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Independent pharmacies say they’re being squeezed by shadowy middlemen tied to big health chains
For more than a decade, independent pharmacist Jay Patel has built a close and enduring relationship with his customers, who come to him for help in sickness and in health.
But now there are interlopers: Drug middlemen, companies known as pharmacy benefit managers (PBMs) that influence which medicines can be bought, where to buy them and at what cost.
Patel and other independent pharmacists say their businesses are threatened by the growing influence of these companies, tied to huge health care conglomerates. In a system that is opaque and complex, patients are steered to affiliated pharmacies, such as CVS and mail-order pharmacies, they say. Pharmacists face high fees and low reimbursement rates, so are unable to cover their costs.
That could put Patel — and other locally-owned pharmacists — out of business.
“I want to do what matters to the community. But how long can I sustain this?” said Patel, 48, who owns Savco Pharmacy in San Jose’s West San Carlos neighborhood. “We are at their mercy.”