Local Pharmacies Overwhelmingly Need Coronavirus Small Business Aid as Reimbursements and Cash Flow Decline

NCPA April 20, 2020

ALEXANDRIA, Va. (April 20, 2020) — Nearly 90 percent of community pharmacies will apply for small business federal aid under the CARES Act to help them get through the coronavirus storm, according to a new survey released today by the National Community Pharmacists Association.

“Pharmacies are ‘essential businesses’ staying open during the COVID-19 pandemic to keep serving their communities, but many are on the brink at the very time they are needed most,” says NCPA CEO B. Douglas Hoey, pharmacist, MBA. “In the 18 months before this crisis, the number of pharmacies had shrunk by over 2,000, mostly due to low reimbursement from pharmacy benefit managers. Ten million patients lost the pharmacy of their choice in just over a year – a staggering number that will only grow during the pandemic recovery if pharmacies don’t have relief from below-cost PBM reimbursements so they can be there into the future.”

As the pandemic strains neighborhood pharmacies, nearly half of pharmacy owners rank the overall financial health of their business as somewhat poor or very poor, according to the survey.

Eighty-five percent of independent pharmacies report seeing an increase in the number of products reimbursed below acquisition cost since March 1, forcing them to dispense more prescriptions at a loss. Additionally, 66 percent are experiencing negative cash flow issues as pharmacy direct and indirect remuneration fees, decreasing reimbursement, and coronavirus-related expenses make it difficult to stay in business. Half of pharmacy owners reported paying more than $10,000 in pharmacy DIR fees since March 1. If this pace continues, the average independent pharmacy will be on track to have approximately $100,000 clawed back in the next 12 months.

“Some of the most vulnerable patients and communities rely on the safety net that is local pharmacy,” Hoey says. “Small businesses are the economic backbone of the U.S. economy. The Trump administration and Congress must work together to authorize additional funds for the Paycheck Protection Program, support America’s small business economy, and help the pharmacy safety net serve communities in normal times and in times of crisis.”

The NCPA survey was conducted from April 9 through April 14. It was sent to approximately 8,000 independent pharmacy owners and managers, with approximately 510 responding.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 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 www.ncpa.org.