John Pastorek knew he wanted to work at an independent pharmacy after spending time in high school working with his mother at Freeport Pharmacy.
But following his dreams has not been easy.
“The pharmacy industry is a really tough business right now,” said Pastorek, 38, of Murrysville.
Across the country, pharmacies buy their drugs from wholesalers and primarily are reimbursed for dispensing them by pharmacy benefit managers, or PBMs. These companies act as middlemen hired by insurance providers, employers funding their own health plans and government programs.
Nationwide, independent pharmacists argue payments set by PBMs often are lower than the actual wholesale cost to fill the prescription — a trend hitting Pennsylvania shops particularly hard.
State lawmakers are seeking to change this.
The Pennsylvania House Health Committee heard testimony on legislation introduced by Rep. Rob Matzie, D-Beaver, that would create a single Pharmacy Benefit Administrator model for all of Pennsylvania’s state-funded healthcare programs. At the hearing, Matzie said the model will allow for more regulation. He noted after adopting a similar model, West Virginia and Ohio saved $54 million in one year and $140 million over two years, respectively.
The legislation is under consideration for a committee vote.
In 2024, Act 77 was enacted, requiring pharmacy benefit managers to publicly report data about their rebates, fees and pharmacy networks.
Pharmacy desert
The challenges of the business have not stopped Pastorek. On May 18, he opened Indy Drug Co. in Blairsville, pulling the borough out of a pharmacy desert.
“Everyone’s been happy we’re back,” Pastorek said.
The town has seen a series of pharmacy changes throughout the years.
Blairsville Pharmacy was taken over by Mainline Pharmacy in 2015 after owner Dan David retired. In 2024, Mainline Pharmacy closed 10 of its locations, including the storefront in Blairsville. A little over a year later, the nearby Rite Aid on Resort Plaza Drive in Burrell closed when the company shuttered 70 Pittsburgh-area stores.
“There was nothing in town,” Pastorek said. “It’s really sad because a lot of these people don’t drive, a lot of them are elderly and have trouble getting around. That was a big thing this town was missing.”
An Indy Drug Co. location opened at Indiana Regional Medical Center in 2025, providing a “Meds to Beds” program that delivers patients’ prescriptions directly to them before they leave the hospital. Customers Pastorek used to serve in Blairsville would drive to the hospital in Indiana to fill their prescriptions. Pastorek said because he already had the building from when the Mainline store was in place, he opened the new store to serve the community.
But Pastorek knows this new independent business will face hardships.
“It’s very thin margins right now,” he said. “We get paid sometimes less than our drugs cost.”
‘Pillar of these small towns’
Blairsville was not the only town in the region experiencing a pharmacy desert. After the closure of Rite Aid, residents in Derry and Scottdale were left in the same situation.
“Every little town, especially in Western Pennsylvania, we’re more elderly population than a lot of the country,” Pastorek said. “People can’t get around … I don’t know how they’re supposed to get their meds. If you get them through the mail, sometimes they don’t come. Sometimes they take way longer than you thought they would.”
Blairsville Mayor Michael Walstrom said it was a “pain” to not have a pharmacy in town.
“It can add a lot of stress,” Walstrom said of traveling out of town to pick up prescriptions. “Having a pharmacy in town is a pretty big deal.”
Local pharmacies also provide a sense of comfort to residents, Pastorek said.
Linda Gwinn of Blairsville has gone to Pastorek since he owned the Blairsville Pharmacy run by Mainline. She started going to Indy Drug Co. as soon as it opened in town. She is happy to support him because he always makes an effort to show up to local events in the borough.
“It’s so personal,” Gwinn said. “He’s happy to support his customers. That’s a nice give-and-take. You don’t see that when you go to Walmart.”
Customers can come in and ask pharmacists questions anytime, and even get advice if they are not feeling well or need medication recommendations. Indy Drug Co. also delivers within a 20-mile radius and provides free adherence packaging.
“The local pharmacy is a pillar of these small towns,” Pastorek said.