PENDER, Neb (KMTV) — It's been a challenging decade for pharmacists.
According to a 2021 study published in Health Affairs, 30% of all pharmacies opened between 2010 and 2020 had closed their doors by 2021.
Its a problem that has only grown in Nebraska in recent years.
"Nebraska had the third highest percentage of pharmacy closures between 2021 and 2024. That puts patients in what we call a pharmacy desert," said Jordan Hanson, the Pharmacy manager for The Apothecary Shop in Pender.
At the heart of the issue for many pharmacies is the growing influence of Pharmacy Benefit Managers.
Hanson says these insurance middlemen are now dictating where patients are getting their drugs and sometimes even who can administer them.
Hanson also says that back and forth, just like what doctors do with insurers, is delaying patient care and causing prices to jump for patients and pharmacists.
"They might not recommend the most affordable medication because of the kickback they are getting from the drug manufacturer on the back end of that," said Hanson.
The kickbacks that Jordan mentions come from a practice called "white bagging".
White bagging is when Pharmacy Benefit Managers require a prescription be filled at a specialty pharmacy then delivered to your doctor or pharmacist rather than filling it locally.
The catch?
"Ultimately though they are all pretty much owned by insurance companies," said Jeremy Nordquist with the Nebraska Hospital Association.
A new bill, LB109, is looking to cut down on white bagging and give more control back to local pharmacists.
It would prohibit insurers from requiring drugs be dispensed only at their pharmacies to receive coverage and prohibit them from charging higher fees to dispense drugs at pharmacy's not selected by insurers.
Jordan is hopeful that stricter guard rails on Pharmacy Benefit Managers will help protect rural pharmacies like The Apothecary Shop and keep the more than 800 patients she serves a month from getting thrown into a Pharmacy desert.
"Every pharmacy that closes increases that and its definitely disproportionately higher in rural areas," said Hanson.
