America’s Pharmacy Crisis: Why Independent Pharmacies Are Closing

Fox 11 News Online Article – November 5, 2025 – Independent Pharmacies Are Closing — How PBMs Are Involved

Across the United States, independent pharmacies are disappearing at an alarming rate, leaving patients without access to trusted care. In Green Bay, Wisconsin, Streu’s Pharmacy will close its retail operations after more than 50 years of service.

For CEO and pharmacist Nicole Schreiner, the decision was devastating.

“One patient said, ‘I’ve been with this pharmacy for over 50 years. I have never gone to another pharmacy in my adult life.’ That was heartbreaking,” Schreiner shared.

Streu’s will now focus on long-term care services. However, this change isn’t about patient demand or poor management. It’s about pharmacy benefit managers (PBMs) — middlemen who control drug pricing, reimbursement, and even where patients fill their prescriptions.

---

How PBMs Became the Gatekeepers

Originally, PBMs were created in the 1960s and 70s to help insurance plans manage prescription benefits and lower drug costs. Over time, though, they transformed into powerful intermediaries that now control almost every transaction between pharmacies, insurers, and patients.

Today, four PBMs dominate more than 70% of the U.S. prescription market. They decide which medications are covered, what pharmacies get paid, and which pharmacies patients must use.

“If you want to bill insurance, you have to work with PBMs,” says Nic Smith, owner of Smith Pharmacy in Little Chute, Wisconsin. “They see all the data, they control reimbursements, and they even decide where prescriptions go.”

This power imbalance leaves local pharmacies with little choice but to accept contracts that pay them less than it costs to dispense medication.

---

When Reimbursement Doesn’t Cover the Bill

Independent pharmacies are not just struggling — they’re losing money every day.
At Smith Pharmacy, some prescriptions cost $100 to fill, but PBMs reimburse as little as $4.

“On one drug alone last year, we lost over $250,000,” Smith said.

Because of these losses, many pharmacies have stopped carrying high-priced medications like GLP-1s for diabetes and weight management. Streu’s faced the same challenge.

“It’s become almost impossible to stay open,” Schreiner said. “We lose money on prescriptions, yet we still have to pay for electricity, heat, and staff. It’s not sustainable.”

Every year, this pattern repeats in thousands of towns across America. As reimbursements shrink, more pharmacies close their doors.

---

The Human Cost of Losing Local Pharmacies

When an independent pharmacy shuts down, patients lose much more than convenience. They lose personalized care, faster service, and a pharmacist who knows their medical history.

As more patients are forced into mail-order pharmacies — often owned by PBMs — medication delays become common.

“If you need an antibiotic after a hospital visit, a mail-order pharmacy can’t help you that day,” Schreiner warned. “They also don’t see your full medication profile, which raises the risk of dangerous drug interactions.”

Independent pharmacists often go the extra mile. Many, like Smith, deliver hospice medication late at night, help families navigate insurance hurdles, and coordinate care between doctors. That personal commitment disappears when corporate PBMs take over.

---

A Broken System Demands Legislative Action

Both Schreiner and Smith believe the only real fix lies in legislative reform. They’re asking lawmakers to rein in PBM power and create fair reimbursement standards.

“We’re not asking to get rich,” Smith said. “We just want fair pay — cost plus 10%. That’s enough to stay open and serve our communities.”

So far, Wisconsin lawmakers have proposed PBM reform bills several times, but none have passed. Without stronger laws, the closures will continue, and communities will lose vital access to care.

Each closure means longer drives, delayed prescriptions, and higher health risks — especially for rural and elderly patients.

---

Why This Matters to RescueMeds

At RescueMeds, we see firsthand how PBM practices disrupt patient care. We serve injured workers, first responders, and families who rely on timely access to medications.

Every day, we work to bridge the gaps created by PBM-driven delays and fight for fairness in workers’ compensation and pharmacy reimbursement.

Pharmacies should not have to choose between serving patients and staying solvent. Reform isn’t just about economics — it’s about preserving access to life-saving medication for everyone.

When independent pharmacies disappear, patients lose their most accessible healthcare partners. It’s time to act before convenience turns into crisis.