulation of “pharmaceutical care” in 1990 sought to redefine and recount pharmacists’ responsibilities and became a touchstone for later practice‐change movements,³ while the clinician‐oriented synthesis by Cipolle, Strand, and Morley offered an influential guide to operationalizing that philosophy in community settings.⁴ Organizational analyses, such as Zellmer’s study of national bodies that sought to implement pharmaceutical care, illuminated how associations attempted to mobilize practitioners and reshape standards across retail practice.⁵

This American‐focused historiography reveals a field that has never been static but also underdeveloped. For instance, relatively few historians and policy scholars who might refer to themselves as Americanists have examined the structural pressures surrounding community pharmacy in depth. Synthetic works in histories of medicines or in Science and Technology Studies, meanwhile, illustrate that discipline formation, professional standing, policing scope of practice, and expertise are deeply relevant to community pharmacy, and that it cannot be easily separated from broader shifts in healthcare labor and the organization of pharmaceutical knowledge. While fully recognizing that there are more areas to explore in the future, the articles collected in this volume add to a growing literature on community pharmacy history that traces institutional transformation as well as contested professional identity.

Andrea Kjos’s “The Push for Practice Transformation of Community Pharmacy” offers a close study of one of the most ambitious efforts to redefine the profession from within: Iowa’s pharmaceutical care initiative of the 1990s. Her account shows how educators, practitioners, and professional organizations sought to embed pharmaceutical care into everyday community practice. What emerges is a portrait of earnest, hands‑on transformation—site visits, coaching, redesigned workflows—but also of resistance and fragility. The initiative’s promise was real, yet its sustainability depended on conditions outside pharmacists’ control, including reimbursement, workplace structure, and interprofessional dynamics. Kjos thus captures the tension that recurs throughout this issue: the gap between what pharmacists are trained and motivated to do, and what the surrounding system allows.

An earlier moment of change and ambition appears in Wesley Sparkmon’s “Rexall Rides the Rails.” Sparkmon recounts the remarkable 1936 Rexall Train, a streamlined, twelve‑car national exhibition that carried pharmacy modernization across the country during the Great Depression. The train was at once a marketing experiment, a demonstration of technological optimism, and a tool for strengthening ties among Rexall franchisees. In reconstructing the event, Sparkmon reveals the long lineage of innovation in community pharmacy—decades before digital platforms, chain loyalty programs, or telehealth, pharmacy organizations were already experimenting with new media and new ways of creating shared identity. His article underscores that “community pharmacy” has always been shaped not only by professional ideals but by imaginative efforts to connect with the public.

Christian Brown and Benjamin Urick’s “An Alternative Community Pharmacy Payment Model” turns to the economic architecture beneath these professional aspirations. Their history of the Iowa Pharmacy Capitation Project (1976–1981) shows how radically different reimbursement models were proposed long before today’s debates over Pharmacy Benefit Managers (PBMs), direct and indirect remuneration (DIR) fees, and value‑based payment. The pilot’s early success—reduced expenditures, increased generic substitution—quickly collided with political opposition, corporate resistance, and methodological obstacles. Brown and Urick present a case study in how difficult it has been to redesign pharmacy payment in ways that reward cognitive services or clinical engagement. Their analysis resonates across the issue: attempts to realign pharmacy around patient care repeatedly falter when the economic incentives remain tied to product distribution rather than professional expertise.

The spatial consequences of these financial and structural pressures are vividly mapped in Taylor Watterson and colleagues’ “Mapping Pharmacy Deserts in Chicago.” Through five decades of geospatial and archival analysis, the authors show how discrimination, redlining, urban renewal, chain consolidation, and changing reimbursement systems collectively hollowed out pharmacy access in Chicago’s South and West Sides. By foregrounding how pharmacy closures disproportionately affected Black and Latino neighborhoods, their work reframes access to community pharmacy as a matter of structural justice. Pharmacy deserts, they argue, are not recent anomalies but the product of longstanding policies and patterns that redistributed healthcare infrastructure along racial and economic lines. Their contribution expands the story of community pharmacy beyond professional debates and into the broader terrain of urban inequality.

Bringing these historical analyses into the present, the interview with National Community Pharmacists Association CEO Doug Hoey adds a candid, contemporary voice. Hoey reflects on more than 25 years of change—technological modernization, expanding clinical authority, shifting workforce demographics, rising consolidation, and the immense power of PBMs. His remarks reveal a profession that remains profoundly tied to local identity and trust, even as its economic foundations grow more unstable. Community pharmacists, he suggests, are deeply committed to their patients and neighborhoods, yet increasingly burdened by opaque reimbursement systems and corporate intermediaries. His perspective echoes themes across this issue: the independence that once defined community pharmacy is now both its greatest strength and its greatest vulnerability.

In the year of its 250th anniversary, focusing on the United States in pharmacy and pharmaceutical history remains crucial because its market‑driven healthcare system, decentralized regulation, and uneven distribution of pharmacy services have created conditions that differ markedly from those in more centralized or publicly financed systems. By identifying and historicizing some of the structural forces shaping US practice, this issue offers a foundation for future comparative work that examines how pharmacy labor, corporate influence, and access patterns unfold in other national contexts. Across these five contributions, several intertwined historical issues emerge that are central to understanding community pharmacy today. One concerns the economic and policy environment that shapes—and often constrains—pharmacy practice. Reimbursement instability, driven especially by PBM practices and insurance consolidation, repeatedly surfaces as a force that undermines both innovation and sustainability. Whether through the failure of capitation in the early 1980s or contemporary complaints about retroactive fees and shrinking margins, economic precarity limits the ability of pharmacies to provide the kind of comprehensive, patient‑centered care envisioned by reformers.

A second issue involves inequity and uneven access. The Chicago case shows that pharmacy closures and limited access are tightly entwined with segregation, disinvestment, and discriminatory policy. The geographic distribution of pharmacies reflects not simply market logic but the historical geography of urban injustice. Community pharmacy, in this sense, becomes a visible marker of broader public health disparities. A third issue is the challenge of transforming practice itself. The Iowa stories—both of capitation and pharmaceutical care—demonstrate how difficult it is to shift pharmacy away from a product‑based model when the surrounding system rewards dispensing speed and volume. Professional identity alone cannot overcome structural incentives; reform requires alignment across payment, workflow, education, and interprofessional collaboration.

A fourth issue involves the power of consolidation and the erosion of local control. Sparkmon’s historical analysis of Rexall illustrates early forms of branding and national integration, while Hoey’s comments describe a present‑day landscape in which insurers, PBMs, and corporate chains hold unprecedented leverage. The rise of vertical integration has transformed community pharmacy from a largely local enterprise into one shaped by distant financial and corporate priorities. Fifth and lastly, a unifying thread across all contributions is the enduring importance of community‑rooted trust. Whether in the hand‑mixed preparations of mid‑century independents, the care‑focused ethos of the ICPC, the resilience of neighborhood pharmacies in Chicago, or the stories of pharmacists aiding communities during crises, the profession’s legitimacy rests on relationships. Even amid structural pressures, community pharmacy remains a frontline institution of everyday care.

The articles in this issue trace community pharmacy’s long arc—from its intimate neighborhood origins to its contemporary struggles within an increasingly complex healthcare system. Together, they illustrate a field continually shaped by experimentation, ambition, policy, and inequity. They also show that while the economic and structural challenges facing community pharmacy are significant, its social role remains indispensable. Understanding the forces that have shaped this sector across the twentieth and twenty‑first centuries is essential not only for historical insight but for charting a more equitable and sustainable future. Community pharmacies have changed dramatically over time, yet the stakes remain the same: ensuring that people can access trustworthy care close to home.

Finally, over the past few months and years, there has been a whirlwind of activity at the AIHP, including floods, new personnel, refurbishment of the headquarters, and—as of this writing—preparations to celebrate the organization’s 85th birthday in 2026. When so much is happening at the organization, time can fly by, and yet it is crucially important to acknowledge the contributions of everyone involved. To begin, we must thank Himesh Mehta for two‐plus years of service as a book review editor and wish him well in the future. Additionally, for the past four years, the journal has benefited from a trio of editors‐in‐chief who have collectively shaped the journal’s voice and sustained its momentum as a developing home for innovative historical scholarship in health, medicine, pharmacy, and pharmaceuticals. After serving two terms, however, two of us, Tanja Pommerening and Paula De Vos, will be stepping away from HoPP as it continues to evolve. Together, we have worked to support new contributors, uphold editorial standards, and foster a spirit of renewal and experimentation for this publication. And now, as the AIHP moves into its 85th year, the journal will continue to evolve, just like community pharmacy has. Stay tuned!