Spotlight PA: Why PA Pharmacies Keep Closing and How Lawmakers Want to Slow the Trend, Explained in 7 Stats

by Ed Mahon of Spotlight PA

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HARRISBURG — Since July, Spotlight PA has written several stories about hundreds of pharmacy closures across Pennsylvania and how they force patients to travel further, wait longer, or simply go without medications they rely on.

One reason our news organization has continued reporting on the issue is the reaction we’ve received from so many people across the state. About 30 readers reached out after our initial story, many describing their own problems.

There are also many different aspects to dive into, including how state lawmakers have tried to rein in pharmacy benefit managers (PBMs), the corporate middlemen frequently blamed for the closures. Critics say these businesses drive up drug costs for patients, offer insufficient reimbursement to pharmacies, and use predatory practices — all while prioritizing their own profits.

The Pharmaceutical Care Management Association, which represents pharmacy benefit managers, has pushed back on the criticisms. A spokesperson for the association recently told Spotlight PA that employers and unions hire PBMs “to negotiate lower drug prices and create more access to affordable medicines for patients” and that PBMs “depend on a healthy network of independent pharmacies in Pennsylvania.”

Here are some numbers that stand out from our coverage these past months:

1,100 — about how many licensed Pennsylvania pharmacies went out of business from early 2020 to early November of last year, according to a Spotlight PA analysis of Department of State records. While some new ones opened, the data showed a net loss of hundreds of pharmacies.

9 — rural counties that would experience the biggest percentage declines in total pharmacies if all Rite Aid locations were to close without a replacement, according to an analysis from the Center for Rural Pennsylvania. The data was as of May 2025. The counties stood to each lose 20 percent or more of their total number of pharmacies.

3 – big pharmacy benefit managers that dominate the industry. Those companies manage 79 percent of prescription drug claims for about 270 million people, according to a 2024 interim staff report from the Federal Trade Commission. The report raised concerns that these and other “powerful middlemen may be profiting by inflating drug costs and squeezing Main Street pharmacies.”

24% — about how much of Pennsylvania’s health insurance market is covered by Act 77, a 2024 law that promised support to Pennsylvania pharmacies and accountability for PBMs. Included are commercial plans that people buy on their own or that their employer purchases. Those figures are according to Pennsylvania Insurance Department estimates.

6 — state senators, including Republicans and Democrats, who signed letters over the summer that raised concerns about how two state agencies under Democratic Gov. Josh Shapiro were handling oversight and accountability for pharmacy benefit managers. The Shapiro administration has defended its approach, both for prescriptions filled through commercial plans and ones under the state’s Medicaid program for low-income residents.

21 — state senators who signed an October letter raising more bipartisan concerns.

3 — Republican state senators who in February proposed giving Pennsylvania’s attorney general more power to take on pharmacy benefit managers.

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Image: A sign announcing a Rite Aid closure is seen in York County, PA. (Ed Mahon / Spotlight PA)