By Arianna Ashby

The relationship between workers’ compensation and pharmacy services is facing a critical juncture. For the last several years, retail pharmacy trends have reflected upheaval, and in the past year fresh challenges have emerged, further complicating the situation. Due to this pattern, there is concern of reliability surrounding retail pharmacies and their ability to serve the workers’ compensation industry in 2024 and beyond.

Retail Pharmacy Closures

While drugstore chains have historically saturated US cities, suburbs and even small towns, retail pharmacy chains have been consistently announcing the closure of thousands of retail stores in recent years. The majority of retail pharmacy sales come from filling prescriptions, but profits have declined due to lower reimbursement rates for prescription drugs. Additionally, front end sales, where household staples are sold, also face rising competition from other big-box stores.

At the start of 2023, Walgreens and CVS began closing many of their locations. In October, Rite Aid, the third largest standalone pharmacy chain, announced they were filing for Chapter 11 bankruptcy protection and would close roughly 400 to 500 of their 2,200 store locations. Pharmacy closures have been linked to health risks, such as medication non-compliance in older patients. Given the increasing retail pharmacy closures, there is also growing anxiety around pharmacy accessibility.

The Retail Pharmacy Business Model is Broken

As evident by the growing number of pharmacy deserts, the retail pharmacy business model is largely a broken one, dependent upon volume and relying on hitting corporate sales quotas. The primary responsibility of pharmacists and pharmacy technicians revolves around patient care—a commitment held in such high regard that pharmacists take an oath to serve patients and ensure their safety when preparing and dispensing medication. However, the retail pharmacy business model’s emphasis on volume and quotas diverts pharmacy staff toward other services like administering vaccinations and pushing membership sales, detracting from their essential role in medication dispensation and patient-focused care.

According to Neil Welch, PharmD RPh, Senior Director of Clinical Operations at Injured Workers Pharmacy, a pharmacist’s training places a significant emphasis on patient care. However, within the retail pharmacy industry, the prevailing conditions often prevent staff from dedicating adequate attention to the patients. “Ultimately, these conditions severely impact patient service and well-being, particularly among injured workers,” says Neil, “Traditionally, retail pharmacists in this sector have lacked knowledge about workers’ compensation. Yet, due to these circumstances, they now also lack the time to acquire this expertise.” Retail pharmacy pressures have contributed significantly to staff burnout and have created additional unrest in the industry.

‘Pharmageddon’ Protest

The nationwide ‘Pharmageddon’ protest has emerged as a grassroots movement organized by retail pharmacists and technicians dissatisfied with the working conditions at the major retail pharmacy chains. The first staff demonstration started in September 2023, when a group of pharmacists and technicians from CVS in the Kansas City area staged a walkout. The key issues highlighted by protesters encompass understaffing, overwhelming workloads, undue performance pressures, and concerns regarding patient safety—each of which directly link to the core responsibilities of providing patient care within a pharmacist’s role.

Since September, the protest has grown and spread across the country, impacting other states, including Florida, resulting in delays and, in some cases, closures. Now, pharmacy workers from major chains like Walgreens, Rite Aid, and Walmart, have participated. Support for ‘Pharmageddon’ has been drawn from the American Pharmacists Association, and at least 4,500 participating pharmacists and pharmacy technicians, causing further concerns of retail pharmacy closures and delays. Additionally, the protesters have taken to social media and are launching a unionization movement under trending hashtags like #Pharmageddon and #PizzaIsNotWorking, underscoring the fact that free pizza or other mundane incentives do not adequately address the unrealistic expectations in retail pharmacies.

Traditionally, retail pharmacies have lacked substantial knowledge about the workers’ compensation industry, posing a persistent challenge for injured workers. In recent years, the retail pharmacy landscape has had its own challenges arise, such as staff burnouts, diminishing reliability, and escalating closures of retail pharmacies. These hardships have affected the workers’ compensation industry, where retail pharmacists remain largely inexperienced in the nuances of workers’ compensation. Inexperience in workers’ compensation coupled with closures, staffing issues, and limited accessibility and availability of crucial medication, all pose large hurdles for injured workers. As the workers’ compensation industry navigates these complications, exploring alternative options to retail pharmacies becomes imperative. Considering independent or niche pharmacies, such as Injured Workers Pharmacy, which focus on injured workers and offer dependable and continuous patient care, has become an attractive and viable solution. Unlike retail pharmacies, independent and niche pharmacies prioritize reliability and aim to provide uninterrupted support to injured workers, potentially filling the void left by the shrinking retail pharmacy sector.