News

Harrisonville, Mo. – Tessa Schnelle, PharmD, DPLA, director of pharmacy at Cass Regional Medical Center, has made it her mission to save remaining independent pharmacies in the region so that rural communities continue to have access to care.

Schnelle, who lives in Louisburg, Kansas, also works as a clinical pharmacist at the University of Kansas Health System and is the current board president of the Kansas Pharmacists Association. She is close to completing a master’s degree in public health, and has been researching growing “pharmacy deserts” in the U.S. as part of her master’s thesis. A pharmacy desert occurs when patients have to drive 15 minutes or more to access a pharmacy.

A recent study found that the number of independent pharmacies in Kansas declined 12% from 2010 to 2019, increasing the number of pharmacy deserts. The problem is not unique to Kansas; two well-known independent pharmacies in Cass County, Missouri, Drexel Pharmacy and Gillen Pharmacy, closed last year.

According to Schnelle and her colleagues, a key factor that has caused the decline in independent pharmacies is the business practice employed by many pharmacy benefit managers (PBMs). PBMs act as brokers between insurance companies and pharmacies, and often require patients to transfer away from independent pharmacies to corporate chain and mail order pharmacies that can accommodate lower reimbursement rates. Larger companies can absorb the impact of lower rates through higher volumes, whereas smaller, independent pharmacies are unable to do so.

“Because I am not in contracts with the PBMs, I am able to raise awareness without concern for retribution, unlike my colleagues,” Schnelle explained. “My independent pharmacy colleagues do a great deal for the rural areas we serve and I’m unwilling to watch them be taken out by corporate monopolies without at least letting patients know why their independent pharmacy is no more. I do not think many independent pharmacies will see 2025 based on the recent reimbursement structures that are in place,” she added.

Schnelle recently testified at a meeting of the Kansas House of Representatives Committee on Insurance to bring awareness to the negative impact that PBM practices have had on patient care, and to urge legislators to provide better oversight of the industry. She also met with Jonathan Blum, principal deputy administrator and chief operating officer for the Centers for Medicare and Medicaid, where she advocated for sustainable reimbursement, provided education on pharmacy deserts, and discussed the underutilization of pharmacists in the healthcare safety net.

“I grew up in rural America, I live in rural America and I choose to serve patients in rural America,” Schnelle said. “Advocating for the best care available is my purpose, and I do it for the patients and colleagues that I serve.”