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Ohioans grapple with medication access as pharmacies shutter

A man stands behind a computer monitor and a counter with pills on the shelves behind him. He is on the phone. Another man stands at another computer monitor in the background.
Ngozi Cole
Nnodum Iheme (L), owner of Ziks Family Pharmacy says big chains and small drug stores like his are facing reimbursement issues and feelign the pinch.

When the Walgreens on Hoover Avenue in Dayton closed in April, patients like Chanel Maston had to figure out where else nearby to get their prescriptions.

“It's just sad. It's ridiculous. They are just closing everything down over here,” said Maston.

Walgreens announced in April that the Westwood location in West Dayton would close, after announcing 150 closures last year.

Walgreens said the Westwood location’s decline in foot traffic lead to unsustainable business performance.

“When faced with the difficult decision to close a location, several factors are taken into account, including our existing footprint of stores, dynamics of the local market, and changes in the buying habits of our patients and customers, among other reasons,” the statement from Walgreens read.

The West Dayton closure comes amidst hundreds of other drug stores closing down around the country over the past year. In the last two years, Rite Aid, CVS and Walgreens have closed over 1,500 stores nationwide.

This year, Rite Aid has closed nine stores in Ohio, after filing for bankruptcy in 2023. A spokesperson for Rite Aid said the company regularly assesses its retail footprint to ensure it’s operating efficiently.

“In connection with the court-supervised process, we notified the Court of certain underperforming stores we are closing to further reduce rent expense and strengthen overall financial performance,” they said.

Pharmacy access

In West Dayton, the nearest other Walgreens location is approximately 15 minutes away by car and about an hour's walk.

A CVS pharmacy and a local drugstore, Ziks Pharmacy, are close by, but some customers said it's not as affordable as Walgreens because of their insurance networks.

Antonio Ciaccia runs 46brooklyn Research, an Ohio nonprofit focused on drug pricing data. He said these closures severely affect communities.

“It's not just losing a physical location and the hassle of access. For those who have transportation challenges, it could literally mean that they're not getting their medicines,” Ciaccia said.

Businesses in the pharmaceutical industry — from pharmacies to insurance companies to drug makers — have been grappling with soaring prescription drug prices, tightening insurance payments and shrinking bottom lines.

David Burke, the Executive Director of the Ohio Pharmacy Association, blames high charges from third-party companies managing prescription benefits for insurance companies.

“It's supposedly all in the name of lower cost. But ever since this has gone on, drug prices have skyrocketed,” Burke said. “Insurance costs for the pharmacy benefit have gone up. So having a middleman has only increased the cost.”

But pharmacy benefit managers, or PBMs, say they are not to blame. Their mandate is to negotiate prices and payments between drug manufacturers, pharmacies and insurance companies. They also create prescription drug lists, called formularies, which decide which drugs are covered by insurance.

Sean Stephenson from the lobbying group, Pharmaceutical Care Management Association, said drug pricing is set by manufacturers. He said PBMs advocate for lower costs to save money for patients and insurance companies.

“PBMs only represent $0.06 of the total drug spend on a prescription drug,” Stephenson said. “We are the only entity that works to reduce costs at the end of the day, on behalf of the patient. ”

An exterior photo of a Walgreens store
Ngozi Cole
The Walgreens in West Dayton closed in April. Four more pharmacies are closing this month.

In 2021, the Ohio Medicaid program — which spends over $3 billion a year on prescriptions — switched over to a new state-controlled PBM. State Attorney General Dave Yost had alleged one of the pharmacy benefit managers overbilled the Ohio Department of Medicaid for services it provided, and the PBM agreed to settle with the state.

"It's very hard to run a pharmacy when you're overly reliant on PBMs," Ciaccia said. "PBMs and health insurance companies don't work to compensate pharmacies in a way that's commensurate with their value to the patient.”

Options for patients

Ziks Pharmacy is locally owned with two locations in Dayton. The owner, Nnodum Iheme, opened the pharmacy in 2009 after Rite Aid closed their nearby Hoover Avenue location the year before.

While Ziks has filled the gap in West Dayton, Iheme agrees that big chains and independent pharmacies like his struggle with poor reimbursement.

“If [Walgreens] are buying medication, it may be $1,000, and insurance reimburses them only $700, how can they stay in business?” Iheme said. “Our overhead is a little smaller, but we go through the same difficulties that they go through with reimbursements.”

Iheme wants to stay open, but admits he’s also feeling the pinch.

“I want to be able to pay my people good money,” Iheme said. “I really want them to feel good about the job they do for the community and compensate them properly, but sometimes because of the limitation of the reimbursement and the cost of medication that we buy, it becomes an obstacle.”

As pharmacies grapple to stay in business, customers around Ohio are left to figure out where and how to get their medication, when they close down.

In the meantime, patients like Chanel Maston and fellow Westsider and Walgreens shopper Sandra Black will have to go farther to get their prescriptions.

“ If I had to go to the doctor and anything, we would come here. It's closer,” Black said. “We're surprised because there's nothing over here anyway, so now there really isn't anything. It's a shame.

Ngozi Cole is the Business and Economics Reporter for WYSO.