02/24/2026
Day in and day out this is what independent pharmacies are dealing with.
Reimbursements that barely cover the vial and label, not including the drug, the pharmacist, the technicians, the software, and the general cost of operation. Pharmacies cannot and will not survive with reimbursements like these, especially when we are losing at minimum $20 on brand names.
Change needs to happen on a state and federal level. Pennsylvania is behind as usual and the changes are not happening fast enough
act
Today one of my technicians spent several hours making phone calls between an insurance company, doctor's office, home health agency, and mail order pharmacy trying to figure out where one of our patient's medications had been filled. We had tried to fill the medication here, but the insurance sent us a rejection back saying it had been filled somewhere else recently, so we couldn't fill it.
To make a long story short, we finally discovered that this patient had been signed up to get his prescriptions through the mail by his home health agency and that is who had in fact filled his medication. He didn't really understand what he was signing up for when this service was recommended, so he was very confused and upset when we initially told him that a different pharmacy had filled his medications.
See, we deliver to this patient almost every week. He is an elderly Vietnam veteran who lives alone and counts on our pharmacy to hand deliver his medications when they are needed. He has no means of transportation and a limited understanding of his medication regimen. He trusts us and, truly, I think he just enjoys the company when he gets to visit with our delivery driver and when he talks to us on the phone. So we had a pretty good hunch that going to a mail-order pharmacy either wasn't his idea or he just didn't understand what he was signing up for when we figured all of this out today.
After those many phone calls and time spent, we were finally able to process his prescription and get it delivered to him. I was so thankful to my technician who spent the time today to do this, and I know this patient was thankful, too. All of that work for a happy ending, right?
While yes, it was wonderful that we could get this figured out for him and get him his medication, the sad part is what came when I looked at what his insurance reimbursed our pharmacy for filling this medication -- $0.45.
Forty-five cents.
Hours spent, medication purchased, materials used, delivery made, worries calmed. And I have $0.45 to show for it.
THIS is why independent pharmacies feel like they are constantly stuck between a rock and hard place. On one hand, we have the duty to our patients to provide them with the best care possible. On the other hand, we have to think about if going the extra mile and doing our job is actually profitable. It shouldn't have to be one or the other. But in today's independent pharmacy world, it is.
THIS is why independent pharmacists and pharmacy owners can't sleep at night. Because the burden of these decisions is often too much for one to carry, especially when you feel like no one is listening and no one is helping.
THIS is the reality for community pharmacies across the country in 2026. And we are just hanging on and praying for the help we need so that we can do our jobs and take care of the people who trust us with their care. 💙
