SpotlightPA – Online Article – December 1, 2025 – Pennsylvania pharmacy closures PBM reform

Pharmacy closures across Pennsylvania are accelerating — and lawmakers from both parties are now questioning whether the state’s 2024 PBM reform law is delivering on its promise.

Act 77 was designed to protect community pharmacies by increasing oversight of pharmacy benefit managers (PBMs) and curbing practices that critics say drive up drug costs and squeeze independent pharmacies. However, more than a year after its passage, hundreds of pharmacies have still closed, leaving patients with fewer options and longer delays.

What Act 77 Was Meant to Fix

When Governor Josh Shapiro signed Act 77 into law, he blamed PBM “greed and conduct” for pharmacy closures and rising drug costs. The law aimed to improve fairness by:

• Limiting patient steering to PBM-owned pharmacies

• Restricting clawbacks, where patients are charged more than a drug’s cash price

• Expanding transparency, including reporting on rebates and fees

• Giving the Insurance Department more oversight of PBM practices

Supporters hoped these changes would stabilize pharmacies and protect patient access.

Why Closures Are Still Happening

Despite the new law, pharmacies continue to struggle. Since 2020, more than 1,100 Pennsylvania pharmacies have closed, with hundreds shutting down after Act 77 became law. While Rite Aid closures account for many losses, independent and small pharmacies are also disappearing.

Lawmakers say the problem lies in limited enforcement and narrow coverage. Act 77 only applies to about 24% of the insurance market, covering certain fully funded commercial plans. It does not apply to Medicaid, Medicare, or many out-of-state plans — leaving major gaps.

As Senator Judy Ward put it, “Some of the things we thought Act 77 would clear up are not.”

Ongoing Concerns from Lawmakers and Pharmacists

In a bipartisan letter to the Insurance Department, six state senators warned that pharmacies still face:

• Unsustainable reimbursement rates

• Predatory PBM practices

• Operational pressures in rural and underserved areas

Pharmacists have told lawmakers that patients are going days without essential medications while staff scramble to transfer prescriptions and contact providers.

Meanwhile, PBM trade groups deny responsibility, arguing closures stem from drug manufacturer pricing, online pharmacy use, and population shifts — not PBM behavior.

What Comes Next

State regulators say Act 77 is rolling out gradually, with major provisions taking effect in 2026. Annual PBM transparency reports are due next year, and studies on patient steering and spread pricing are underway.

Some lawmakers see Act 77 as a first step, not a final solution, and are calling for stronger enforcement and additional reforms at both the state and federal level.

Why This Matters for Patients

Every pharmacy closure means longer travel times, delayed prescriptions, and reduced access to care — especially for seniors, injured workers, and rural communities.

At RescueMeds, we see these impacts firsthand. Pharmacy access isn’t just a business issue — it’s a patient care issue. Transparency, fair reimbursement, and accountability are essential to keeping medications accessible when people need them most.