"...But the main problem...is simple: They’re no longer getting paid enough to stay in business. In the multifront battle to cut costs in America’s expensive health care system, pharmacies say they are shouldering a disproportionate...burden.
“That traditional model of that corner drugstore that is just dispensing prescriptions is very difficult, if not impossible, to make work these days,” says Oftebro, adding that at his pharmacies, “reimbursement on the majority of prescriptions is now at or below the acquisition cost of the drugs.”
For this, many blame the middlemen: the pharmacy benefit managers. The three largest PBMs are owned by or affiliated with insurance companies—CVS’s Caremark (which shares a corporate parent with Aetna), UnitedHealth’s Optum Rx, and Cigna’s Express Scripts—and together they control how 80% of all U.S. prescriptions are processed..."