Opinion: PBMs closed my pharmacy: It’s time for PA lawmakers to act

For years, Vine Pharmacy in Benton wasn’t just my business; it was my life’s work and a cornerstone of our community in Columbia County. I opened my doors in 2018 to do what pharmacists like me are trained to do: care for people, answer questions, catch medication errors and make sure my neighbors had access to the treatments they needed. I wasn’t looking to get rich. I just wanted to serve.

In April 2025, seven years after opening Vine Pharmacy, I closed those doors for the last time.

Mine is just one of more than 1,100 pharmacies that have closed across Pennsylvania since 2020. And if nothing changes, more than 200 additional pharmacies are at risk closure in the next six to 12 months. This is not a series of isolated failures. It’s a system-wide collapse — and it’s creating a pharmacy desert crisis across the commonwealth.

You can see it for yourself. Pennsylvanians for Pharmacy Access, a coalition of pharmacists, healthcare providers and other stakeholders, has created an interactive map that shows just how widespread this crisis has become. It’s eye-opening. You can search by address to see what’s happening to pharmacies near you. Urban, suburban and rural communities are all affected. No community is immune.

When Vine Pharmacy closed, my patients were left scrambling. Some now rely on mail-order prescriptions while others must travel 20 or more miles to the nearest pharmacy. That may not sound like much to some, but for elderly patients, working families or those without reliable transportation, it’s a serious barrier to care.

The consequences are real: missed doses, delayed treatments, worsening chronic conditions and fewer opportunities for preventive care. Pharmacists do far more than count pills. We provide vaccines, medication counseling, emergency refills, and support for managing diseases like diabetes and hypertension. When a pharmacy disappears, so does that access to care.

So what’s driving this crisis? Pharmacy benefit managers, or PBMs — the powerful middlemen that control prescription drug benefits.

PBMs sit between health plans, drug manufacturers and pharmacies. In theory, they’re supposed to negotiate lower drug prices and streamline the system. In reality, they often reimburse pharmacies at rates far below what it actually costs to purchase medications. No business can survive selling products at a loss.

On top of that, PBMs impose unpredictable “clawback” fees after prescriptions are dispensed, making it nearly impossible to operate sustainably. They also engage in spread pricing, which means they charge health plans more than they reimburse pharmacies and pocket the difference. Millions of dollars flow through this system with little transparency or accountability.

What we need is PBM reform, and Pennsylvania lawmakers have an opportunity to act. House Bill 2270 and Senate Bill 1186 offer a path forward by establishing a single PBM model for the state’s Medicaid program. These bills would ban spread pricing, increase transparency and prevent PBMs from steering patients to pharmacies they own, a predatory practice that limits patient choice.

That’s a critical start, but more must be done.

We need to raise the Medicaid dispensing fee to reflect the true cost of safely providing prescriptions. We need fair reimbursement for all pharmacies, not just those owned by PBMs. We need to guarantee payment for pharmacist-provided clinical services, which expand access to care and improve health outcomes. And, most importantly, we need transparency. Right now, PBMs operate behind a curtain, handling millions of taxpayer dollars with little oversight. That has to change.

The bottom line is simple: it cost more to run my pharmacy than I was being paid to provide care. No business, no matter how dedicated, can survive under those conditions. Closing Vine Pharmacy was devastating — not just for me but for the patients who relied on us, the families who trusted us and the community that counted on us every day.

If we don’t act now, more communities will feel that same loss. We can’t let this happen again.

Charlotte Moss
Pharmacist at Shade Mountain Pharmacy, Mount Pleasant Mills, and Trutt’s Pharmacy in Mifflinburg
Former owner of Vine Pharmacy