The results of this study indicate that the Gini coefficient of the distribution of pharmacies in different provinces of Iran has decreased over time, indicating an improvement in the distribution of pharmacies for different population groups throughout the country. Similar results have been obtained in separate studies conducted in different provinces. For example, in a study conducted in 2010 on the distribution of pharmacies in Kerman province, the Gini coefficient was found to be approximately 0.4. According to the results obtained, the Gini coefficient showed a decreasing trend during the years under study[9]. In other studies conducted in 2010, a relatively similar Gini coefficient was reported for western provinces such as Lorestan and Kermanshah[2, 5]. Also in some other studies in Iran, the distribution of healthcare specialists, especially pharmacists, in the past years was not acceptable, recent studies, including the results of this study, show an improvement in this regard(1, 9). Therefore, the results of this study, like other studies mentioned, show that the Gini coefficient was not acceptable at the beginning of the study period, which was from 2011. However, the Gini coefficient has decreased at the end of this period, which is in 2021. Therefore, it can be said with greater confidence that the Gini coefficient is decreasing. While there have been various reasons for the decrease in the Gini coefficient in recent years, the most significant reason is the significant increase in the number of pharmacy schools and the acceptance of pharmacy students, leading to a large number of pharmacy licenses being issued by the Food and Drug Administration of the provinces for pharmacy graduates across the country, resulting in increased access to medication for the public [15–18]. Additionally, the generic-based drug system in Iran has led to an increase in domestic drug production by more than 90%,[19–21] which has created a high capacity for employment and utilization of pharmacy students and the issuance of pharmacies in cities across the country[22, 23]. As a result, all provinces and deprived areas have taken advantage of this opportunity, leading to increased access to drugs and pharmacies for people in these provinces.
In this regard, in other developing countries, a study assessed equity in the geographical distribution of community pharmacies in South Africa in preparation for a national health insurance scheme. The study found that community pharmacy density was higher in urban provinces, and maldistribution persisted despite the growth of corporate community pharmacies. Experts expressed concerns that a lack of rural incentives, inappropriate licensing criteria, and a shortage of pharmacy workers could undermine access to pharmaceutical services, especially in rural areas[4].also a study examined the trend in the distribution of primary healthcare professionals in Jiangsu province of eastern China. The study found that the number of health workforces increased every year, and the inequality in the distribution of health workforces showed a decline to 2012. There was a disproportionality between physicians and nurses, and the values of three inequality indicators based on area were larger than those based on population[8]. So the results highlight the importance of the allocation and distribution of health resources in developing countries, given the scarcity of these resources. Policymakers and health officials should review the optimal distribution of scarce resources. Additionally, the lack of access to specialized pharmacists in most underdeveloped city pharmacies contributes to the lack of justice in individuals' and patients' access to pharmaceutical services. Proper access to pharmaceutical services, including pharmacies, promotes the improvement of health.