Pharmacies 'going to be the Blockbuster Video of health care.' What to do if yours closes

• Health experts share tips for Ohio residents whose pharmacies are closing.
• Experts suggest to act fast to transfer your presription to your preferred location before the pharmacy does the transfer for you.
• You also can file a complaint with the state if your prescriptions aren't filled within three business days.

Pharmacies are closing all over Ohio, leaving people alarmed about the future of their prescriptions.

Rite Aid filed for Chapter 11 bankruptcy in October, closing more than 500 locations nationwide. Stark and Cuyahoga counties are losing roughly a dozen Rite Aid stores each, more than any other county in Ohio.

Walgreens is also closing about 25% of its 8,600 nationwide locations, 140 of which are in Ohio. A Columbus Walgreens shut down permanently in April.

What happens if closure befalls your chosen pharmacy? Here's what health experts recommend to keep tabs on your prescriptions.

What happens to my prescription when my pharmacy closes?

If you know your pharmacy is closing, act fast, said David Burke, executive director of the Ohio Pharmacists Association. Contact your pharmacy to find out the deadline to transfer your prescriptions to a new pharmacy and the process of doing so yourself.

When your pharmacy closes, your prescriptions are required by law to have a home, so pharmacy workers will send your prescriptions to another location if you don't choose a new pharmacy first. He said your pharmacy must notify you of its closing date and your prescription's new location before it closes.

Brad White, president of Medicine Center Pharmacy in Canton, said you don't have to be stuck with the new pharmacy that is chosen for you.

"People don't know what's going on because they can't understand how such a huge chain can suddenly be closing," said White, whose pharmacy has seen an influx of former Rite Aid patients. "A lot of people also feel trapped, like they have some obligation to go to wherever Rite Aid sent their prescription, but you are the consumer and have the right to choose."

Summer Corson, policy and public affairs liaison for the Ohio Board of Pharmacy, said the board has a rule stating that requests to move a patient's prescription to a new pharmacy must be approved timely and moved to a location of the patient's choosing. Transfers can be done only with the patient's consent, she said.

How can I change my prescription's location after it is moved?

If you don't like your new pharmacy, you can move your prescription by going to the new location and requesting that future pickups be delivered to a different pharmacy. But Burke said when and how often you can transfer your prescription to a different pharmacy depends on whether the prescription is for a controlled medication or a noncontrolled medication.

Talk with your doctor to confirm whether your medications are controlled or noncontrolled, but, generally, the National Institutes of Health say controlled medications are substances deemed by doctors to have a potential for physical or mental dependency and follow strict and consistent intake and refill plans. These include medications for anxiety, ADHD, depression and nerve pain and substances such as marijuana, sleep medications and opioids.

Prescriptions for noncontrolled substances, such as insulin, asthma inhalers and medications for blood pressure, cholesterol, coughs and colds, can have their location moved an infinite number of times at a patient's request.

Under law, controlled prescriptions can be moved to another location only once. A closure-switch counts for this one allotted location change because the prescription moves to a new license holder, Burke said.

If your controlled prescription is moved, you will need to either complete its full cycle of refills or have your doctor fill out a new prescription at a preferred, new location.

What if my new pharmacy doesn't accept my insurance?

White said some insurance providers lock patients into a specific location, an issue he said is especially prominent with insurance plans for retirees. He said these providers steer patients to a particular location that may not be convenient for them and can be rectified only by opting into mail-order prescriptions.

"My vote for anyone is that they should plan ahead because some providers are real sticklers," White said. "Check with your doctor, your insurance and your current pharmacy so you don't get caught in the lurch. Plan ahead however you can do it."

What happens if I experience new delays with my prescriptions?

Corson said the Board of Pharmacy requires prescriptions to be filled within three business days.

She said patients who experience delays beyond this timeframe can file a complaint with the board at https://www.pharmacy.ohio.gov/forms/complaint.

Will my prescription price increase?

White said he does not expect patients to see the price of their prescriptions increase if their pharmacy changes. However, he said some Medicare plans have a preferred network program, which may lead to an increase depending on the new location.

"If a patient has a generic co-pay of zero dollars at Rite Aid, it might be a dollar or two if their new pharmacy is a nonpreferred network location," White said.

What happens if pharmacies continue to close?

Burke, with the state pharmacists association, said the closing of pharmacies is not a new problem. Independent pharmacies and pharmaceutical providers have been closing long before the issue began toppling the country's largest chains like Rite Aid, Walgreens and CVS. This "race to the bottom" of major providers leaves Burke concerned about patient accessibility.

In areas where pharmacies have closed in large numbers, Burke said excess pressure is put upon fewer locations and pharmacists to fill and supply more prescriptions, possibly even turning a smaller profit. Burke said patients may see wait times increase from a few days to weeks at a time.

"I'm concerned with all these closings that we'll see pharmacies start to say they can't take any more patients at this time," Burke said. "So if you know this is happening to you, act now. The last thing you want is for Grandma or Auntie to find out their new location is on the other side of town when it could have been across the street."

Burke also said a lack of pharmacies may force patients to go to urgent care or the emergency room to get the medicines they need to stay healthy. White added that hospitals are feeling the strain as well.

"Now what we're starting to see are what we call pharmacy deserts, which means patients are required to travel an unreasonable distance to get their prescriptions," White said. "We're doing the best we can in our environment but something's got to change."

Iris Udeck is one patient adjusting to the closures.

The retired 80-year-old Canton resident said the Rite Aid at 2574 Easton St. NE in Plain Township never notified her of its plans to close.

She plans to start going to a Walmart that is just around the corner instead. Still, the Rite Aid closure is disappointing to her in other ways.

"I'm going to miss this location because they've really been a wonderful place to go to pick up all kinds of things, even foods," Udeck said. "Plus there's never been a wait time."

Udeck does not expect wait times to increase or become an issue when she switches pharmacies.

Why are so many pharmacies closing?

Burke said pharmacies are experiencing the near end of their business models' life cycles.

Reimbursements are shrinking along with profit margins, largely due to pharmaceutical producers offloading price setting to third-party pharmacy benefit managers or PBMs. Burke cited a lack of competition as a concern, as three PBMs — CVS Health (Caremark), Cigna (Evernorth/Express Scripts) and UnitedHealthcare (OptumRx) — control about 80% of the pharmaceutical market.

"Insurers have become the price-makers and the price-takers," Burke said. "This decoupling of the manufacturers from the costs leaves patients living in a world of made-up numbers made by people with obligations to shareholders and zero connection to the patients themselves."

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Burke expects things to get worse unless entities such as the Federal Trade Commission get involved to fix what he calls a "broken system."

"These locations aren't going out of business because they've made so much money that they need time to go to the Bahamas to count it all," Burke said. "You see patients' costs go up and payments to pharmacies go down. Where did the money go? I think that's a valid question."

White said he's concerned for the future of health care in Ohio.

"I've been a pharmacist for 30 years in a family-run business for 50 and I'm finding myself asking, 'What's gonna be left?'" White said. "Affordable, accessible health care is important to everyone, but now pharmacies are looking like they're going to be the Blockbuster Video of health care."

Reach Canton Repository writer Jack Solon at jsolon@gannett.com.