Kaine Vows Change as Pharmacies Face Lower Revenue

Independent pharmacies in Virginia struggle with reimbursement rates from insurance companies and PBMs

Apr. 3, 2026 at 6:34pm

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A ghostly, translucent X-ray photograph of a pharmacy pill bottle, revealing its internal structure in glowing lines against a dark background, conceptually illustrating the financial challenges facing independent pharmacies.An X-ray view of a pharmacy medication bottle highlights the financial pressures facing independent pharmacies across the country.Williamsburg Today

U.S. Senator Tim Kaine met with independent pharmacists in Virginia's Hampton Roads region to discuss the financial challenges facing community pharmacies, including reimbursement rates from insurance companies and pharmacy benefit managers (PBMs) that are often below the cost of medications. Kaine acknowledged the issue and said reform is on the horizon, though pharmacies may not see real change until 2029.

Why it matters

The declining number of independent pharmacies, including the closure of some rural locations, has left some communities without easy access to medications. This issue disproportionately impacts lower-income patients who rely on local pharmacies for their prescriptions.

The details

Pharmacies mainly make money through reimbursement fees from insurance companies or PBMs, who act as intermediaries in the medication supply chain. However, independent pharmacies say those reimbursements are not enough to cover their costs, leading some to cut staff or consider closing. The abrupt closure of many independent pharmacies over the last few years has left some jurisdictions, including Surry and Charles City counties, without any pharmacists at all, forcing patients to travel long distances to fill prescriptions.

  • The number of community pharmacies in Virginia has decreased by about 10% since 2019.
  • Kaine said reform is on the horizon, though pharmacies may not see any real change until 2029.

The players

Tim Kaine

A U.S. Senator and member of the Senate Health, Education, Labor and Pensions Committee, who is working to address the financial challenges facing independent pharmacies.

Jamie Fisher

The executive director of the Virginia Pharmacy Association, who stated that the issue of declining reimbursement rates is a "big issue" affecting pharmacies across the nation.

Dr. Anna Casey Peoples

The CEO and founder of Peoples Pharmacy & Diabetic Clinic in Norfolk, who said the reimbursement rates from insurance companies and PBMs are "below what we are paying for our medications and that's what we need fixed."

Dr. Henry Ranger

The co-owner of The Prescription Shoppe in James City County, who said he sees patients daily who are unable to afford their medications, but he doesn't turn them away.

Deb Prosek

A pharmacist with Williamsburg Drug Company, who said "It's the patients who will suffer" if more community pharmacies are forced to close.

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What they’re saying

“They are below what we are paying for our medications and that's what we need fixed.”

— Dr. Anna Casey Peoples, CEO and founder of Peoples Pharmacy & Diabetic Clinic

“Patients have to ride the ferry to get their medications. That is unbelievable.”

— Dr. Henry Ranger, Co-owner of The Prescription Shoppe

“We are taking those losses every day.”

— Dr. Henry Ranger, Co-owner of The Prescription Shoppe

“It is ingrained in our DNA to help people. It is hard to say no to our patients' though pharmacies may have to 'restructure' in order to stay in business.”

— Dr. Anna Casey Peoples, CEO and founder of Peoples Pharmacy & Diabetic Clinic

“It's the patients who will suffer. We are all so passionate about our patients and it breaks my heart that in five or 10 years some of us won't be here.”

— Deb Prosek, Pharmacist at Williamsburg Drug Company

What’s next

Kaine said a hearing with independent pharmacies about the matter might be beneficial, stating that such businesses have a good reputation in Washington D.C., which would help their cause.

The takeaway

This issue highlights the financial pressures facing independent pharmacies, particularly in rural and underserved areas, and the potential impact on patient access to affordable medications. Addressing the reimbursement rates from insurance companies and PBMs will be crucial to ensuring the survival of community pharmacies and preserving their role in providing personalized, accessible healthcare.