Access for All

Lynne Fruth says patients deserve access to safe, affordable pharmacy services

By Lynne Fruth

On October 31, 2022, a judge blocked the proposed merger of Penguin Random House and Simon & Schuster. The decision was based on concern for authors’ compensation and the possible decrease in the diversity of stories that would be published.

Weeks later, another huge company was thrust into the media spotlight after Taylor Swift fans were crying foul over the Ticket Master fiasco. The House Energy and Commerce Committee sent a letter to Live Nation’s CEO Michael Rapino asking the executive to clarify Live Nation’s ticketing process for the upcoming Swift tour and provide a list of actions the company will take to ensure consumers will have better access to live entertainment. Live Nation is the parent company of Ticketmaster.

I love music and good books, and I support the notion that readers and concertgoers should have equal access to the products and services they want. But I can’t get past the idea that overseeing the publishing or the event ticket-selling industry should be more important than providing patients with access to safe, affordable pharmacy services.

Over the years, patients and pharmacies have seen prices go up, while many pharmacies receive reimbursement so low that their businesses are no longer viable. Retail pharmacies are seeing shrinking payments while pharmacy benefit managers and health companies such as CVS/Caremark/Aetna, Cigna/Express Scripts and United Healthare/Optom are experiencing record profits.

When will the FTC, the public and our federal lawmakers realize that we are on a pathway to disaster? In the past three years, many pharmacies have closed. Bartell Drug, a family owned chain, sold out in 2020. Rite Aid announced plans to close 145 stores. Walgreens has closed 200 stores since 2019, and CVS announced plans to close 900 stores over the next three years.

Kroger also announced that it was ending negotiations with ESI and was dropped from ESI Networks. Kroger Health President Colleen Lindholz said the ESI proposal being offered to them was “far out of line with comparable terms Kroger has with all other pharmacy providers, and far outside the industry standard.” This decision will displace thousands of patients who have relied on their local grocer to meet their medication needs, but is it fair to ask a retail pharmacy to provide services below their cost?

As the president of a family owned regional chain that operates 28 stores in Appalachia, I see firsthand the impact of these closures. I receive calls every month from smaller communities asking if Fruth Pharmacy can come into their town. The story is always the same: either an independent pharmacy can no longer survive and has sold the files to a large chain or the CVS/Walgreens/ RiteAid store closed because it no longer fits their business model.

The fact is, profitable stores in affluent America will not be the ones closing. I believe the pharmacy closures will impact two distinct areas: the urban poor and the rural communities, disproportionately impacting black, brown and poor communities.

If you think healthcare is expensive now, just wait until our oldest and poorest patients no longer have access to care. PBMs and vertically integrated healthcare companies claim they exist for the purpose of lowering healthcare and prescription costs. If that is true, then why are pharmacy costs to patients, employers and health plans going up sharply while the net cost of medications have gone down?

So what is the value in ensuring that local pharmacies survive? In West Virginia, you can see the results of what local pharmacies accomplished during Covid. We were the first state to vaccinate all nursing home and assisted living patients, and led the way in vaccinating the elderly.

Even after all this, retail pharmacies find themselves begging for a level of reimbursement that will allow our stores to stay in business. Many pharmacies believe that their stores will not survive even two years without relief.

Now is the time for state and federal government to consider what America will look like without the local pharmacy. It’s time to act while the trend can still be altered. Healthcare belongs in every community, even if the large PBMs and vertically integrated healthcare companies don’t agree. dsn pr sspogo om

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