Majority of Independent Pharmacies Affected by Ongoing Labor, Supply Chain Issues, NCPA Survey Says

Pharmacy DIR fees, PBM consolidation, possible tax increases, inflation also top of mind

Alexandria, Va., Nov. 10, 2021 (GLOBE NEWSWIRE) -- A new survey of independent pharmacists released by the National Community Pharmacists Association finds that while the majority of independent pharmacy owners/managers are struggling to fill staff positions and deal with supply chain disruptions, market pressures like pharmacy benefit manager direct and indirect remuneration fees and vertical integration continue to be their top two concerns.

Strong majorities also report being worried that possible tax increases on small businesses (76 percent) and inflation (64 percent) will be additional issues they’ll have to confront. These would be tricky problems for small business pharmacies, many of which are already cash-strapped due to pharmacy DIR fees and low reimbursements from health insurance plan prescription drug divisions, among other things. According to the survey, just 31 percent of respondents described the overall financial health of their business as very good or somewhat good. Twenty-eight percent described it as average, and 41 percent described it as somewhat poor or very poor.

“Pharmacists have worked heroically throughout the pandemic so to have insurance middlemen push so many of these small business owners to the edge is troubling,” said NCPA CEO B. Douglas Hoey pharmacist, MBA. “Policymakers in Congress, the Biden administration, and in the states should keep this in mind. There are important policy changes they can make to lower drug prices for seniors and protect small businesses, like eliminating pharmacy DIR fees.”

Sixty percent say they are dealing with supply chain disruptions. Additionally, nearly 70 percent of respondents reported struggling to fill staff positions, with the pharmacy technician and clerk/front-end staff slots being the most difficult to hire. As a result, many pharmacies are increasing wages and offering employee incentive pay. The wait time for patients getting prescriptions has increased as well. Workforce issues are ongoing challenges across the industry, with unique characteristics depending upon the pharmacy practice setting. They were first quantified among independent pharmacies in June.

“Between rollouts of COVID-19 vaccines for children, boosters, and seasonal flu shots – on top of their other existing patient care services – pharmacies are stretched very thin, while patients need them more than ever,” Hoey said. “Independent pharmacies are the safety nets protecting their communities, and owners are working overtime, docking their own pay, and doing everything they can to answer the call. Policymakers must repair the broken prescription drug payment model to better support pharmacy teams; successful pharmacies mean healthier, happier lives for patients.”

Note: This NCPA survey is based on 318 responses to a survey sent to nearly 5,000 pharmacy owners/managers from Oct. 26-Nov. 6, 2021. NCPA is the country's largest organization of independent pharmacy owners.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America's most accessible health care providers. To learn more, visit


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