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Pharmageddon Protesters Fight for Dignity at Work

A three-day walkout is intended to highlight high stress and low pay at
chain pharmacies.

This week, hundreds of pharmacists walked out

of multiple locations of major drugstore chains CVS and Walgreens. For
weeks, pharmacists and technicians have been expressing that they feel
overworked, underpaid, and unsupported in their work.

The walkouts occur in a troubling moment for the pharmaceutical
industry. Earlier this month, Rite Aid filed for Chapter 11 bankruptcy
,
and announced the closure of more than 150 stores. Prior to the
walkouts, Walgreens was struggling with retail theft (though this may be
overstated
),
debt, and other issues, as others have noted
.

The official walkout, nicknamed "Pharmageddon
"
on social media, has ended, as it was only slated for three days.
Walgreens and CVS both responded to the walkouts, denying that there
were any service disruptions. And the original Kansas City walkout at 12
CVS stores that started the wave has also officially ended. Pharmacists
have pronounced themselves "hopeful
"
about a new plan to add staffing and institute paid overtime at the
locations..

Shane Jerominski, an organizer of the walkout, told the

**Prospect** that when CVS executives flew

to Kansas City to negotiate with the workers, it signaled to him and his
fellow organizers that there was a moment to seize.

"This is happening all across the country," Jerominski told the

**Prospect**. "This is a systemic problem across all chains."

The pharmacists say they are overworked to the point where their
licenses are at risk. Stores have increased the workload for
pharmacists, requiring them to vaccinate people, answer questions,
approve and administer medications, and increase sales for the store. At
the same time, stores are staffing fewer technicians, and giving those
that are on staff fewer hours. As a result, Jerominski told the

**Prospect**, pharmacists are overburdened and more prone to mistakes,
which puts patients at risk. As Jerominski put it, stores are
"comfortable with a certain amount of medication errors," but
pharmacists have to answer to an independent board that governs their
licenses and does not have such a generous error policy.

Overall, pharmacists say they need more help, which is why some decided
to strike even though they are generally paid well. The official
justification for the walkout was the low pay for technicians, who often
still make less than $20 an hour. The technicians say they are so
underpaid that they need other jobs to supplement their income, which
leads to increased turnover. Pharmacists are then constantly retraining
their staff, instead of focusing on filling prescriptions properly.

"There is not a pharmacist shortage, there is not a technician
shortage," Jerominski said. "There is a shortage of pharmacists willing
to put their licenses at risk in these environments."

The pharmacy industry is dominated by big-box stores that have an
expansive presence across the country. CVS, Walgreens and Rite Aid are
the largest, but mega-retailers like Walmart and Kroger also have a
substantial pharmacy presence. Pharmacy benefit managers (PBMs), which
operate drug benefits on behalf of health plans, have recently
established their own specialty mail-order pharmacies, and are working
to steer patients away from physical stores. As the large chains falter,
closing hundreds of stores, "pharmacy deserts
"
have popped up across the country, forcing patients to travel longer to
fill their prescriptions, and increasing the workload on the remaining
pharmacy outlets.

Meanwhile, there are far fewer independent pharmacies that have deeper
relationships with customers and communities, as well as better working
conditions for pharmacists.

All of this puts stress on patients, who are faced with long wait times,
are stuck fighting unwilling insurance companies who differ with the
advice of their doctors, or are paying high costs out of pocket.

The Inflation Reduction Act (2022) included various

reforms to the drug pricing industry, including allowing Medicare to
negotiate certain drug prices for seniors and introducing out-of-pocket
spending caps. And legislation has been introduced

to curb the power of PBMs, which critics say squeeze pharmacies on every
prescription, increasing the need to raise prices elsewhere in the store
to maintain the business.

But technicians, and the pharmacists that support them, are taking the
moment to air their grievances. They are stuck in the middle of the
pharmaceutical supply chain, as the first line of contact for patients,
and insurance companies. Interactions with patients have become
increasingly hostile as PBMs and insurance companies penny-pinch, make
arbitrary denials, and interfere with medical advice. People are at risk
daily, if only because the potential for error is wide.

Pharmageddon might have been rather short-lived in an official sense.
But the issues that have been raised are reflective of the way people
struggle to navigate this landscape. The workers are aiming for changes
in the rules and corporate culture that hinder their ability to help
people.

~ RAMENDA CYRUS, WRITING FELLOW

Follow Ramenda Cyrus on Twitter

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