We have been in business for
over seventy years.
The local drugstore was once
upon a time a staple in communities
across the country.
We look at our financials
every month and it's scary
and we think about how how
long can
We last.
Today, whether it's the local
drugstore or a chain pharmacy,
the brick and mortar presence is
dying. The feasibility of
having an independent pharmacy is
Nicole Schreiner is the new CEO
of Struze Pharmacy in Green
Bay and president-elect on the
board of the Pharmacy Society of
Wisconsin.
We've
Alongside her commitment to the
mission, she takes on her new dual
roles in one of the most challenging
times for pharmacies.
From 2010 to 2021,
30% of drugstores in
the U.S. Closed.
Last year alone, 2,300
pharmacies closed, half of
them being independent or mid-sized
businesses.
It's creating an access issue
for patients.
We oftentimes talk about in rural
areas, you know, patients
having to travel, you know, perhaps
twenty miles to find a pharmacy
that would be able to provide their
medications.
And but we're having that
even in urban
In city areas For some,
a visit to the pharmacy is a quick
stop, picking up one or two
prescriptions.
But for many patients, it's much
more than that.
Your pharmacist a lot of times
will be a critical
component of your medical care
team.
Senate President Mary Velzkowski
authored legislation trying to help
local pharmacies keep their doors
open.
We saw our small independent
pharmacy starting to go out of
business in rural
Wisconsin.
When it may take months for a
patient to get a clinic visit.
Pharmacists say they bridge
that gap, available for anyone
to walk in and ask questions at
any time.
And prevention leads to healthcare
savings.
For patients with asthma, we did
a study with the Pharmacy Society of
Wisconsin and showed that when they
sat down with the pharmacists on two
30 minute interventions,
that they reduced the number of ER
visits, the number of
hospitalizations.
These things are making a difference
in overall reducing healthcare
dollars spent.
Like with most retail stores, it'd
be reasonable to assume that
internet sales are putting
pharmacies out of business.
And while mail order and online
retailer giants like Amazon
do compete with onsite service,
advocates diagnose a much
deeper and chronic issue.
PBMs, pharmacy benefit
managers, have been around for a
very long time.
Pharmacy benefit managers
or PBMs act as
middlemen between drug
manufacturers, wholesalers,
providers, insurance
companies, and pharmacies.
And they've monopolized and they've
gotten in between prescribers
and the delivery of drugs, driving
up the cost of drugs instead of
lowering them.
The three largest PBM companies
accounted for eighty percent of
prescription claims last year.
They'll claim that they negotiate
with drug manufacturers and
pharmacies reduce overall
prescription drug costs.
However, despite these claims, PBMs
regularly inflate what patients pay
and force pharmacies to operate a
loss.
It's become very powerful
and independent pharmacies like
myself have no negotiating
power anymore with
these PVNs.
The impact of PVMs that
PVMs are having on rural pharmacy
s is staggering.
The legislation takes aim at a
number of their practices,
including not allowing patients
to fill prescriptions at certain
pharmacies.
PBMs dictate where
prescriptions can be filled.
Punitive audits against pharmacists
who inform patients of lower cost
options.
What to charge a patient?
And perhaps the biggest of all for
pharmacies.
What they will reimburse the
pharmacy.
Рімберсинг медикайш
боло кост.
And when they'll pay the pharmacy.
Forcing them to take losses.
At a Senate Health Committee
hearing, numerous local pharmacies
attested to this issue.
That my pharmacy is currently
operating in the red right
now, solely due to PBM
reimbursement rate.
Margins estimated to PBMs
have increased by forty six percent,
and during the same time margins
to pharmacies have decreased by
forty seven percent.
The contracts have become basically
take it or leave it.
They've continued to erode
year after year after year.
And it's estimated that independent
pharmacies, depending on your
particular location in the country,
can have anywhere from twenty to
forty percent of their claims are
actually reimbursed below cost.
But not all health industry experts
agree.
We believe all these provisions will
be associated with increased costs
to health plans and sponsors.
Those in opposition to the bill,
such as health insurers, say
it will increase prices for health
plans, employers, and patients.
The exorbitant cost of drugs,
they say, begins with the drug
manufacturers.
Instead of taking away the few tools
and health plans and employers used
to address ever creasing drug
prices, the legislature should focus
on fixing the market distortion
caused by drug manufacturer pricing
schemes.
Work very hard on showing them
through data from other states that
have allowed that, have the same
legislation where it's actually
lowered the cost of healthcare.
Whatever the cause, the impact
on the patient is real,
like the ability to obtain diabetes
medications.
GLP ones, those some
pharmacies are just choosing not to
carry them because they get
reimbursed below their cost.
Or having your insurance accepted.
Some pharmacies are choosing not to
carry particular plans because of
the poor reimbursement.
Every day in my pharmacy, I
witness patients facing exorbitant
copays, sometimes exceeding
five hundred dollars for
medications they cannot afford.
These patients are confused,
they're overwhelmed, and they're
forced into impossible decisions
about their health.
For a patient having to fill
prescriptions at multiple pharmacies
The consequences can cause
Recently, when interviewing a
patient, we learned that they had a
duplicate prescription.
The it was at another pharmacy
from a different doctor.
If they had gone home and taken
both, they would have needed
emergency care and it could have
been fatal.
From the extremes of the pandemic,
Yeah. To the work they do every
day. Independent pharmacists
say their commitment is to their
community.
What happens if PBMs continue to
drive us out of business?
Who will step up during this crisis?
Who's gonna be doing seven day a
week testing?
Who's gonna deliver meds late at
night for a hostice patient?
Who's gonna get a call at two AM?
I just got that last week.
It won't be a mail order pharmacy in
another state that's doing that.
Being able to provide that service
to patients and to be
part of making sure that they are
taken care of is really what we
wanna ultimately do.
Reporting from Green Bay, I'm
Marissa Wochek, for here and
now.