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.