Jennifer Riley, Executive Director for Patients Come First Pennsylvania, said that Pennsylvania needs stronger pharmacy benefit manager (PBM) transparency and fair reimbursement standards to stem pharmacy closures and ensure savings reach patients.
“Pennsylvania has already taken steps to address PBM practices. Their market power and lack of transparency have been linked to rising costs and a growing number of pharmacy closures,” said Riley. “Yet pharmacy closures continue, underscoring that current reforms have not gone far enough. Since early 2020, roughly 1,100 licensed pharmacies have closed in Pennsylvania. As a result, patients lose convenient access to prescriptions, face longer travel times and lose trusted relationships with local pharmacists who often serve as a first line of care. Lawmakers are increasingly aligned on the need for greater transparency and fair reimbursement standards so that savings reach patients rather than being absorbed by intermediaries. Pharmacy access is no longer a niche issue.”
According to Riley’s op-ed in PennLive, PBMs, although largely invisible to patients, have a significant impact on formularies, prescription fulfillment locations, and reimbursement rates. She links these pressures to pharmacy closures across Pennsylvania and notes that lawmakers are considering tougher transparency and fair-pay rules to ensure savings benefit patients rather than intermediaries. Riley highlights that access to pharmacies is now a critical affordability issue.
Department of State records reviewed by Spotlight PA indicate that approximately 1,100 licensed pharmacies in Pennsylvania closed from early 2020 to early November 2025. This represents a net loss of hundreds of locations even after accounting for new openings. While around 500 closures are attributed to Rite Aid’s downsizing, independent pharmacies have also been affected, resulting in longer travel distances for refills and weakened first-line care in many communities statewide.
The Federal Trade Commission’s (FTC) second interim report on PBMs found that the “Big 3” PBMs significantly marked up specialty generics, including treatments for cancer and HIV. The report highlighted price markups and steering practices that may increase costs and harm access. This has contributed to bipartisan support for reforms aimed at increasing transparency and curbing anti-competitive conduct.
Patients Come First is a health advocacy organization dedicated to removing barriers to timely, evidence-based care. Its Pennsylvania branch is led by Jennifer Riley, who has two decades of experience in public policy campaigns. The group’s mission focuses on patient-first reforms, including holding PBMs accountable to improve access and affordability across the Commonwealth.
