'It's awful right now': Customers see long wait times, drug shortages. Little Chute pharmacist explains why.

LITTLE CHUTE — Frankly, Nic Smith said he's never seen so many angry people come to Smith Pharmacy because they had such poor experiences elsewhere.

"It's just one story after another," said Smith, pharmacist and owner of the Little Chute business. "People ... go to a pharmacy, and they wait in line for over an hour and they're mad. Or they tried calling for four hours and they can't get through to anybody. Then they come here, and they're upset, and ... we try to make things work.”

Flu and cold season is always a busy time, Smith said, especially with the latest RSV and COVID-19 vaccines. But it's been extra tricky, he said, to keep up with the "huge influx of customers" that his family-owned, independent pharmacy has experienced in recent months. Still, Smith said, they're doing they're best. And they're not alone.

Drug and staffing shortages have created long wait times and frustrated customers at pharmacies across the country, the Associated Press reported this fall. Meanwhile, thousands of pharmacists and pharmacy technicians from large retail chains, such as CVS and Walgreens, walked out to protest deteriorating working conditions, according to USA TODAY.

“They’re sick of getting yelled at by customers all day, or they're so hectic that they don't feel comfortable with the safety of what they're doing because they're under such pressure," Smith said.

Leaders of CVS and Walgreens previously said they've hired more people and added resources, among other steps, according to the Associated Press.

From Smith's perspective, though, there's an underlying issue that's snowballed over the years, he said, and led up to this point.

One Appleton resident struggled to get medications after surgery, another says he's switching pharmacies

In early December, The Post-Crescent asked readers about their recent experiences at area pharmacies. People who responded asked to not have their full names included in this story as they discussed private medical information.

After he had quadruple bypass surgery in early November, Jim, 78, of Appleton, said his doctor sent medications that he needed to start taking right away to the Walgreens at East Calumet Street and South Kensington Drive. Jim's wife checked with the pharmacy multiple times that Tuesday and Wednesday, and an employee said they were 460 prescriptions behind, according to Jim.

So, Jim had his medications resent to the Walmart on East Calumet, he said, and they were ready when his wife arrived.

It's "been a pain in the neck" for Bob, 80, of Appleton, to get what he needs at that same Walgreens. Bob said he feels trapped there, though, because of his insurance.

“I’ve been in sales and marketing all my life," Bob said, and "there’s three reasons why you buy: price, quality and service."

Quality is the same everywhere because it's the same prescription, he said. His insurance keeps him at Walgreens. But if he could find another place that would fill his prescription, even for a couple of a hundred dollars more, Bob said, "I would run away from Walgreens."

Next year, Bob said he plans to switch healthcare systems and start going to Hometown Pharmacy. It's a group of independent locations throughout Wisconsin and upper Michigan, which Bob hopes will provide a more personal touch.

More: 24-hour pharmacy on the horizon at ThedaCare Regional Medical Center-Neenah

Other people discussed pharmacies' limited hours. Many locations in the area close for a half an hour in the afternoons for meal breaks, according to the companies' websites.

An 89-year-old Appleton woman said she regularly waits about 30 minutes at the Walgreens at West Northland Avenue and North Richmond Street. Recently, she said she sat in the drive-thru for a little over an hour.

"I will say that everyone that works there is extremely friendly and helpful, even under really busy conditions," another person wrote about that location.

Drug shortages for diabetes, ADHD medications continue

While Kathleen, 78, had no problems getting vaccines at her pharmacy, the Appleton resident said she's had trouble getting her Trulicity prescription for her diabetes.

“I’m really worried ... because I have no doses left in my refrigerator," she told The Post-Crescent in mid-December.

Kathleen said she checks with her Pick 'n Save pharmacy on North Ballard Road every couple of days. The staff has been helpful, she said, checking at other pharmacies in the system. They told her Green Bay had a dose, but the time Kathleen called, she said, someone else had already purchased it.

While, Kathleen's prescription is for a 90 day supply, she's considered getting smaller doses, she said, but that could lead to insurance issues. Kathleen also hasn't tried other area pharmacies yet because she imagines everyone is in the "same boat."

This has been an "enormous problem," said Smith, of Little Chute's Smith Pharmacy, because this class of medications became popular on social media over the past year because of how well they work for weight loss.

“Now everybody wants to be on it, so manufacturers literally cannot make it fast enough," he said, and people who need it for diabetes struggle to get their doses.

There have been other drug shortages, too. For instance, Smith said access to medication for attention-deficit/hyperactivity disorder continues to be a problem.

Smith Pharmacy lost $200K on one drug, says insurance reimbursements getting 'worse'

In the 10 years that Smith Pharmacy has been in business, "this is one of the toughest times" they've faced, Smith said, second to the COVID-19 pandemic.

"It's awful right now, to be honest," Smith said about the struggles that customers, pharmacies and staff are facing.

In Smith's opinion, "it all boils down to PBMs," he said, or pharmacy benefit managers. According to the Wisconsin Independent Pharmacy Association, PBMs "act as middlemen between drug makers, health insurers and pharmacies." Over the years, Smith said, PBMs have put a tighter squeeze on pharmacies, making insurance reimbursements "worse and worse and worse."

"We lost over $200,000 on one drug alone this year from insurance reimbursements," Smith said.

More: Prescription for disaster: America's broken pharmacy system in revolt over burnout and errors

Pharmacies have had to adapt to survive, according to Smith. In order to be profitable, pharmacies run a "very lean staff," he said, but then employees get burned out and customer service struggles, creating "a trickle down effect."

Smith Pharmacy has about 50 employees, he said, including 10 pharmacists, 32 technicians and two registered nurses. They plan to expand at Freedom Road, but Smith said that's still months away.

"It scares me because customer service is our forte," he said. "That's our bread and butter, and I don't want to lose that by having crazy volume and chaos every day."

Pharmacist hopes Wisconsin bill will help; Universities create programs to get more people in field

There is currently a PBM reform bill — cosponsored by representatives from Fond du Lac, Harrison, Hobart and Oshkosh — in the Wisconsin Legislature, which Smith said would "help a lot." Among other things, Senate Bill 737 says a pharmacy benefit manager would have to reimburse at least the same rate as Wisconsin Medicaid.

Smith said he sees Wisconsin Medicaid as a "fair insurance, where you’re making five to 10 dollars on every prescription."

"You're certainly not going to get rich off it," he said, "but you're not going to lose money on it."

Steve Swanson, dean of the University of Wisconsin-Madison's School of Pharmacy, recently wrote about this legislation and the challenges that pharmacies face. Swanson also reflected on a "dramatic decline in applications to pharmacy schools nationwide."

Earlier this year, the UW-Madison School of Pharmacy created the PharmD Early Assurance program to help high school seniors enter the field. This fall, University of Wisconsin-Milwaukee also partnered with the Medical College of Wisconsin School of Pharmacy to create an accelerated path for pharmacy students.

"For us, technicians are hard to find," Smith said.

More: They stayed in nursing after COVID. But these Wisconsin nurses will never be the same.

Be kind, 'have patience,' pharmacist says

As problems persist, Smith recommends that people find a pharmacy they trust and "have patience." Be kind, he said, and don't get mad at pharmacists at area stores.

"It's not their fault," Smith said. "They're trying their tail off."

Even the corporate leaders of chain pharmacies are "in a tough spot" right now, he said, navigating whether to staff stores appropriately and lose money, or hope a lean staff can keep things running and make a profit.

It's also helpful to keep an eye on prescriptions and request a refill before running out to give pharmacists extra time to fill them, according to Smith.

Reporter Alexandria Bursiek Kloehn contributed to this story.

Reach Becky Jacobs at bjacobs@gannett.com or 920-993-7117. Follow her on Twitter at @ruthyjacobs.

This article originally appeared on Appleton Post-Crescent: Little Chute's Smith Pharmacy owner explains delays, drug shortages