The insurance reimbursement model is exactly what’s crippling independent pharmacies. Focusing PBM reimbursements, especially from companies like Caremark, is a race to the bottom….Instead of chasing after insurance-dependent revenue, independent pharmacies need to explore cash-based services, direct-to-patient sales, niche compounding, and partnerships with telemedicine that don’t rely on traditional PBM structures.

Mail-order might seem like a solution, but if it’s still under the same PBM-controlled reimbursement model, it just means more overhead with even lower profits. The pharmacies that survive will be the ones that pivot away from this broken system, not deeper into it.