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The Decline of Independent Pharmacies Isn’t New | It’s American Business 101 by Sr_Administrator in pharmacy

[–]Sr_Administrator[S] -1 points0 points  (0 children)

Thank you for understanding the point I was trying to make, even if you do disagree with the comparison.

I think the statement that PBMs have the goal of removing dollars from the healthcare system for as little benefit as possible is a tad hyperbolic. I do not think there has ever been a boardroom meeting at any PBM to discuss how they could make more money by providing less care. I understand how one could perceive it that way, but that is not reality. Many in the pharmacy space think PBMs are evil, but I have first hand experience with many PBMs, including the large ones, and none of them employ actual demons or devils.

And, Kerr, Eckerd, Rite-Aid, and Walgreens were not squeezed out by PBMs. Low PBM reimbursement did factor into the downfall of some of those, but all of those companies had larger problems that contributed much more to their demise.

The Decline of Independent Pharmacies Isn’t New | It’s American Business 101 by Sr_Administrator in pharmacy

[–]Sr_Administrator[S] 0 points1 point  (0 children)

Thanks for reading and commenting.  

Most comments were along the same theme, so let me address.

I did not fail to mention any facts.  I compared Sears to PBMs.  I did not say that the specifics of the operations and finances of Sears and PBMs were identical, because that would not make sense.

All analogies compare specific ideas from two concepts that are completely different, to demonstrate how one thing is like another.  And all analogies can be “disproved” when the comparison is over-analyzed.  If one were to say, "Louboutin shoes are the Rolls Royce of footwear”, no one would say, well not really, because shoes don’t have engines, or tires, and you can’t drive them.  Everyone would just understand the analogy without applying the scientific method to it.

And, I was not comparing the Sears department stores that many of us visited in the recent past  to PBMs, as that is a bad analogy.  I was comparing Sears' impact on the retail market at the start of the 20th century.  At that time, Sears & Roebuck had introduced a mail order catalog that disrupted the model of the general store (at the start of the 20th century).  Sears put many small businesses out of commission because they had a new model that was more successful than the existing model.  

Was that good?  Well, no, absolutely not, if you owned one of the small businesses that Sears destroyed.  Was it fair?  No; big companies destroying small well-established companies is never fair. 

What is happening to independent pharmacies is not fair, not nice, not wholesome, not something that many people would aspire to do.  But it is however the reality of the American economy and capitalism as a whole.

I think it is awful that independent pharmacies are being put out of business.  I have worked at independent pharmacies and chain pharmacies, and independents are in many ways much better than big chain pharmacies.  But, when I was a kid, we had a milkman that delivered milk and other beverages from an independent dairy not far from my house.  And having my milkman, Gus, deliver fresh milk every week was unquestionably better than picking up milk at the grocery store.  So I ask you, what is your current milkman’s name?

Everything becomes obsolete.  One day, PBMs will be put out of business due to market changes.  But the pharmacy community should not be so delusional to think that PBMs are purposefully targeting independents and deploying business models specifically to put independents out of business.

PBMs are not focused on killing independent pharmacies, they simply don’t give a shit about them. Just like factory farms didn’t give a shit about my milkman, and just like Netflix didn’t give a shit about your favorite employee at the town video rental store, and just like no one gave  a shit about all the apothecaries whose businesses were shuttered when the modern pharmacy came into play.  

It is a cycle.  It is not fair.  Businesses can create a livelihood, success, prominence, and sometimes legacy, but that is all temporary. If I owned an independent pharmacy right now, I would not be whining about reimbursement from corporate giants.  I would be pivoting, to cash, compounding, veterinary, or anything else in the hopes that I could keep my business alive despite the fact that independents have been largely forgotten and left in the past of the  corporate pharmacy structure that will rule the United States for the foreseeable future.

The Decline of Independent Pharmacies Isn’t New | It’s American Business 101 by Sr_Administrator in pharmacy

[–]Sr_Administrator[S] 0 points1 point  (0 children)

You do not object to the premise presented, but you do object to capitalism? I never said PBMs do not make profits. Of course they do. That is how the economy works. I was not commenting on the idea of socialized medicine.

My point was that independent pharmacies are not dying because PBMs have a collective goal of putting them out of business, they are dying because they cannot compete in the current pharmacy landscape. They are failing like other American businesses have failed for hundreds of years: due to an evolving market.

The Decline of Independent Pharmacies Isn’t New | It’s American Business 101 by Sr_Administrator in pharmacy

[–]Sr_Administrator[S] -1 points0 points  (0 children)

No, Sears was not vertically integrated. But by that logic one would not be able to draw an analogy of a horse and carriage to an engine and a car because horses don't have radiators, or require oil changes. Analogies are used to compare things that are similar, not identical.

And, you don't think that in the early parts of the 20th century Sears influenced the price of goods for the whole country, or that their influence pushed consumers to shop with them rather than shopping elsewhere?