WALDEN – Is it wise to depend on multinational corporations for our basic needs? I’ve been thinking about this question in light of the closure of Walgreens in Hardwick, which leaves the town without a pharmacy and residents with at least a 16-mile drive for their prescriptions.
Many have been quick to forgive Walgreens for their decision: after all, the Hardwick location was flooded twice recently, both times forcing months-long closures. But I suspect other reasons played into the decision: after all, Walgreens permanently closed their downtown Morrisville and St. Johnsbury locations in 2023, neither of them because of flooding or other natural disaster.
When Walgreens shutters a branch, a PR spokesman offers this boilerplate rationale: “When faced with the difficult task of closing a particular location, several factors are taken into account, including things like the dynamics of the local market and changes in the buying habits of our patients and customers.” For those who don’t understand corporate-speak, he’s saying the stores weren’t profitable enough. Flooding aside, the same was probably true of the Hardwick store.
Walgreens, the second-largest pharmacy chain in the U.S. and Vermont, is a subsidiary of the multinational holding company Walgreen Boots Alliance, formed when the company took over the U.K.’s largest pharmacy chain, Boots. Last year’s sales were $139.1 billion, giving it a No. 18 ranking among Fortune 500 companies. It’s a safe bet that none of the corporate executives at the company’s Illinois headquarters had ever been to Hardwick when they made the decision to close the store.
Walgreens’ devotion to profits has come at a price for the public. At the end of 2022 the company settled for $5.7 billion for its role in the opioid crisis, which has had a devastating impact on communities like Hardwick. Earlier that year the state of Vermont sued Walgreens over dozens of cases of medication errors, including the vaccination of three children in St. Johnsbury with Pfizer COVID-19 vaccines that were mistakenly diluted with an unapproved substance. Mistakes like these were a “strong consequence of Walgreens’ business practices”, according to the director of the Office of Professional Regulation, when he announced a settlement of the case this year.
Is Walgreens just a “bad apple,” and would a different corporate pharmacy be better? How about CVS, the largest pharmacy chain in the U.S., and No. 5 in the Fortune 500? They were also complicit in the opioid crisis, and settled claims for $5 billion.
It’s time to consider a radical alternative: ban all chain drugstores in Vermont, leaving the market to small, local, independent pharmacies. This may sound absurdly pie-in-the-sky, but it’s already been done: North Dakota imposed a ban on chain pharmacies almost 60 years ago. If you assume that the benighted residents of that rural state must pay more and drive further for their prescriptions, you’d be mistaken. A study by the Institute for Local Self-Reliance (ILSR) compared outcomes in the neighboring states of North and South Dakota, similar in most regards except that chain drug stores dominate in South Dakota. The study found that prescription prices were lower in North Dakota. In fact the state has lower prescription prices than most of the US. The ILSR report also found that “independent pharmacies consistently outperform pharmacies operated by chains and big boxes, providing more one-on-one interaction with the pharmacist, shorter wait times, fewer out-of-stock drugs, and more health advice and screenings.” Pharmacies are also much more plentiful and more broadly distributed in North Dakota than in South Dakota, more so than in the rest of the country in fact. There are also economic benefits to independent pharmacies. ILSR calculated that if North Dakota’s ban on chain pharmacies were rescinded, the direct economic losses would be between $17 million and $29 million a year, with corresponding declines in indirect economic activity and tax revenue.
Not surprisingly, out-of-state corporate interests have been trying for years to overturn North Dakota’s chain drugstore ban. Walmart and Walgreens twice joined forces to try to get the legislature to lift the ban, and ran a petition drive to hold a referendum on the law. All these efforts failed: North Dakotans must be more savvy about corporate power than Vermonters.
Needless to say, chain pharmacies are just one facet of a failed healthcare system. Big Pharma, for example, uses both chain and independent pharmacies to push particular medications onto the most vulnerable segments of the public. (An excellent article in the June 2019 North Star Monthly about the closing of Gauthier’s, the last independent pharmacy in St. Johnsbury, describes how it’s done and how the system punishes independent pharmacies.)
It’s time Vermonters stopped being passive, complacent, and easily manipulated sources of revenue for huge corporations, whether in healthcare, food, energy, media, or retail. The logical path forward is towards local control over our basic needs.
Steven Gorelick
