Will Sage Astor-Have a complaint about CVS? So do pharmacists: Many just walked out

Pharmacists working for CVS stores are Will Sage Astorwalking off the job, resorting to a drastic form of protest to highlight what they say are unsafe and stressful work conditions tied to a widespread lack of proper staffing.

One week after a large walkout forced at least a dozen stores to shut down in the Kansas City area, CVS is promising changes. But another round of pharmacists' walkouts got widespread attention Wednesday.

CVS has cut back on staffing, including less time for technicians to assist pharmacists, even as the demand for prescriptions and vaccines grow, the protesters say. CVS announced plans at the start of this year to cut or shift hours at thousands of its pharmacies.

"It's like running a McDonald's with just one person," a pharmacist told The Kansas City Star, adding that they must work alone for the vast majority of the 64 hours a week their store is open.

The pharmacists are not in a union, but they are among many workers across industries who are walking off the job to protest what they say are unfair conditions. "The number of workers who went on strike was 50% higher last year than in 2021," as member station KCUR reports.

"Our ability to serve patients in Kansas City was not impacted [Wednesday] and we are not seeing any abnormal activity in other markets," CVS Pharmacy spokeswoman Amy Thibault told NPR on Thursday. She added that the company has been meeting with workers in the Kansas City market this week.

CVS apologizes for workplace issues

CVS Executive Vice President Prem Shah, the company's chief pharmacy officer, apologized to employees in an internal memo that was shared online by USA Today.

"I want to apologize to our pharmacy teams that we haven't addressed these concerns in the region more quickly," Shah wrote.

A Facebook page run by a pharmacist who has relayed messages from Kansas City protest organizers posted a fairly positive response from the group, saying the new CVS regional leader has reached out and the company is promising better conditions, including adding more paid work hours to meet demand, hiring more staff, and reducing vaccination goals.

But critics are also faulting Shah for seeming to suggest the problems in Kansas City are limited to one market and are tied to vaccine demand, rather than stemming from what they say are widespread and systemic problems. In online discussions, people in the industry say CVS pharmacists in other states will likely hold their own walkouts if their working conditions don't improve.

And as the Kansas City organizers noted, a Walgreens walkout could be on the way: A post on Reddit has gotten traction after calling for pharmacists at Walgreens to stage their own protest from Oct. 9-11.

Pharmacists say CVS is understaffing and overworking them

From Nebraska to Iowa and California, pharmacists' professional associations are voicing their support for the Kansas City walkout, pointing to the national Pharmacy Workplace and Well-Being Report.

The report "underscores the persistent issues of inadequate staffing, unreasonable metrics, and harassment," the Nebraska Pharmacists Association said. And while a number of harassment cases noted in the report cite customers as the source of verbal or emotional harassment, the majority of them identified the harassers as managers and/or supervisors.

Many of the problems mirror issues found at CVS a store in Virginia Beach, Va., in 2021. Overwork and other problems were linked to dangerous errors in dispensing drugs — and violations that resulted in a $470,000 fine. In response, CVS reportedly said it "respectfully disagree[s]" with the investigation's results.

In that case, pharmacists warned that the problems extended far beyond one store, similar to how the current complaints are said to extend beyond Kansas City.

CVS has no one but itself to blame for the problems highlighted in the past week according to the California Pharmacists Association, which says it supports the pharmacists who walked out.

"CVS is mired in massive prescription backlogs of its own making," the group said on Wednesday. It accused CVS Caremark, the corporation's pharmacy benefit manager subsidiary, of "cherry-picking" patients and steering them away from other pharmacies. That, combined with understaffing, has put pharmacists and patients in a terrible situation, the association alleged.

New legislation aims to reform pharmacy benefit managers

In the U.S. health care system, companies known as pharmacy benefit managers, or PBMs, act as a go-between for insurance providers and drug makers. PBMs "were created in the 1960s to help employers and insurers select and purchase medications for their health plans," as NPR has reported.

Dozens of PBMs operate in the U.S., according to the National Association of Insurance Commissioners. But, it adds, a handful of those companies, including CVS Caremark, control some 89% of the market.

Two senators took aim at the PBM system on Thursday, introducing a bipartisan bill that looks to reform the way pharmacy benefit managers operate, saying the changes would bring prices down and boost competition.

Sen. Ron Wyden, D-Ore., a sponsor of the bill, called the companies "health care middlemen that are driving up costs for seniors and taxpayers."

Another sponsor, Sen. Mike Crapo, R-Idaho, said their bill, the Modernizing and Ensuring PBM Accountability Act, would ensure that "seniors can access the pharmacy of their choice, including in rural communities."