Clinton pharmacy hosts roundtable as independent pharmacy closures mount statewide

Sadler Hughes Apothecary in Clinton hosted a small group of pharmacists, patients and state lawmakers Thursday, Oct. 22, for a roundtable on the pharmacy closure crisis in South Carolina and what the losses mean for the communities they serve.

From January 2023 through May 2026, 155 pharmacies closed across the state, according to the South Carolina Pharmacy Association. Independent pharmacies have been hit especially hard, with 117 closing from 2023 through 2025. Behind those numbers are patients, and several of them came to Clinton to share concerns about delayed medications, limits on which pharmacy they can use and the value of personal care from a pharmacist who knows them.

Participants pointed to pharmacy benefit managers, or PBMs, as a major cause. PBMs are companies hired by insurers and employers to run prescription drug coverage, deciding which drugs are covered, what patients pay, how much pharmacies are reimbursed and where patients can fill their prescriptions.

The pharmacy has served Clinton since 1917. Walter M. Hughes III, the fourth generation of his family to own the business, said independent pharmacies are not asking for special treatment.

“All we’re looking for is a level playing field,” Hughes said. “We’re not asking for the competition to be taken care of for us. We’re just asking to compete on the same level as these multinational organizations.”

He pointed to the days after the recent hurricane as an example.

“We were open two hours later than our normal start time, while a lot of the big box, multibillion-dollar corporations were not open for five or six days,” Hughes said. “We were operating a food bank, a bank, a charging station and a health resource for the community. That’s the value we bring to the table.”

Joining Hughes were Lynn Connelly, who has owned Medicine Mart Pharmacy in West Columbia for 42 years; Brian Clark, a pharmacist and CEO of the South Carolina Pharmacy Association; local patients; state Sen. Danny Verdin, a Republican who represents District 9; and state Rep. Heath Sessions, a Republican who represents District 46. Miguel Rodriguez, executive vice president and general counsel of American Pharmacies, an advocacy group and buying cooperative for independent pharmacies, moderated.

Paid less than the cost of the drug

Connelly said his pharmacy did not miss a single day during the COVID-19 pandemic, but reimbursement has fallen so low that many pharmacies cannot survive.

“Some of these PBMs are paying us 20 cents or less,” he said. “I saw one study where 80% of a pharmacy’s prescriptions were underwater. There’s no way people can stay in business with that kind of reimbursement.”

Clark said South Carolina is losing a net of about 40 pharmacies a year, about half of them independent.

“Once these pharmacies close, they’re not coming back,” Clark said. “Insurance rates keep going up, and the amount pharmacies are getting paid keeps going down. The math just isn’t mathing.”

Enforcement is key

Clark said PBM reform will require action at both the state and federal levels, along with real enforcement. South Carolina has passed two PBM laws in the past, he said, but the companies have adapted, and the state lacks the resources to hold them accountable.

The state has 46 licensed PBMs, which pay $1,000 to register and $500 to renew. That brings in about $20,000, not enough to fund a single full-time employee to enforce existing PBM laws. Clark said South Carolina must give the S.C. Department of Insurance clear authority and effective processes to hold PBMs accountable.

Walter Hughes Jr., also a pharmacist at the store, said much of the money involved comes from taxpayers and should be tracked.

“When taxpayers are involved, there needs to be accountability from these companies,” he said. “I don’t know how much longer everybody else is going to be able to last.”

Patients share their stories

Larry Hall, a retired Air Force veteran, said his TRICARE for Life coverage runs through Express Scripts, which began requiring him on Oct. 1 to get one medication by mail.

“It’s been 10 days, and I have no idea when it’s going to get here,” Hall said. “Fortunately, Sadler Hughes has bailed me out again, and it’s been multiple times.”

The Rev. Anthony Sims, whose family has used the pharmacy for three generations, said the difference is personal.

“At the bigger drugstores, you’re more like a number than a friend or a patient,” Sims said. “When you come here, you’re family. To lose a hometown drugstore like this would be a big loss.”

Lawmakers weigh in

Sessions said his own family was pushed toward mail order when their insurance changed PBMs, even though their local pharmacy was two blocks from home.

“Somehow we have ceded our own rights to an insurance company making billions of dollars to tell us where to go,” Sessions said. “How did we get to an environment where patients don’t have a choice to walk into their neighborhood pharmacy?”

Sessions said some of the solution may not require new legislation at all, but the will to enforce laws already on the books and investigate PBMs that steer patients to affiliated pharmacies outside the state. He said this year’s state budget creates a joint House and Senate ad hoc committee on PBMs, expected to begin work after the election, and called on the next governor to make enforcement a priority.

Verdin said the issue crosses party lines.

“It doesn’t matter if you’re a Republican, a Democrat or an independent,” Verdin said. “This country can unify around being healthy. Heaven forbid there’s not a fifth generation of this family operating here 30 years from now. That would be a sad testimonial for the community, the state and the country.”

Clark said patients will be key to any change and encouraged them to ask their legislators to support stronger PBM protections and enforcement.

“The one thing the other side doesn’t have is the patients, and we do,” he said. “If the patients don’t stand up, we’re going to continue to lose these pharmacies.”