****

In the heart of America's Midwest, the recent wave of Rite Aid pharmacy closures is having profound effects on small towns and urban centers alike. Rite Aid announced its bankruptcy filing in October 2023, revealing plans to shutter 800 of its stores nationwide, with Ohio bearing the brunt, losing 180 stores primarily in small towns and Rust Belt cities. The outcome is a growing number of "pharmacy deserts," where residents find it increasingly difficult to access essential medications.

One such community is New Lebanon, Ohio, home to 3,756 residents. This small town, despite having three dollar stores, a Groceryland, fast-food outlets, a public library, and a robust school system, now finds itself without a pharmacy. Following Rite Aid’s closure in September, New Lebanon’s prescriptions were transferred to a Walgreens in Dayton, a 30-minute drive away. New Lebanon Mayor David Nickerson, elected just last year and with a military background, expressed his concerns, noting the inconvenience and potential risk for elderly residents uncomfortable with venturing far from their community.

The closures not only impact convenience but also signal broader financial strains within the retail pharmacy business. Smaller towns near New Lebanon, which may still have their own pharmacies, are also feeling the squeeze as they are typically a 15-minute drive away. For longtime residents like Joyce Dingman, who moved to New Lebanon two years ago when there were three pharmacies, the recent loss of CVS last year followed by Rite Aid means traveling further afield to get prescriptions filled at a Kroger's pharmacy 30 minutes away.

This wave of closures is compounded by broader industry challenges. Fierce competition and decreased reimbursements for medications are threatening the survival of retail pharmacies. Pharmacy benefit managers (PBMs) are under fire, with a new FTC lawsuit alleging inflated drug prices and claims that PBMs drive patients toward their pharmacies while underpaying community establishments. Experts like Miranda Rochol from Prescryptive Health emphasize that PBMs hold significant sway over the industry, often to the detriment of small, independent pharmacies.

Walgreens, which may close as many as 25 percent of its 8,200 stores, shares these struggles but maintains its independence from PBM affiliations. However, the shrinking footprint of large chains like Walgreens and CVS only exacerbates the issue, with CVS also citing changing consumer buying patterns and population shifts for its store closures.

For towns like New Lebanon, the loss of a local pharmacy not only represents a logistical inconvenience but also diminishes the sense of community. Rob Anderson, the acting village manager, lamented how Rite Aid’s departure misrepresents the town’s otherwise positive trajectory, underscoring the community’s yearning for the personalized care that neighborhood pharmacies traditionally offered. As both national chains and independent stores grapple with industry pressures, the human element of healthcare, highlighted by pharmacists’ roles in community well-being, faces an uncertain future.