Tuesday, January 25, 2022

Rural residents struggling with pharmacy closures

National Public Radio reported on this phenomenon this week, with a focus on Oregon.  
SCOTT SIMON, HOST: Americans have been going to their local pharmacy for more than just prescriptions during the pandemic. They've been going there for masks, COVID-19 tests and vaccines. But even with that increased business, retail pharmacies, big and small, are closing their doors. Oregon Public Broadcasting's April Ehrlich reports that these closures are straining small towns where options were already limited.

APRIL EHRLICH, BYLINE: Lisa Raffety has rheumatoid arthritis and needs to take an anti-inflammatory medicine every day. If she can't get it on time, the consequences are severe.

LISA RAFFETY: I'll go two to three days at the most, and then I'm pretty much - I can't walk.

EHRLICH: She lives in Baker City, a small town in eastern Oregon that had one of its four pharmacies closed last year. Fifty-five-year-old Raffety says, since then, lines at the remaining pharmacies started going out the door.

RAFFETY: And it hurts to stand for any length of time, to be on my feet. It's a hard, cement floor.

EHRLICH: Raffety says some people bring their dinners and eat them in line. Store clerks have to bring out wheelchairs for people who can't stand that long. Last year, the Pacific Northwest retailer Bi-Mart announced it was getting out of the pharmacy business, closing nearly 60 pharmacy counters in three states. Many of them were in rural areas.

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Bi-Mart's spokesman Don Leber says there are several factors that went into the decision to close its pharmacies.

DON LEBER: We were really forced to make a decision we never wanted to make.

EHRLICH: He says one big issue is affecting pharmacies across the country - increasing fees, specifically from the middlemen that bridge pharmacies and insurance companies, called pharmaceutical benefit managers, or PBMs. Oregon Senator Ron Wyden has had his eye on these companies recently, which he says are charging excessive fees that are pushing smaller pharmacies out of business.

RON WYDEN: For rural communities in Oregon, this is a five-alarm emergency.

EHRLICH: Basically, when someone gets a prescription through an insurance or Medicare plan, the PBM is supposed to reimburse the pharmacy for the drug cost and some overhead. But in recent years, PBMs started decreasing the amount they reimburse when pharmacies don't meet certain sales markers. Wyden has called on Congress to increase its oversight of pharmaceutical benefit managers. And some states like New York have started regulating PBMs at the state level.

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