Ohio Capital Journal – Online Article – November 26, 2025 – Ohio pharmacy closures PBMs

The wave of pharmacy closures across rural America continues. Fruth Pharmacy, a regional chain that once operated more than 20 locations across southeastern Ohio, West Virginia, and Kentucky, has announced it will close and transfer prescriptions to Walgreens next month.

For many small communities, this closure is more than a business change — it deepens the growing crisis of pharmacy deserts, where patients must travel long distances just to access essential medications.

PBMs and the Pressure on Independent Pharmacies

Fruth Pharmacy’s leadership has long warned about the role of pharmacy benefit managers (PBMs) in accelerating pharmacy closures. PBMs — owned by corporate healthcare giants like CVS Health, UnitedHealth Group, and Cigna-Express Scripts — control nearly 80% of prescription drug transactions nationwide.

These PBMs also own insurance companies and pharmacies, giving them the power to:

• Decide which drugs insurance plans cover

• Set reimbursement rates for pharmacies

• Favor their own affiliated pharmacies over competitors

According to Fruth President Lynne Fruth, this creates a clear conflict of interest. When PBMs reimburse pharmacies less than the cost of the medication, independent and small-chain pharmacies cannot survive.

A Cyberattack That Accelerated the Collapse

While PBM pressure had strained Fruth Pharmacy for years, a 2024 ransomware attack on Change Healthcare, a UnitedHealth-owned company, delivered the final blow.

The attack halted prescription processing across the country. For Fruth, it meant:

• No prescription fills for six days

• No electronic prescriptions for another week

• Delays in controlled substance prescriptions

During that short disruption, the company lost 15% of its customers, many of whom never returned.

The Growing Impact on Rural Communities

Fruth’s closure follows 223 other Ohio pharmacy closures last year, dropping the state’s total below 2,000 pharmacies for the first time in memory.

For patients in towns like Wellston, Ohio, losing a local pharmacy means traveling 10 miles each way to the nearest Walgreens — a serious barrier for seniors, low-income residents, and those without reliable transportation.

In many rural communities, pharmacists are often the most accessible healthcare professionals, helping patients manage chronic conditions like diabetes and high blood pressure.

Walgreens, Private Equity, and an Uncertain Future

Fruth’s prescriptions are transferring to Walgreens — a chain facing challenges of its own. Walgreens recently announced its sale to private equity firm Sycamore Partners, raising concerns about future store closures and aggressive cost-cutting.

Meanwhile, federal scrutiny of PBMs continues. Earlier this year, the Federal Trade Commission accused major PBMs of inflating drug prices and steering patients toward affiliated pharmacies. However, leadership changes at the FTC have slowed momentum.

Why This Matters

Pharmacy closures are not isolated events. They are the result of systemic pressures driven by PBM reimbursement practices, consolidation, and lack of transparency.

At RescueMeds, we see firsthand how pharmacy access impacts patient care — especially for injured workers and underserved communities. Without reform, closures like Fruth’s will continue, leaving patients with fewer choices and longer delays.

Protecting pharmacies means protecting patients.