Why were pharmacies viable before? Presumably they didn't lose money for their whole history.

Most pharmacies are having financial issues basically due to being stuck in the middle of the battle between insurers, drug manufacturers, and PBMs over reimbursement rates, and having the weakest negotiating position of all of the parties.

AI probably will save the pharmacies some money, but IMO this will probably cause reimbursement rates to decline further, leaving the pharmacies in the same position as before.

	▲	taurath 2 days ago \| parent \| next [-]
		Weakest negotiating position other than the customers. The funny part is probably a majority of pharmacies are owned by CVS or Walgreens each of which are insurance companies in their own right, and often people with company health insurance will ONLY allow reimbursements through their company pharmacy.
	▲	Scoundreller 2 days ago \| parent \| prev [-]
		Tbh, this is most industries. Very few have much of a moat and have some wedge/pressure from their suppliers (land/labor/capital), their clients and competition. Insurance companies and PBMs would probably say the same they have competitors (ie:replaceable) and can’t just pay more for this or that, or reject any cost saving measure available.

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jonathan-adly 2 days ago | parent | prev | next [-]

https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2024.0...

Of the 88,930 retail pharmacies operating during 2010–20, 29.4 percent had closed by 2021.

	▲	nickphx 2 days ago \| parent [-]
		and that was not due to answering phones .. adding a nondeterministic black box of bullshit will change nothing.

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milkshakes 2 days ago | parent | prev | next [-]

see: https://en.wikipedia.org/wiki/Pharmacy_benefit_management

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quickthrowman a day ago | parent | prev [-]

PBMs gained control of drug pricing and squeezed out the small pharmacies that don’t offer additional services like compounding.

CVS And Walgreens both own and operate PBMs. And UHG (Optum), 19 Blue Cross plans collectively own Prime Therapeutics, Kaiser owns one, the DVA has one, Express Scripts is owned by Cigna. There’s likely more I am unfamiliar with too.