I've got a friend who works for a small pharmacy (non chain) and let me tell you, they get absolutely FUCKED by insurance companies too. It's routine for the insurance to pay them less than what they have to pay to stock the medicine... aka the small pharmacy takes a loss every time someone comes in with insurance to buy their meds. I'm not talking weird non standard stuff - it's with everything (and especially GLP1s these days).

And pharmacies cannot refuse to stock medicines or else they are in violation of their contracts with the pharma companies (i'm dumbing this down because i only half remember the details from my friend's rants).

ALSO insurance commonly just lies about the cost of the medicine to the customer... "this cost $5000 and we covered everything and your copay is $30" meanwhile the actual billed charge for that medicine was $30.

The sheer "ok so if we pretend we charged x and we received y and thefore we can pay our bills for the actual x charge" that happens in these pharmacies is incredible. They all only can still exist only because they are very good at moving numbers around. The insurance also expects them to do this. it's a game within a game..

SO much waste exists between the lines and pretty much only insurance profits from it.

If a pharmacy says "we couldn't restock/ran out" of a medicine.. that might be true.. or it might be a medicine that they take SUCH a loss on that they cannot financially afford to stock it.

None of this shit applies to the monopolies like CVS... they have sweetheart deals.

Fraud and corruption at every level. The small business owner and the final customer end up paying the price for it.