GOOCHLAND COUNTY, Va. — As pharmacy deserts present a growing health threat to Virginians, the owners of an independent drug store in Central Virginia are calling attention to a significant issue that they say is putting some pharmacies at risk of closure.
The pharmacists point to middlemen in the industry called pharmacy benefit managers that they say are supposed to work to lower drug prices but actually do the opposite. But representatives for pharmacy benefit managers reject those claims and say pharmacists' concerns should be redirected toward drug makers.
'A huge frustration and disappointment'
When patients enter the Goochland Pharmacy, they expect greetings from familiar faces and personalized service.
The locally owned drug store planted its roots in the community more than four decades ago, and when only two pharmacies are open for business in all of Goochland County, the store's very existence, customers say, is crucial to accessing healthcare.
“It’s very important, very important," said 100-year-old Raymond Cooley, who has patroned the pharmacy since its opening. "They're close to my house, and it don't take long to get here. It’s a beautiful place to come.”
“Why have to drive into town if I can take care of everything right here locally and close by?” another customer told CBS 6.
Co-owners Kelly Corcoran and DJ Johnson said they took over Goochland Pharmacy in 2022 after previously working for a corporate pharmacy. One of the benefits of a running an independent pharmacy, they said, include building relationships with the community through sponsoring sports teams and participating in local events.
“These patients and these customers, they are what keeps us open right now. They are so grateful and so thankful that we are here," Corcoran said.
But Corcoran said keeping the operations financially viable is a constant struggle, at a time when pharmacy deserts are exponentially growing in Virginia.
Earlier this month, the Board of Health declared pharmacy deserts a public health threat in Virginia, adopting a resolution that calls for action and highlights a net loss of 32 pharmacies so far in 2025. State licensing data shows this year, 14 independent community pharmacies have closed their doors while just seven have opened.
Those closures, Corcoran said, eliminate vital services beyond picking up prescriptions.
“Not only are we just a pharmacy, but we look at rashes, they come in for questions, over the counter medications, but we also do strep testing. We do flu testing. We can prescribe antibiotics for strep testing and flu testing if the person is over the age of 18. We can prescribe EpiPens, prenatal vitamins, smoking cessation products," she said.
“What do you see as the biggest challenge of being a pharmacy owner right now?” reporter Tyler Layne asked.
“The biggest challenge of being a pharmacy owner right now is the reimbursements through the insurance companies, and that is directly related to the PBMs," Corcoran answered.
PBM stands for pharmacy benefit manager. A PBM is essentially a middleman company that works with an insurance company to negotiate prices with drug manufacturers and then reimburses pharmacies for dispensing medications to patients.
The problem though, according to Corcoran, is that PBMs oftentimes do not reimburse enough to fully cover their costs.
“We are negative on a majority of our medications," she said.
Co-owner DJ Johnson showed CBS 6 documentation of examples, including one claim that Goochland Pharmacy submitted for $493 for an inhaler.
However, the PBM reimbursed $472.
“We are losing $20.97 in this particular example," Johnson said.
“Do you have to eat that cost at that point?” Layne asked.
“You're either going to eat that cost or you're going to ultimately, unfortunately, have to turn the patient away," Johnson said.
“If you get too many of these, what is the impact to this pharmacy?” Layne asked.
“To this pharmacy, it makes it very creative as far as what you have to do day in and day out to keep the doors open," Johnson responded.
Corcoran said low reimbursements from PBMs have almost become the norm.
“It is definitely a frustration, from a business owner perspective, a huge frustration and disappointment and anger," she said.
Push for change and accountability
PBMs have come under scrutiny in recent years for these very concerns, with attorneys general across the country, including Jason Miyares in Virginia, calling for reform. In a letter to Congressional leaders last year, they said PBMs have made the pharmaceutical market more opaque, have been a cause of rising drug prices, and make it difficult for independent pharmacies to survive by dictating rules and reimbursements.
In a report issued earlier this year, the Federal Trade Commission (FTC) accused PBMs of significantly marking up the prices of drugs and steering highly profitable prescriptions to pharmacies that they own or are affiliated with and away from unaffiliated pharmacies. The industry rejected the FTC's findings as sweepingly inaccurate and based off anecdotal information.
“Those companies tend to steer patients to their own pharmacies and their own organizations against the others. Needs to be a lot more study done into that," said Republican Delegate Otto Wachsmann, who represents parts of Southside Virginia.
Wachsmann is pushing for PBM reform at the state level, an issue that's personal to him after selling the pharmacy that he owned in Sussex County back in 2019.
“My fear right now is that maybe we’ve gone beyond the tipping point," he said.
“What do you mean by beyond the tipping point?” Layne asked.
“Most of the pharmacy owners that I know, they've been running at margins below zero for long enough. They've exhausted a lot of their resources," Wachsmann said. "I'm not sure where new pharmacy owners like Kelly—how many of them are out there that are willing to sacrifice and put that investment into running that store."
That's in part why he supported a measure that passed through the recent General Assembly session and was signed into law that will require Virginia's Medicaid agency to contract with one PBM in an effort to bring more transparency to costs and spending.
Wachsmann said the move is a "great step forward," but more work could be done to hold PBMs accountable though addressing vertical integration since parent companies over PBMs also own insurance companies and/or pharmacies and by putting "teeth" into existing regulatory requirements.
But Greg Lopes, with the Pharmaceutical Care Management Association (PCMA), the trade group that represents the PBM industry, said PBMs are not to blame for the challenges of independent pharmacies.
“What we're seeing through the data and the research is that PBMs are reimbursing independent pharmacies at higher average rates than the retail chain pharmacies that are part of a PBM business," Lopes said.
He points to a study, that was funded by the three biggest PBM companies, that disputes claims that PBMs are squeezing independent drug stores out of business.
The root problem, Lopes argued, lies with manufacturers.
“PBMs are in no way responsible for high drug prices. Only drug companies can set and increase the price of a drug. PBMs exist to lower prescription drug costs," Lopes said.
“So how do you square that with what it seems like a lot of other people are saying," Layne asked. "That PBMs are to blame for rising drug prices?”
“I think a lot of it has to do with the big pharma's ability to spend money on advertising to blame PBMs for the high prices that they set," Lopes said.
Lopes added that some of the complaints about low reimbursements from independent pharmacies could be attributed to the role of what is known as pharmacy service administrative organization, which negotiates reimbursements from PBMs to pharmacies. He said contracts between PBMs and independent pharmacies often include this component.
“Change just has to be made. It has to be made. PBMs have to be held accountable," Corcoran said.
Goochland Pharmacy's hope is continue serving the community for as long as it can survive.
“The passion to be able to do the profession that I love and that I went into 22 years ago is still there," Corcoran said. "I know it's never going to be what it was 22 years ago, but it still is such a huge thing for health care, especially in rural America.”
CBS 6 is committed to sharing community voices on this important topic. Email your thoughts to the CBS 6 Newsroom.
📲: CONNECT WITH US
Blue Sky | Facebook | Instagram | X | Threads | TikTok | YouTube
