Pharmacies Vanishing: Why Pennsylvania Must Act Fast

Pennsylvania is losing more than a thousand pharmacies since 2020, turning towns and suburbs into “pharmacy deserts. ” When a pharmacy closes, residents must drive farther for medicine, vaccines, and advice from trusted experts. Missing doses or delayed treatment can lead to serious health problems. The problem is real and growing. A group called Pennsylvanians for Pharmacy Access has mapped out which communities are most at risk. The map shows that if 213 more pharmacies shut down, the gaps in coverage will widen dramatically. One key culprit is pharmacy benefit managers (PBMs). These middlemen sit between health plans, drug makers, and pharmacies. They often pay pharmacies less than the cost of the drugs they sell, a practice known as spread pricing. PBMs also push patients toward their own owned pharmacies and add hidden fees, leaving community shops with little profit. Even though Medicaid enrollment in the state hasn’t dropped, prescription spending has jumped from $1. 4 billion in 2013 to $4. 6 billion in 2022. The money isn’t going to patients, pharmacies, or the state; it’s ending up in PBM pockets.To stop the crisis, Pennsylvania needs immediate reforms. First, raise Medicaid dispensing fees to match federal standards so pharmacies can cover the full cost of safe medication delivery. Second, ban spread pricing and require PBMs to reimburse all pharmacies fairly, with clear price lists. Third, pay pharmacists for clinical services like shots and health checks, which can reduce hospital visits. Fourth, stop PBMs from steering patients toward their own stores. A bipartisan bill, Senate Bill 1186, proposes a single pharmacy benefit administrator for Medicaid. This would give the state clear rules and accountability, preventing PBMs from setting their own terms. Pennsylvania has a chance to set an example. If the state acts now, it can keep pharmacies open and ensure residents have local access to essential medicines. Waiting for federal changes could mean more closures and fewer choices for communities.