Klingensmith’s Pharmacy in Leechburg welcomed about 200 new customers seeking an alternative source for their prescriptions after Wednesday’s abrupt closing of Health Mart pharmacies in Leechburg and Lower Burrell.
The closings are part of a trend among some independent pharmacies that struggle to make a profit as big-box retailers buy privately owned ones. The local owners are responding with refined customer service that includes packaging prescriptions for ease of use, along with delivery.
Ted Cibik of Gilpin was at the Leechburg Health Mart on Wednesday when he learned of its looming closure. He immediately transferred his prescription account to Klingensmith’s.
“I want to support small-town businesses, and of course we have to stick together as a community. If we don’t, it’ll be one business after another failing,” Cibik said.
Klingensmith’s pharmacist Sam Gigliotti said customers depend on independent pharmacies for specialized customer service. In addition to Leechburg, Klingensmith’s operates pharmacies in FordCity,Kittanning,WestKittanning,Numine,Reimersburg andNewBethlehem.
“We can provide a deeper level of care,” Gigliotti said. “I don’t foresee it being a challenge — fitting in the new customers — in our day-to-day workflow.”
Gigliotti, 24, was hired at Klingensmith’s after graduating from Duquesne University in May. He said the biggest amenity requested by customers, many of them senior citizens, is home delivery.
Mainline Pharmacy, which operates close to a dozen locations in five counties, has seen its customer base grow in recent years. Still, last year company officials decided to close a Murrysville store. The Harrison City location now is its only presence in Westmoreland County.
Jack Moschgat, co-owner of Mainline, said the covid-19 pandemic had a silver lining for Mainline as it brought in new customers.
“We were able to effectively administer and distribute so many vaccines that people got exposure to us who wouldn’t have had exposure to us,” he said.
Mainline is able to set itself apart from some large pharmacy chains by offering services such as compounding combinations of prescription ingredients, packaging individual doses for customers and making deliveries, Moschgat said.
The pharmacy’s biggest financial challenge is being reimbursed by insurance companies at rates lower than the actual cost of prescription medications, a problem he said is industry-wide, he said.
For other players in the world of prescription drug supply, administration and payment, he said, “Profits go through the roof every year, while pharmacies go down.”
Corporate interest
Anthony Roperti, pharmacist and owner of Town & Country Pharmacy in New Kensington, said he turns down frequent offers from chain-store pharmacies wanting to buy his family-owned business that has been in operation since 1957.
“I get something in the mail every month,” Roperti said. “They try scare tactics, and they’ll pay you as little as they can. They wait for someone who is afraid or wants to get out. I could sell in a second, but those offers go right into the shredder.”
Roperti works alongside his son and daughter, both pharmacists, and said his family business isn’t going anywhere.
Roperti pointed out Medicare prescriptions are the most likely to result in a lower reimbursement amount.
“We’re lucky where we’re at because we don’t just have Medicare,” said Roperti, blaming the three largest U.S. pharmacy benefit managers — Caremark, Express Scripts and Optum — for reimbursing pharmacies less on Medicare scripts.
Roperti said his business will be OK because Medicare prescriptions make up less than 50% of his business and warned the increase in pharmacies closing won’t bode well for the pharmacy benefit managers, or PBMs.
Nicholas Roperti, Anthony’s son, has begun organizing medications for customers with a large amount of prescriptions.
When an online competitor called Town & Country to request two prescription transfers, Nicholas Roperti asked his customers why they were considering using online prescription services. They mentioned custom preparation.
“Through those customers I taught myself how to do it, kept the customers and now offer this,” Nicholas Roperti said. “My sister and I are newer pharmacists, and I’m trying to incorporate newer things that we learned in pharmacy school. I’m trying to figure out those things as we move forward.”
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Following the pharmacist
Customer loyalty is one of the areas where local independent pharmacies may have an edge. When a Greensburg pharmacy he patronized closed, Ken Allen of Youngwood followed his favorite pharmacist, who joined the staff of Hayden’s Pharmacy in Youngwood.
Allen stops at the pharmacy about twice a week, mostly to fill prescriptions.
“They know we me when I come in. It’s a little hometown place,” Allen said. “They know what I need and take care of it. They do a good job and are quick about stuff. It would be a big inconvenience without it.”
Hayden’s operates other pharmacies in Donegal Township and Mt. Pleasant. The Mt. Pleasant pharmacy shares its space with the Main Street Deli and Cafe.
Though he fills his prescriptions elsewhere, Richard Koval of Mt. Pleasant Borough said he stops regularly at the town cafe and buys over-the-counter medications at the pharmacy when he needs them.
“I come down two days a week,” he said. “I like the chicken sandwiches.”
Reimbursement impact
At Hilltop Pharmacy in Pittsburgh’s Allentown neighborhood, manager Alex Rothey said she worries about the future.
“It’s getting tough to operate. It’s always been on the tighter side,” she said.
Low reimbursements from Medicare and Medicaid mean that Hilltop sometimes ends up with net losses on expensive brand medications. As a pharmacy where 90% of customers rely on either Medicare or Medicaid, it adds up.
Rothey said she is proud of the personal touch Hilltop can offer, including free prescription delivery Monday through Friday, advice for patients on how to access assistance programs and a welcoming, safe atmosphere.
“I feel deeply embedded in this community. I really do care about my patients and the people in it,” she said. “With the lower reimbursement, it’s hard to hire more staff to take on more people. It’s hard to offer the services that made independent (pharmacies) special.”
Hilltop Pharmacy’s owner Pat Lavella works for Value Drug Company, a cooperative pharmaceutical wholesaler that supplies medications to about 400 independent pharmacies in Pennsylvania.
“This is not a small struggle, (an) independent pharmacy issue … this is an industry issue,” he said, citing the low reimbursements and inefficiencies of pharmacy benefit managers, the third-party companies that serve as intermediaries between drug manufacturers and insurance providers.
Lavella, citing statistics from the National Community Pharmacists Association, said that between 2017 and 2022, the number of pharmacies in Pennsylvania dropped about 15%. For independent pharmacies, the drop was closer to 18%.