Local pharmacies fight to stay afloat in sea of chains

A shelf at Stewart's Pharmacy on Mahan Drive. 
Photo Submitted by Kristian Thomas.

Local Tallahassee pharmacies are facing new challenges as chain pharmacies become more numerous.

Calling in a prescription to a Walgreens or CVS seems all too simple today. An automated system might help you fill your order. A day or maybe only hours later — your prescription is filled and can be picked up via drive thru.

To some that may be the more convenient option, while others go to smaller pharmacies catering to the medical needs of the community. No automated calls or drive through — only a consistent pharmacist, a known entity who cares for a patient’s medical needs.

This rings true for Economy Drug Store. Located on Macomb Street just north of Tennessee Street, it has been a service to the community since the early 50s, says pharmacist manager Alexis Roberts McMillan.

She said chain pharmacies pose an ongoing challenge to community drug stores.

“It’s very difficult to compete because we find that everything that used to be an item you would find in a local pharmacy, independent small pharmacy you can now find in the grocery stores and the big box places,” said McMillan.                              

McMillan says the competition is real but there are still unique things that the big chains don’t carry that customers want. At times big box pharmacies send their customers to them.

“They know the kinds of things people ask about. They’ll call and ask —‘Do you still have Turpentine or Father Johns cough syrup?’ that they may have grown up with,” McMillan said.

Leah, an employee of one of the major pharmacy chains who asked that her last name not be used, said, “I can see why it’s hard for them (community pharmacies); one of our stores is on every corner.”

Although this is a factor, Danny Jackson, owner of Stewart’s Pharmacy since 2012, says pharmacy chains aren’t the only problem. Pharmaceutical Benefit Managers or PBMs “are the biggest threat to the independent pharmacy,” Jackson said.  

PBMs work with insurance companies and pharmacies to determine benefits under health plans as well as pay drug claims. PBMs are under the umbrella of the lobbying Pharmaceutical Care Management Association. One of their four main goals is to “lower pharmacy costs for America’s employers and consumers.”

But for community pharmacies they are playing a game of how low can you go, when looking at the profit from a particular claim. Jackson explains a bit of the process.

“I have a contracted rate, and they will pay me above that rate when I submit the claim. Unbeknownst to me six months later they come to recoup what they consider to be an overpayment. It’s hard to budget a business that way and it’s causing a lot of problems.”

When it comes to regulation of PBMs, states have been taking on this concern.  

In March of 2018, Arkansas passed a bill to regulate PBMs and requires them to give reasonable reimbursement to pharmacies or they will lose their license.

As of Jan. 1, 2019, the Florida Legislature introduced HB 351, a bill that would require PBMs to register with the Office of Insurance Regulation. The bill also specifies what PBMs can and cannot do in relation to a consumer prices as well as pharmacist reimbursement.

With this regulation, the state hopes to see a fair playing field between community pharmacies and big chain pharmacies.