Geographical access refers to the distance patients must travel or the time they need to go to the nearest pharmacy. Geographical access depends on the number and location of pharmacies. In rural areas the proportion of the population that lives within a radius of 5 km of a pharmacy may be taken as indicating geographical access, but this is often complex to measure. A pharmacy in a locality where there is no prescriber is of little use, so the presence or absence of pharmacies associated with health services should then be taken as an indicator (Table 9).
Optimizing geographical access must balance the extra cost of pharmacies serving small populations against the cost to those populations of travel to more distant pharmacies. To finance these extra costs, subsidies need to be established by the government, by local authorities, or by taxes on pharmacies in the large cities.