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Why Your Neighborhood Pharmacy Isn’t So Friendly Anymore

CVS and Walgreens pharmacy employees say they are overworked, understaffed, and more liable to make prescription errors due to the companies prioritizing profits

Long lines of disgruntled customers. Harried pharmacists shuffling back and forth to counsel patients and answer phones that seem to never stop ringing. Household toiletries locked behind theft-proof cases.

America’s big chain pharmacies are a mess.

CVS Health CVS -2.14%decrease; red down pointing triangle and Walgreens Boots Alliance WBA -3.00%decrease; red down pointing triangle took in big profits in the pandemic thanks to generous reimbursement for administering millions of Covid-19 vaccinations. But now the companies are struggling to respond to gripes from pharmacy employees who say they are overworked and understaffed, and more liable to make prescription errors that put their patients’ safety at risk.

CVS and Walgreens pharmacists and their support staff have staged sporadic job walkouts around the country in recent weeks, hoping to publicize their complaints and goad management into concessions.

“Companies have put in place practices that drive revenue and have created a fast-food scenario. Vaccinations every five minutes. Fill prescriptions in 15 minutes,” says Bled Tanoe, a former Walgreens pharmacist in Oklahoma City who left the company in 2021. “All of the focus was on profits, but not better staffing, better pay and better training.” Customers are also increasingly unhappy. CVS’s satisfaction rating dropped 23% from 2021 to 2023, according to an annual survey by consumer research firm J.D. Power. Walgreens’s rating dropped 25% over the same period.

Molly Priesmeyer, 50, has been going to the same Walgreens in Minneapolis for years, but since the pandemic the lines are often 15-people deep, with wait times as long as 20 minutes, Priesmeyer says. The pharmacy is staffed by longtime employees who are dedicated to their jobs but appear to be increasingly stressed out as they scramble to provide vaccinations and deal with grumpy customers complaining about delays, she says. CVS and Walgreens say they are trying to address an industrywide shortage of healthcare workers, amid unprecedented demand for vaccines.

“We know there are areas where we can improve and are working to develop a sustainable and scalable action plan that supports both our pharmacists and our customers so we can continue delivering the high-quality care our patients depend on,” a CVS spokeswoman says. At Walgreens, the company is making “behind-the-scenes infrastructure changes as well as scaled investments to provide additional support to our pharmacy teams so that they can spend more time with patients, and so that we can provide the best possible experience for our customers,” a spokesman says.

The investments at Walgreens to recruit and retain pharmacy staff included $265 million in its fiscal year that ended in August, on top of $190 million in the prior year. The investments are aimed at addressing greater demand for flu, Covid-19 and RSV vaccines amid industrywide labor shortages, the spokesman said.

CVS is also experimenting with ways to ease the burden on its pharmacies. One idea that is being tested in certain stores: Don’t answer the phone and instead send customer calls to voicemail, CVS employees told The Wall Street Journal. Pharmacists then have a few hours to call them back. The CVS spokeswoman said the aim is “to help ensure our pharmacy teams can focus on providing clinical care.”

The problems inside pharmacies have been building for years but accelerated during the pandemic, says Michael Hogue, chief executive of the American Pharmacists Association, a professional group. How Amazon, CVS and Walgreens Are Tapping Into the $4 Trillion Healthcare MarketPlay video: How Amazon, CVS and Walgreens Are Tapping Into the $4 Trillion Healthcare Market “What we have is a crisis that is been brewing for quite a long time,” says Hogue. “Chain drugstores and others haven’t been providing an adequate amount of staffing for pharmacies, and the pharmacist is being asked to do a whole lot more than putting pills in bottles.”

Filling prescriptions has become less profitable because of reduced payments from insurers and pharmacy-benefit managers, analysts say. The so-called front end of the pharmacy store, which sells everything from shaving cream to beach balls, has been hurt by consumers doing more shopping online.

To diversify, CVS and Walgreens are branching out to provide a broader set of healthcare services, and acquiring primary-care clinics and home-healthcare doctor practices, while closing hundreds of pharmacy stores. Investors want to see the companies focus on these new lines of business rather than invest in improving the retail experience, analysts say. “There is not really a structural change coming to the pharmacy business that would help drive greater profit growth going forward,” says Elizabeth Anderson, an Evercore ISI analyst. Like much of the healthcare industry, CVS and Walgreens are grappling with labor shortages, particularly for the support staff known as pharmacy technicians. They are the workhorses of the pharmacy, doing most of the work of putting pills in bottles. But the jobs are often underpaid, and many techs have left the industry in recent years for better-paid or less-demanding work, says Hogue.

Through the third quarter of 2023, there were nearly 32,000 job openings for retail pharmacists, and nearly 112,000 pharmacy technician job openings, according to the Pharmacy Workforce Center, a nonprofit that collects pharmacy employment data. The median hourly wage for pharmacy technicians was $18.17 last year, according to the Bureau of Labor Statistics. Pharmacists earn on median $132,750 annually, according to BLS. Last year, Vermont’s Office of Professional Regulation filed a complaint against Walgreens with the state board of pharmacy, alleging that understaffing had led to unscheduled store closures, prescription delays and errors including giving a patient a Covid-19 booster shot instead of the flu shot they were supposed to get. Another Walgreens customer was given an incorrect dosage of medication, resulting “in low blood pressure, dizziness and fogginess,” the state alleged.

The Vermont complaint alleges that a large cause of the problems is that Walgreens gave priority to vaccination appointments even when it had inadequate staff to administer them. At times, the company allowed vaccine appointments to be booked every five to 10 minutes, and disallowed pharmacy staff to reduce or cancel appointments to maintain safe pharmacy conditions, the state alleged.

Walgreens declined to comment on the pending litigation. Retail pharmacies brought in gross profits of more than $7.5 billion in 2021 and about $3.6 billion in 2022 from administering Covid-19 vaccines, according to estimates by Adam Fein of the Drug Channels Institute, a provider of pharmaceutical supply-chain research. CVS and Walgreens administered more than half of the 90 million Covid-19 vaccine doses distributed by retail pharmacies last year, according to Fein. In September, 32 CVS pharmacists as well as pharmacy techs in Kansas City, Mo., refused to show up to work, leading to multiple store closures. Some Walgreens employees followed suit in early October, with employees calling in sick or otherwise not showing up for work, resulting in what Walgreens said were disruptions at a small number of pharmacies.

One of the CVS pharmacists in Kansas City said that understaffed stores have been overwhelmed with vaccination appointments, leading to backlogs of unfilled prescriptions as high as 1,700, the pharmacist said. CVS brass took notice of the walkout, sending Chief Pharmacy Officer Prem Shah and Frank Brown, senior vice president of retail human resources.

“I want to apologize to our pharmacy teams that we haven’t addressed these concerns in the region more quickly,” Shah said in a staff memo sent to pharmacy managers and other staff in Kansas City in September and viewed by the Journal. He promised to make immediate investments to reduce the workload of pharmacies in light of “unprecedented demand for vaccinations.”

CVS raised its minimum retail store wage to $15 an hour in 2021, and new pharmacy techs now start at an even higher rate, the spokeswoman said. The CVS spokeswoman said the company is making investments in its pharmacies “in direct response to feedback from our pharmacy teams in Kansas City and across our footprint,” including allowing pharmacies to schedule additional staff when needed and improving employee hiring and training. CVS is starting to implement the changes this month, the spokeswoman said.

This week, some Walgreens and CVS employees staged a walkout from Monday through Wednesday to protest their working conditions in what online organizers dubbed “Pharmageddon.”

CVS said it hadn’t experienced any store disruptions because of the walkout. A Walgreens spokesman said that three stores were temporarily closed out of 9,000 nationwide.

WSJ Reporter: Joseph Walker with contribution by Anna Wilde Mathews

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