$189 charged, $15 collected: The life and death of a local independent drugstore
BRATTLEBORO — Eye all the photos, postcards and news clippings that paper Mary Giamartino’s office, and you’ll see how the Hotel Pharmacy opened at downtown’s Brooks House in 1940, then kept its name when it moved to the old fire station in 1978 and to the former Methodist church in 1993.
But just past the store shelves lit by century-and-a-half-old stained-glass windows is a stack of bills that illuminates an even bigger contrast.
Take the prescription for the pain reliever hydromorphone. The pharmacy bought it for a patient at $189.12. Yet, after the customer’s $10 copay, insurance reimbursed only another $15.21.
“I lost $163.91,” Giamartino said. “But do you not fill it? No, this woman was dying.”
And so, as a result, is the local independent drugstore — a shooting star outside a larger galaxy of corporate insurers, big-box pharmacies and generic manufacturers.
“Loss, loss, loss, loss, loss, loss, loss …” Giamartino said as she ran her finger down record after record calculating what’s charged versus what’s collected. “It just kept getting worse and worse and worse and worse and worse and worse. Like beyond worse.”
That’s why the Brattleboro mom-and-pop will close for good Tuesday after 83 years, dispersing customers to one of the town’s four chain drugstores while dropping the number of Vermont independents from upward of 50 a decade ago to 16 today.
“Insurance company reimbursements to us are so low, we can’t make any money,” Giamartino said. “It just got to the point where there was nothing else I could do.”
The 67-year-old didn’t envision her current predicament when she and her fellow pharmacist husband, Frank, bought the business in 1982. Working more collaboratively than competitively, the drugstore was one of three downtown seemingly founded by Mr. Gower in the film “It’s a Wonderful Life.”
Moving to the former Methodist church, the metropolitan New York family hung Mets baseball banners under the vaulted ceiling, rock-riffing stereo speakers where the choir once sang, and snapshots everywhere else of sons Vincent and Nicholas — the latter pictured on a school bus alongside classmate (and current state treasurer) Mike Pieciak.Then came tragedy. In 2001, Nicholas died in his sleep from an infection at age 17. Five years later, in 2006, Frank was killed in a car crash at age 53.
“The only good thing about this,” the wife and mother told the local paper upon her husband’s death, “is that every day he won’t have to wake up and say, ‘I love you, Nick. I miss you.’”
Giamartino has run the business ever since, heading a team of 20 employees who offer 24-hour emergency service, local delivery and the ability to compound medication in-house.
“They go out of their way to support the clientele,” said Karen Peterson, outgoing executive director of the AIDS Project of Southern Vermont. “It doesn’t matter who you are or what your status is in the community. You feel cared for there. You are an individual, not a number.”
Hotel Pharmacy has stood alone after the closure of Brattleboro’s three other mom-and-pop drugstores. Statewide, it has seen counterparts recently shuttered or sold to larger outfits in Bennington and Manchester; Bristol, Middlebury and Vergennes; Rutland; and Woodstock.
Independent drugstores hope a new Vermont law boosting state regulation of pharmacy benefit management will start to stem the losses.
“Pharmacies are not in control of their financials — we don’t control the cost of the medications, nor do we control the reimbursement,” said Jeff Hochberg, president of the Vermont Retail Druggists Association. “Every state in the country is feeling this, rural ones in particular. I think that pharmacy is a great bellwether for true reform of the health care system.”
The Vermont Department of Financial Regulation is set to release a report on the issue this month. But it’s too little too late for Hotel Pharmacy, which has waded too many years in red ink.
Giamartino tried to cut costs by dropping advertising, then donations to community causes, then staff raises and bonuses. This past year she looked for someone to buy the business.
No one made an offer.
“A friend said, ‘Mary, it’s going to break your heart. Get ready.’ And I said, ‘I bet everything I have that it won’t.’ I was wrong.”
And so Giamartino reached out to Brattleboro’s two chains, Rite Aid and Walgreens, before deciding to pass on her customer files to the latter upon the close of business Tuesday.
No one is happy with the ending, as seen on social media or heard through talk about town.
“We made sure our patients would be OK,” said Jodi Harrison, a pharmacy technician for three decades. “Now we’re not sure who’s going to make sure.”
Giamartino is set to sell the building, but not before gathering the photos, postcards and clippings that hold so many memories.
“I am going to remember working with a wonderful group of people that gave the best possible pharmacy care that anybody could,” she said. “There’s nothing like helping somebody, making them feel better, letting them die the way they want to die.”
Even if, as she understands firsthand, they ultimately don’t want to.
Filed under: General Problems
its been said that the PBMs reiumburse the larger pharm chains that they own at higher rates.
So sad. So bloody sad