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His former customers now have to travel more than 10 miles to get to the next nearest pharmacy. He worries they’ll skimp on their medications rather than make the drive. Falk also closed a pharmacy in Mount Zion, about 30 miles away, last summer.

Since former Gov. Bruce Rauner expanded Medicaid managed care last year, more than a dozen independent pharmacies across the state have closed, with their owners blaming their demises, in part, on the program, which they say wasn’t paying them enough money for medications.

The program is meant to save the state money, but the pharmacists say that instead of doing that, it has merely shifted the dollars that pharmacies once made to industry middlemen called pharmacy benefit managers.

Pharmacy benefit managers work for insurers and employers, negotiating with drug companies to buy medications on their behalf. But one of the ways pharmacy benefit managers take in money is through a practice known as “spread pricing,” in which they charge more for medications than they pay the pharmacies.

It ultimately adds an incentive, pharmacists say, to underpay them. And the small pharmacist who doesn’t have deep pockets is particularly vulnerable, they say.

Owen Sullivan, a third-generation pharmacist, said that last year his pharmacy, Sullivan Drugs in Carlinville, lost money for the first time in 28 years. “That’s where a lot of (pharmacies) are,” Sullivan said. “They’re sitting on the edge going, ‘Man, I hope this gets fixed.’”