By Katie Bass, PharmD
The Fresno Bee
May 9, 2025
Being a pharmacist is in my blood.
My family owned and operated San Joaquin Drug for nearly 20 years before I purchased the pharmacy in 2019. I was committed to continuing the important services and traditions my family established, like the annual health fair, free delivery to neighboring communities and incorporating new services to increase our value to the patients. Looking to help my rural neighbors even more, I later opened Yosemite Drug, a pharmacy in Coarsegold.
One of my favorite parts about being a community pharmacist is interacting with my patients, becoming the friendly neighborhood drug store on which everyone could rely. We do more than dispense essential medications, we listen to our patients, we know about their kids and we know about their jobs. We are a part of their lives.
We have never hesitated to step up for our rural community. During the pandemic, we were one of the first to offer COVID testing, including rapid testing, and we quickly distributed the vaccines once available. We held blood drives, used grants to fund smoking cessation efforts, administered HIV prevention medications and filled prescriptions for inmates at the Mariposa County Jail.
Although our community was thriving, both of my pharmacies were struggling financially. That’s because pharmacy benefit managers, the third-party middlemen between health insurers and pharmaceutical companies that determine what medicines are covered and how much they’ll cost, were severely underpaying us. For a medicine that costs $500, they’d reimburse us at $450. Over time, these types of discrepancies really add up, and the continued undercutting of costs led to the eventual closures of both San Joaquin Drug and Yosemite Drug.
Instead of supporting patient care, pharmacy benefit managers have created a system that actively hurts small, independent pharmacies like mine.
It was devastating to close our doors both for me and for the Coarsegold and Planada communities. San Joaquin Drug served a high-poverty, predominantly Latino community, and the closure of Yosemite Drug left Coarsegold residents — nearly a third of whom are over the age of 60 — without a local pharmacy.
Pharmacy benefit managers didn’t just shut down a small business, they took away a part of the community, directly impacting residents’ health and well-being.
When independent and community pharmacies like mine are pushed to the brink of extinction, it creates pharmacy deserts, which is exactly what’s happening in rural and even urban regions throughout the state. Between 2013-2022 almost 10% of the nation’s independent rural drug stores closed due to pharmacy benefit managers’ substantial influence in the pricing of essential medications. Pharmacy benefit managers are monopolizing communities and reducing patients to dollar signs instead of treating them like real humans with lives and families.
Our health care system is failing patients by forcing them to rely on pharmacy benefit manager-owned pharmacies (primarily mail order) instead of having real choices. There are efforts underway to increase oversight of pharmacy benefit managers, like Senate Bill 41 by Senator Scott Wiener, D-San Francisco, which would hold PBMs accountable, ban several unfair business practices and create long overdue transparency protocols.
It’s past time to fix this broken system. The state must act now before more community pharmacies are forced to close. Our patients deserve better.
Katie Bass is a pharmacist and former owner of San Joaquin Drug and Yosemite Drug. As a member of the California Pharmacists Association, she advocates for independent pharmacies, patients and the future of PBM reform in California.