Jennifer Riley, Executive Director of Patients Come First Pennsylvania, emphasized the need for stricter oversight and transparency regarding pharmacy benefit managers (PBMs) in Pennsylvania. She said that reforms are necessary to prevent PBMs from undermining local pharmacies and leaving rural communities without adequate care.
“Since early 2020, roughly 1,100 licensed pharmacies have closed, leaving communities with fewer options for prescriptions, vaccines, and basic health care support,” said Riley. “When a local pharmacy closes, residents often face long drives, delayed refills, or skipped doses, creating real risks for people managing chronic conditions. PBMs continue to set reimbursement rates that often fall below the cost of dispensing medications. Independent pharmacists are still filling prescriptions at a loss just to keep their doors open. As pharmacy closures accelerate, Pennsylvania needs stronger enforcement, greater transparency, and broader reforms to ensure PBMs cannot continue practices that undermine the pharmacies rural communities rely on.”
According to an analysis by NBC10 of Pennsylvania Department of State data, the state has experienced widespread pharmacy closures since 2020. More than 1,000 pharmacies have closed across 61 of the state’s 67 counties, creating “pharmacy deserts” and causing delays in care for residents, particularly those without vehicles.
The Federal Trade Commission’s (FTC) second interim staff report revealed that the “Big 3” PBMs—CVS Caremark, Express Scripts, and OptumRx—generated $7.3 billion between 2017 and 2022 by marking up specialty generics significantly. The report also highlighted preferential reimbursement practices for PBM-affiliated pharmacies, which increase pressure on independent pharmacies and raise overall system costs.
Despite ongoing reform efforts, pharmacy closures accelerated in 2025. Data from the Pennsylvania Department of State indicate that approximately 1,100 licensed pharmacies ceased operations from early 2020 to early November 2025. This represents a net loss even after accounting for new openings. Notably, around 500 closures were attributed to Rite Aid’s downsizing; however, independent pharmacies also continue to close their doors.
Patients Come First is a patient advocacy organization committed to ensuring patients receive necessary care without barriers or delays. Led by Jennifer Riley in Pennsylvania, the group focuses on advancing patient-centered policy through advocacy, education, and collaboration.
