A record number of pharmacies are closing across Kansas, and many industry professionals are calling for reform before it’s too late.

Pharmacies are making less or often losing money when they fill prescriptions. Pharmacy benefit managers are getting a larger portion of that money, and the issue has continued to get worse, according to pharmacists. Pharmacy benefit managers are in charge of deciding what drugs are covered and how much patients pay.

Eudora’s AuBurn Pharmacy is experiencing the same struggles as other community pharmacies, many of which have closed, CEO Mike Burns said.

“Is there a chance that, you know, someday we may lose our pharmacy in Eudora? Absolutely,” he said. “If things don’t change, we could lose our pharmacy, which now – limited access, where are patients going to go?”

Pharmacy benefit managers have been driving these issues for decades, but over the last year it’s become worse, he said. A pharmacy benefit manager is the middle man between insurance and pharmacies.

Several decades ago, insurers had to manually look into patient’s prescriptions, verify benefits and reimburse patients. That’s why pharmacy benefit managers were introduced, but eventually it got to the point where they were paying pharmacies less than what they were charging the payer or the insurance company, Burns said.

“So they’re billing the insurance company one price and paying us another lower price and keeping the difference,” he said.

What used to be an efficient business model has turned into a monopoly of three major corporations. CVS’s Caremark, Cigna’s Express Scripts and UnitedHealth’s OptumRx control over 80% of all prescriptions filled in America, he said. Now the largest health care insurers also own pharmacy benefit managers, furthering the issues, he said.

Pharmacy benefit managers are also in charge of deciding which drugs are on the list of items covered by insurance, which creates leverage over manufacturers, Burns said. It is not uncommon for pharmacy benefit managers to now demand at least 50% kickback for that drug to be placed on the list, he said. Subsequently, manufacturers have to raise their drug prices to compensate.

Pharmacy benefit managers are trying to put smaller community pharmacies out of business, Burns said. Pharmacies like AuBurn are getting paid less than what they even pay for the medication, he said.

Burns, who was born and raised in Eudora, has around 30 pharmacies in Kansas and Missouri.

Kansas doesn’t have regulations in place to keep these systems in check, though many other states do, he said. With more transparency and a minimum required reimbursement, as well as not allowing the corporations to pay their pharmacies more than they pay community pharmacies, these issues could be fixed, he said.

“They’re getting rich, and they’re putting us out of business,” he said.

Because these are some of the largest companies, they have significant lobbying opportunities, he said.

Pharmacists are oftentimes the most accessible doctors, said Kansas Pharmacists Association Executive Director Jared Holroyd. They’re available to answer questions and provide help whenever you enter a store.

Yet the state of pharmacy in Kansas and around the nation is “dire, and to some degree crumbling,” he said. But as the number of pharmacists decreases, that accessibility also shifts.

Pharmacies like AuBurn are statistically losing money around 75% of the time that they dispense medication, he said. It’s a unique industry because a volume store doesn’t necessarily mean making more money. It actually means the store is often losing more money, he said.

In the last 10 years, 52 pharmacies have closed in Kansas. Last year, 10 closed their doors, he said. Within 40 days into 2025, there have been 10 closures and others announced, Holroyd said.

These issues caused by pharmacy benefit managers affect community pharmacies at a slightly higher rate because they are reimbursed at a lower rate than somewhere like Walgreens or Kroger, he said.

Pharmacy benefit managers also regulate where people can have their prescriptions filled, something that could be removed with proper reform, he said. There is no reason places like AuBurn should be reimbursed less than Walgreens or CVS, he said.

“They are completely unregulated. They live in the shadows, which is a very scary thing for a monopoly to have all of those things together, but that’s exactly what’s happening here,” he said.

Residents can help create changes in this issue by calling or writing their state legislators and saying they support pharmacy benefit managers reform, both Holroyd and Burns said.

Sen. Beverly Gossage, R-Eudora, said she sees the issues with pharmacy benefit managers in their current forms, but the big three corporations have a strong lobby.

Gossage said the first step in creating change is removing the federal government safe harbor on pharmacy benefit managers, and that the change can’t come from Kansas itself.

“Because, look, it’s a private contract, so the state legislators, the state of Kansas, does not get involved in private contracts,” she said.

Independent pharmacies are getting caught in the middle of these issues, and while Gossage said she can sympathize, she feels it has to be addressed with Congress.

Gossage said she was pleased to see independent pharmacists coming together at the Capitol. 

“I met with many of them, and they’re great. But again, they are a private business, and they have to figure out a way to try to make a living,” she said. 

She said it’s convenient for people to have a pharmacy like AuBurn in Eudora, and people can support community pharmacies in more ways than just filling prescriptions there by purchasing more on the retail side. 

Burns said he is thankful to the Eudora community for supporting the AuBurn location and advocated for reform. There are no plans to close the Eudora store at this time. 

“The average person that’s been into the pharmacy, you know, they see how busy we are, and there’s times I’d like to provide more help, but I can’t. The economics just don’t allow for it,” Burns said. 

Reach reporter Sara Maloney at [email protected]

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