September RxNews: 2275 Closed Pharmacies: Is Your Job Safe?

Are we witnessing the birth of a new era in healthcare, or will pharmacy deserts become the new normal?

Welcome to September’s RxNews, where we break down the game-changing events shaking up the pharmacy world. 

Here's what's making waves this month:

💥 Rite Aid’s Leaner, Meaner Comeback

🚨 Kroger-Albertsons: Merger Mayhem and Pharmacy Deserts

📉 The Great Pharmacy Closure Wave of 2024: Is Your Job Safe?

🔥 PBMs Under Fire: The Fight for Fair Drug Costs

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Great Closure Wave of 2024

📉 The Great Pharmacy Closure of 2024: 2,275 and Counting! 😱

It’s been a brutal year for pharmacies. 

Thanks to the work of Benjamin Jolley, he’s tracked since January 1st 2024, 2,275 pharmacies have closed, leaving 23,000 pharmacy staff without jobs. 💔 

Take Tom Wullstein, owner of Brandon Pharmacy, who reflects: "You do everything right—get a doctorate, open a small business, serve your community—and still, it’s not enough." 😞

The harsh reality is that pharmacies, especially small independents, are struggling to stay open due to low reimbursement rates and rising costs.

📊 Breaking Down the Numbers:

• 1,139 chain pharmacy closures (think CVS, Walgreens, Rite Aid).
• 1,136 independent/small chain closures.
• 298 ownership changes (some good news in the mix, but still challenging).

That’s a 2.8% drop in U.S. pharmacy locations since the start of 2024. 📉

💡 Why Is This Happening?

1. PBM reimbursements are shockingly low, meaning pharmacies lose money on most prescriptions.
2. Specialty drugs eat up all the profits, leaving little for standard prescriptions.
3. Big wholesalers charge independents higher prices than chains, squeezing margins even further.

🏆 What Can You Do? If you care about the future of independent pharmacies, now’s the time to act! Support H.R. 9096 (Pharmacists Fight Back Act) and push for fairer pharmacy reimbursements. Your voice could help save small pharmacies across the country! 💪

Go to this website to spend <5 minutes to support the bill and get your representative to hear! 

P.S. Please subscribe to Benjamin’s substack! This was wonderful investigative journalism that few pharmacists are capable of (or have the time to do).

💬 We Want to Hear from You! Have you experienced or been impacted by pharmacy closures? Share your thoughts! 💌

📢 Rite Aid's Big Comeback: Rising from Chapter 11 Bankruptcy!

After a few rocky months, Rite Aid is back in the game! They’ve officially emerged from Chapter 11 bankruptcy as a private company, making big moves to secure their future. 💼 While they’ve closed stores and trimmed operations, they’re still committed to providing top-notch pharmacy services—just with a leaner team and sharper focus.

What happened?

🏪 Store Closures & Strategic Shifts: Rite Aid bid farewell to hundreds of stores, including all locations in Michigan and almost all in Ohio. 📍These tough decisions were necessary to keep the company afloat, ensuring long-term financial health. It doesn’t make it any easier for the hundreds of people who lost their roles.

💊 Selling Elixir & Cutting Debt: Rite Aid sold its pharmacy benefit company, Elixir, and cut $2 billion in debt. 💸 That’s some serious trimming!

👨💼 New Leadership: CFO Matt Schroeder steps into the CEO role, replacing Jeffrey Stein. Leadership changes like this are part of their strategy to move forward.

💸 Fresh Financing: With $2.5 billion in new financing, Rite Aid has the cash to keep operations on track as they move into the next phase as a private company. 🚀

What’s Next for Rite Aid? Despite the downsizing, Rite Aid remains in the retail pharmacy game. They’re smaller, yes, but more focused and determined to innovate in a challenging landscape.

🚨 Kroger-Albertsons Mega-Merger: Will It Create Pharmacy Deserts?

The $24.6 billion Kroger-Albertsons merger has everyone talking, especially in California, where the Attorney General is asking a critical question: Will this deal create pharmacy deserts? 🏥 With over 3,980 pharmacy locations combined, there are concerns that divesting stores could leave some communities without access to pharmacy services.

Here’s what we know so far:

🔍 California’s Investigation: California Attorney General Rob Bonta is diving into whether this merger could lead to pharmacy deserts, similar to the ones left behind by Rite Aid’s recent closures in Michigan and Ohio.

FTC sueing to block the merger: The FTC began this process in early 2024 and currently the case is on recess until December 2024. Until this is resolved, it’s highly unlikely the merger will ever go through.

🛡️ Kroger’s Commitment: Kroger insists no pharmacy closures will happen, even as they divest up to 650 stores to satisfy regulators. They’ve assured the public that divested stores will still operate pharmacies.

🏪 Similar Challenges, Different Strategies: Both Rite Aid and Kroger are managing closures and community impacts. While Rite Aid had to shrink to survive, Kroger is confident they can expand without leaving pharmacy deserts behind.

💬 What’s Your Take? Will Kroger’s confidence hold, or are we looking at more communities losing access to pharmacies? Let us know what you think

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Fight for Fair Drug Costs

📢 Pharmacy Protest Ignites PBM Debate: Optum Faces Scrutiny A fiery protest outside Optum's Eden Prairie headquarters last week reignited the ongoing debate about pharmacy benefit managers (PBMs) and their role in inflating drug costs and squeezing independent pharmacies. Around 50 people, including pharmacists, gathered to accuse PBMs like OptumRx of driving local pharmacies out of business and hiking medication prices. 💊💰

John Hoeschen, owner of St. Paul Corner Drug, didn’t hold back: "People go without services they need, for their greed," he declared, underscoring the devastating impact PBM practices have on patient care.

OptumRx, part of UnitedHealth Group, defended its practices, claiming they’re helping pharmacies operate more efficiently and offering reimbursement for essential services like medication management and basic needs assistance. 🚑🥗

📉 PBMs in the Hot Seat This protest adds fuel to growing criticism of the PBM industry. A recent FTC study found evidence that PBMs may be inflating drug costs while cutting into independent pharmacies' bottom lines. Meanwhile, Minnesota Attorney General Keith Ellison is pushing for stronger regulation of PBMs. 🏛️

Despite PBMs claiming they foster competition and generate savings, state Sen. Glenn Gruenhagen pointed to a sharp decline in Minnesota’s independent pharmacies—down from 550 in 1996 to just 156 last year. 💔

What’s your take? Is the PBM system broken, or are they just misunderstood? Let’s get the conversation going! 🔥

💊 UnitedHealth to Drop AbbVie’s Humira from Reimbursement Lists in 2025 Big news in the pharmacy world: UnitedHealth Group has announced that starting Jan. 1, 2025, it will remove AbbVie’s blockbuster drug Humira from some of its preferred drug reimbursement lists. Instead, UnitedHealth will recommend lower-cost biosimilars like Amgen’s Amjevita. ⚖️💉

UnitedHealth’s PBM arm, OptumRx, is the last of the big three PBMs to make this move, following similar actions by Cigna and CVS Caremark. Together, these companies control about 80% of the U.S. prescription drug market, so expect this to impact a large number of patients. 📊

🧬 What Does This Mean for Patients? Patients using Humira will still have options, at least until the U.S. FDA grants interchangeable status to the biosimilars (expected in 2025). At that point, pharmacists can swap the biosimilars without needing doctor approval. Until then, patients can still request Humira coverage.

This shift is all about cutting costs. While Humira has been a dominant player, biosimilars are gaining ground fast, with 10 launched just this year. AbbVie has been able to maintain most of its market share so far by securing favorable deals with insurance providers.

📈 Biosimilars on the Rise Biosimilars now represent nearly 20% of the U.S. Humira market, up from just 2.2% earlier this year. Analysts predict this trend will only accelerate as more insurers transition to biosimilars. 💸

What do you think? Is switching to biosimilars a win for patients, or just another twist in the PBM debate? Share your thoughts! 🗣️

💉 FTC Takes on PBMs Over Skyrocketing Insulin Prices The FTC is launching a legal battle against CVS Caremark, Express Scripts, and OptumRx, accusing the PBMs of artificially inflating insulin prices. 🚨 The FTC says these PBMs used unfair rebate practices to prioritize higher rebates from drugmakers, driving up the cost of insulin for millions of Americans with diabetes. 😠

Rahul Rao, deputy director of the FTC’s Bureau of Competition, didn’t hold back: "Millions of Americans with diabetes need insulin to survive, yet... their insulin drug costs have skyrocketed over the past decade thanks in part to powerful PBMs and their greed."

The lawsuit claims that these PBMs — which manage about 80% of U.S. prescription drug plans — have been profiting at the expense of patients, leaving many with higher out-of-pocket costs.

💊 PBMs Push Back Unsurprisingly, the PBMs are defending themselves. CVS Caremark touted its success in making insulin affordable, noting that its members pay less than $25 for insulin on average. OptumRx called the FTC's claims "baseless," pointing out that its clients' insulin costs are down to $18 per month. 💸

Express Scripts accused the FTC of "scoring political points" instead of focusing on protecting consumers. The PBMs argue that they are critical in negotiating lower drug prices and passing along savings to their clients.

📈 The Bigger Picture This lawsuit comes at a time when insulin prices are under intense scrutiny. From 2017 to 2022, insulin prices in the U.S. shot up by 24%, and many Americans pay far more for the drug than patients in other countries. Some are even forced to ration insulin or skip doses due to the high costs, a tragic reality that has sparked outrage across the nation. 📊

Will this lawsuit reshape the pharmacy benefits industry and bring relief to millions of struggling Americans? Or will PBMs continue to dominate the market?

🤔 What’s your take? Will this lawsuit make a difference in insulin pricing, or is it just another chapter in the PBM saga? Let us know! 🗣️

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Pharmacy Heist Bust

💊 DEA Busts Largest Pharmacy Burglary Ring in History 

In a major crackdown, federal authorities dismantled the largest pharmacy burglary ring in DEA history, targeting over 200 pharmacies across 31 states. This Texas-based operation stole powerful prescription drugs like Oxycodone, Xanax, and Adderall, focusing on small, independent pharmacies in rural areas. 😲

Operation #RichOffMeds led to the arrest of 24 more suspects in July, adding to the 18 arrested last November, bringing the total to 42 defendants. These criminals employed tactics like shattering glass and crawling on floors to bypass security systems, clearing pharmacy shelves for illegal sales in Houston. 🚔💉

DEA Administrator Anne Milgram commented, “These criminals even crawled on floors to dodge security, but they couldn’t escape us.” The stolen drugs had an estimated street value of over $12 million. 💰

🕵️♂️ How the DEA Uncovered the Ring The investigation began with a string of pharmacy burglaries in Arkansas between February 2022 and November 2023, revealing a coordinated network of thieves linked to Houston’s 5th Ward gang. Over 200 burglaries nationwide allowed the criminals to distribute opioids and benzodiazepines across the U.S.

💥 Seized Assets & Ongoing Battle The operation recovered 11 firearms, $79,000 in cash, and $510,000 in custom jewelry—all linked to illegal drug sales. However, the opioid epidemic continues to wreak havoc, with more than 81,000 opioid overdose deaths in 2023. The DEA has recorded a sharp rise in pharmacy burglaries, with nearly 900 incidents reported in 2023, causing a loss of 3.8 million doses of controlled substances. 💥

🌿 Challenging Federal Marijuana Laws While the DEA focuses on busting criminal drug operations, some pharmacies are testing the waters of legal but contested areas. In Georgia, Vic Johnson, owner of Living Well Pharmacy, is selling medical marijuana in defiance of DEA warnings. 🌱

Georgia law allows pharmacies to sell low-THC cannabis products, but the DEA insists that pharmacies can only dispense drugs listed in Schedules II-V, excluding marijuana, which remains a Schedule I drug under federal law. 💬

💥 The Conflict Between State and Federal Laws Last November, the DEA sent letters warning Georgia pharmacies not to dispense cannabis, but Johnson is moving ahead, selling products like gummies, tinctures, and capsules from licensed producer Botanical Sciences. 🏪

Although Johnson risks losing his DEA registration, which allows him to sell other controlled substances, he’s willing to take that chance, with those medications making up just 10% of his business. Johnson is banking on federal rescheduling of marijuana to smooth out the conflict. 📉

🚀 Increased Demand for Medical Marijuana Since offering medical marijuana, Johnson has seen a 50% increase in business. Patients appreciate buying cannabis from a trusted pharmacy, where their medical history is known, and purchases are recorded securely. 🧾

As the DEA continues to tackle illegal operations, the growing acceptance of medical marijuana points to a possible shift in pharmacy practice. Could pharmacies soon offer both traditional and cannabis products? 💭

⚖️ What’s Next for Pharmacies? If marijuana is reclassified to Schedule III, pharmacies like Johnson’s could legally sell medical cannabis more broadly. However, FDA approval remains a significant hurdle. Until then, pharmacies continue operating in a legal gray area. Johnson is optimistic: “We’re in a wait-and-see mode, but I believe we’re moving in the right direction.” 🌿

Are curious about the booming cannabis pharmacist career? Click here to watch my in-depth video, where I break down everything you must know to thrive in this growing field!

💬 What’s Your Take? Should more pharmacies embrace medical marijuana despite DEA warnings? How can pharmacies better protect themselves against burglaries? We’d love to hear your thoughts!

We’ve covered a lot of ground, from Rite Aid’s comeback and the pharmacy desert debate to major shifts in the drug market. 💊 

Pharmacy is changing fast, and whether you’re an independent owner or a retail pro, staying informed is key to navigating the waves.

Catch you in the next edition of RxNews, where we’ll continue to tackle the issues that matter most to your career and the profession. 

Until then, stay informed, stay inspired, and stay in the fight. 💪