Rite Aid's 'Zombie' stores take over America
qz.com
qz.com
If drug costs were lower then we would see more independent pharmacies, and probably more chains, but in this economy..
https://www.commonwealthfund.org/publications/explainer/2019...
So I tried a bunch of local pharmacies, which were all much worse experiences in various ways (failure to fill scripts because they couldn't source things, their online systems straight up didn't work, the lines to pick things up were very long...)
Then I tried Capsule, which was great...at first. Then one day, they completely failed to deliver a med I was about to run out of, and their "24/7 live chat" took 4+ hours to respond that they couldn't get it to me until after I would have missed a dose, and when I replied to that, got an automated message that it was closed for the day.
So now I just suck it up and deal with the Duane Reade, because there is so much further down to go.
Then I wonder who they are trying to cater to. If it's a smaller and quicker grocery experience, they're competing with nearly every dollar store and gas station. In my experience at least, they're often severely understaffed and not at all quicker.
I guess grocery and online expanding into prescriptions, and the death of print photo were a one-two punch. What's interesting is that they've been declining for years, and at least to myself the consumer, don't appear to be trying to do anything different.
But I haven't seen one since the 80s.
The bulk of the profit margin for gas stations come from things other than fuel sales, i.e. the convenience store.
But that convenience stuff was always more expensive, and depending on your taste and preferences not especially desirable.
Mostly tabac and alcoholics, I guess.
That was pre-Covid. Post-covid full greedflation set in.
Like two to five times more expensive, than the also more expensive stuff in supermarkets.
Memories from about 1.5 years ago, for something on 'special sale' for €9,99(20 Deutsche Mark, Alder, Ey!), a 0,33L can of some whiskey-coke, which sells for about €2,50 to €3 normally.
Bag of chips, €4,99(10 Mark!1!!), single candy bar, €3,99 WTF?!
I don't see that to this level in the .us for comparable stuff.
Their membership offers a monthly store credit of $10 at a monthly cost of only $5 and it still barely feels worthwhile.
Services like package drop off (CVS does UPS, Walgreens Fedex), bill pay, etc. While print photo isn't what it used to be, if you want a specialty photo printed like a larger size, it's pretty fast and cheap to do so (you can typically upload your photo and pick up in a couple of hours)
A family owned dollar store with pharma and fresh grocery would be a good replacement for many of these cookie cutter pharmacies that are disappearing.
In American suburbia, having the smallest store possible isn't an advantage at all: We are mostly talking strip malls, where it takes some time to get in or out. The energy expenditure of leaving an arterial, parking and walking us much higher than just turning inside a store from a sidewalk in a trip you were already taking. This leads to minimal demand for stores that are very small, or sell cheap items. The smallest you are going to find is the restaurant with a drive-through, which is still quite big.
The other issue is that instead of having most prescriptions in blisters, and a quick, automated dispensing system that lets you in an out of the store in seconds, American pharmacies just do way too much work to dispense medicine. Part is insurance and price variation, part regulation, and part just not having everything standardized and in blisters and bottles. So if you go to the pharmacy, you either call in advance, or you are going to sit there for a while.
Both of those things are pushing you to sell something more in the pharmacy, so you get a build in convenience store, which is as bad at pricing as any other convenience store.
The Spanish pharmacy, where you can get in and out in under a minute, and yet it's often seen as the first layer of the medical system for medical advice, is so much better, but it'd not make any sense given how the US is built, and how we regulate the pharmacy.
They have cleverly, although transparently, applied the fee model to prescriptions. You see one price on their page, but when you get to checkout the total price inclusive of everything might be more expensive than your local Walmart.
Their marketing is incredibly effective, though. I can’t believe how many people think Cost Plus must be the cheapest option who are then shocked to discover the same prescription is $4 at their local Walmart.
I haven’t filled a prescription in a brick and mortar pharmacy for a long time. Only limitations of online pharmacies are no consults, no vaccinations and no controlled substances.
I still go to a Safeway pharmacy for my shots. Even with an appointment I have to wait 30 mins or mlre because the staff are slammed. Pharmacist friends tell me it’s not a great time to be a pharmacist because of the shortage of techs.
I tell folks that if they can move their prescription online, they should. Not only will it save you the hassle, it’ll take the pressure off brick and mortars and actually help them improve in-person service for those who need it.
Oddly enough, their non-insurance/Prime price is more affordable than my Bronze-level insurance plan.
The HEB a few minutes further down the road also is fine, so it’s often branch dependent in my experience (mismanagement?)
Never, ever let CVS get hold of your cell number. They start texting and texting and texting, and to get it to stop you have to phone your local store AND the headquarters.
It feels like everywhere at all times, people are playing dirty to protect their cash flows, doing anything they can get away with to keep new entrants out of markets. They even weaponize it against other giants, too (eg JEDI, or wielding the EPA against SpaceX).
This doesn’t seem like a failure of capitalism to me, but a failure of government. Not that the government failed to regulate, no; that they were explicitly captured in such a way that results in regulation that ensures nobody except the existing, connected players can participate.
If you want to have even a tiny chance to edge in, you have to be backed by immense capital and be connected with someone who can put in a word with the right people. In tech, VCs like YC or a16z or the so-called PayPal mafia come to mind.
Innovation, but only via undocumented, preapproved channels.
It’s illegal or effectively illegal to make new pharmaceutical factories, or new retail pharmacies, or new hospitals, or new financial services and payment systems, or new banks, or new safe deposit boxes, or transit services, or ISPs, or schools, or any myriad other verticals that have been regulated to oblivion for entrants in the name of “consumer safety”. If search engines or public libraries were invented today they’d be shut down in days, perhaps hours. Even Tesla fought the biggest uphill battle to be able to sell cars direct to consumers, as it was outlawed in many states.
I really want to see orders of magnitude more new small businesses, but the American population seems to be regarded as a resource to be harvested rather than an economic talent pool to be developed.
Everyone wants more mom-and-pops, except the existing ownership class, because they aren’t on SecondMarket.
It’s late USSR economics with feel good nomenclature.
With e.g. Elon Musk getting heavily involved in government in sort of a vague way we’re stepping into some new stage of this. We must slash entitlements to fund corporate tax cuts comrade.
Apparently we’re kind of over it on even pretending a tiny corporate elite doesn’t just directly set policy in flagrant, naked, unapologetic self-interest.
Capitalism sounds dope: I hope I live to see it.
There are way more than two car manufacturers and for prescriptions in particular, just near me there is CVS, Walgreens, Publix, Target and Walmart.
Cable is very much a natural monopoly because of the infrastructure and right of way issues.
None of the rest of your list is illegal or hard to do. But it takes capital to build physical stuff.
I travel a lot and my wife and I did the digital nomad thing for a year. I got my prescriptions refilled at CVS from San Juan to Las Vegas that year.
Speaking of deposit boxes, we also have a virtual mailbox whose physical location is in the back of a tax preparation office. Our important mail is sent there and when we were traveling, we could have it scanned and discarded once we viewed the image or bulk shipped to where we were. It’s dead simple to either get 1Postal or UPS franchise.
You aren’t going to have a mom and pop transit service that works globally. Again as frequent travelers, Uber and Lyft were a god send.
Banks definitely have capitalization requirements and dozens of virtual banks went out of business around 2008. I worked at a company that did bulk commercial physical and virtual mail for them - not spam, statements, notices, etc
> Lowe’s or Home Depot
Harbor Freight, random local lumber yards
> Cox or Centurylink
Comcast. A few others too. Usually you only have one choice though. Dish if you're talking about TV instead of internet, various phone company offerings if you're talking about internet.
> Ford or Chevy
There's more auto companies than I can count, particularly if you include all the foreign brands sold in America, which you should because some of them are very popular and are broadly recognized to have superior vehicles.
> * Kroger or Walmart, *
Giant, Food Lion, Aldis, Target, Wholefoods, Trader Joes, more regionals than you can shake a stick at.
So much faster then going to CVS, you just give them the scrip, they put the pills in the bottle, done in 5 min. Pay cash, no insurance BS. No ID since they know all their customers. Somehow they always have what you need, even when there is a shortage of a particular medicine.
Sometimes grandma tries to give me free stuff when she rings me up and I am like, no dammit, I need you to say in business or else I am doomed deal with the megacorps again. Take my money please!
In the US, insurance companies and Pharmacy Benefit Managers (PBMs)[0] are the biggest threat to smaller, independent pharmacies. Even if your neighborhood has a Mom and Pop pharmacy (a rarity, as you suggest), if most insurance providers do not provide coverage for that pharmacy I doubt many folks will go there. Instead they would go further across town or use online services - driving independent pharmacies out of business.
On the side of the PBMs influence, the consumer might not see a difference in the price in order for the indie pharmacy to stay competitive, but the cost of medicine for indie pharmacy can be much higher than the corporate pharmacy - meaning they make no money on a sale and in some cases actually lose money. (I recently learned that in some cases, specifically with GoodRx, indie pharmacies can be forced to pay the PBM when a customer uses a PBM discount card at their pharmacy - so the consumer pays the PBM and the pharmacy pays the PBM)
Large corporate pharmacies have the strength and power to influence insurance providers and PBMs - and some even control them. That in my mind is the bigger issue in the US.
0: https://www.reuters.com/legal/litigation/goodrx-pbms-accused...
Everywhere.
Give me a zip code and I will find an independent pharmacist near it.
Here's one in downtown Manhattan: https://www.elmdrugs.com/
Here's one in Fairbanks, Alaska: https://akfamilypharmacy.com/
Here's one 30 miles away from the center of Loving County, Texas, the least-populated (pop: 64) county in the United States: https://www.facebook.com/p/Hometown-Pharmacy-Kermit-10007757...
Just like with purchasing products made locally/sustainably, it is often a matter of convenience and lack of effort which leads people to believe that there are no other options than what is being marketed towards them.
I found them the same way I found my pharmacy-- the National Community Pharmacists Association pharmacy locator: https://ncpa.org/pharmacy-locator
I had this exact conversation recently. When I pointed out that we have a mom and pop drug store within walking distance of our neighborhood, the conversation shifted to imagined complaints that they wouldn’t have necessary medications in stock, they might not accept the right insurance, or that prices would be higher.
Many people’s stated preferences favor small, independent products. Often their revealed preferences favor the large company, cheapest, or most convenient option.
This conversation plays out for cheap Amazon products, too. I’ve heard so many people complain that Amazon is full of cheap foreign products, followed by them bragging about how little they paid for some cheap thing from Amazon recently.
Now remember that, in theory at least, basically everything in the pharmacy that is not behind the counter is more or less the equivalent of the candy by the register in grocery stores, for pharmacies - something they hope you'll go "oh, yeah, I could use that" and buy.
...of course, given that most of the pharmacies I've been to have started locking 90% of their stuff behind "call an associate" barriers anyway, vending machines would probably be a better-scaling model, but that becomes a little awkward because you can't easily mix "things you must go pay at the register for" and "things you bought from the machine", and I think in the limit case you wind up with something like Amazon's experiments in checkoutless groceries to make this work, or a store that's just rows of vending machines and then the pharmacy at the back.
Especially when it seems to me, in the Jersey suburbs outside of NYC, CVS and Walgreens are doing just fine.
> Meanwhile, Walgreens is also having a tough time. The pharmacy giant said in October it would close roughly 1,200 U.S. stores over the next three years, including 500 locations in fiscal 2025. In June, it said about 8,600 locations would be shuttered over the next few years.
If burdened with sufficient debt, there is no such thing as a viable business.
They have acquired 18 companies in 10 years.