A Pharmacist's View: Trusted community pharmacies being run out of business

From the column: "As small, local businesses, we are facing mounting pressures that are forcing many community pharmacies to close — for good."


As Minnesota and the rest of the country gain greater control over the COVID-19 pandemic, the role of independent community pharmacists grows ever-more important. With vaccine eligibility finally reaching all adults over 16, many of us are helping to administer vaccine doses to help the country reach herd immunity as fast as possible. And this comes after over a year of providing care to families and neighbors across communities as our nation faced the worst health crises in many of our lifetimes.

Community pharmacists in Minnesota have always been dedicated to caring for patients. It is fundamental to our business. Whether operating in densely populated cities or rural towns, we develop individualized care plans for our patients in coordination with health professionals. Not only that, we are seen as accessible and approachable, and we are close by for patients in nearly every community nationwide.

But, as small, local businesses, we are facing mounting pressures that are forcing many community pharmacies to close — for good. With increased competition from large pharmacies and complexities within the pharmacy market, we are losing steam.

Moreover, pharmacy benefit managers, or PBMs, the middlemen in charge of controlling prescription-drug prices, are squeezing our profits, failing to reimburse us properly, and increasing fees.

PBMs steer patients away from their local pharmacies by forcing patients to use PBM-affiliated pharmacies and mail orders while offering lower or no copayments. This might prohibit a patient from getting any refills from a local pharmacy paying in cash. Patients are losing the right to choose their pharmacy and health care provider.


These multibillion-dollar corporations have become bloated with influence, and their control over the prescription-drug market is immense. Unfortunately, independent community pharmacists are forced into bad deals with PBMs that end up hurting our businesses and customers, which limits access to prescription medications and drives up costs.

That is why some pharmacies turn to pharmacy services administrative organizations, which help small pharmacists navigate the administrative process of communicating and working with third-party payers and PBMs. The organizations also raise our voices and interests during one-sided contract negotiations with PBMs. Being part of a pharmacy services administrative organization allows me the opportunity to focus on patients instead of getting bogged down by the administrative complexities and unfair practices of PBMs.

For the first time, lawmakers have recognized the skeptical practices of PBMs, with the Minnesota House and Senate introducing bills to increase transparency and lessen their power and hold over the market. If passed, the legislation would be a good step toward protecting Minnesota’s community pharmacists and making care more accessible and better for our patients. However, in true form, PBMs are trying to fend off regulation in an apparent attempt to shield their profits at the expense of pharmacists and our patients.

Unfortunately, in some areas across the country, they have even begun attacking pharmacy services administrative organizations, claiming that these critical organizations are responsible for the lack of transparency within the drug-pricing market. This could not be further from the truth.

The reality is that pharmacy services administrative organizations have no control over the prescription-drug prices consumers see at the pharmacy counter. Instead, they help independent pharmacists survive in the PBM-controlled marketplace and focus on patient care.

Independent pharmacies are incredibly important to communities across Minnesota. We provide the most trusted care to our patients and constantly put them above all else. In order for my colleagues and I to continue being this symbol of health for our communities, we need protection from the dangerous actions of PBMs.

Deborah Keaveny is the owner of Keaveny Drug in Winsted, Minnesota.


Deborah Keaveny.jpg
Deborah Keaveny

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