A pharmacist with a 'thank you' bag in hand.
Photo: Gregory Reid

Love Oak Pharmacy in Eastland, Texas, puts together individualized daily pill packs for customers with multiple prescriptions in order to reduce the risk that they will mix up drugs or skip doses. Asti’s South Hills Pharmacy in Pittsburgh offers free home delivery, sometimes on the same day. And pharmacists at Hayat Pharmacy in Milwaukee speak a total of 19 languages, helping them to serve a diverse community.

Personalized care like that seems to be what people value in a drugstore—and where independent pharmacies often seem to excel. That’s according to Consumer Reports’ new pharmacy ratings, based on survey responses from more than 78,000 CR members.

Mom-and-pop stores earned high marks on such measures as courtesy, helpfulness, and speed of checkout and filling prescriptions, as well as pharmacists’ knowledge and accuracy.

More on Drug Costs & Pharmacies

“People want to be treated as individuals,” says Chris Antypas, Pharm.D., co-owner of Asti’s pharmacy. “Independent pharmacists can do this because we are focused on the patient relationship.”

Daniel Holt, 53, a CR member who says he’s loyal to Suba Pharmacy in New York City, calls it a neighborhood gem. “I’d rather give my money to small, local businesses owned by members of my community,” he says.

But powerful forces are threatening the more than 23,500 independent pharmacies across the U.S. Mega-mergers among national corporations could disrupt the $453 billion retail pharmacy industry.

In June 2018, Amazon announced it would enter the prescription drug business with its purchase of the online pharmacy PillPack for $753 million. And CVS Health, one of the largest pharmacy chains in the U.S., purchased one of the country’s biggest health insurers, Aetna. A merger between another major insurer, Cigna, and one of the largest prescription “middleman” companies in the U.S., Express Scripts, could further change how drugs are bought and sold here.

Still, “independent pharmacies historically have been really good at adapting when faced with competition,” says Hashim Zaibak, Pharm.D., an owner of Hayat Pharmacy. Being small means they can make decisions and changes quickly based on what customers need, Zaibak says.

Mike Swanoski, Pharm.D., an associate professor of pharmacy practice at the University of Minnesota, agrees. “The owners live in these communities,” he says, “and decisions about how to best serve their communities may be made due to a deeper understanding of the needs of their patients.”

While independents land at the top of our ratings because of their customer service and speediness at filling prescriptions, that’s not all you should consider when choosing a pharmacy. Other factors include cost, convenience, and the services offered. Below, our tips on how to find the best pharmacy for your needs, and how to get the most out of any pharmacy you go to.

Find a ‘Preferred’ Pharmacy

If you have insurance, your copay might be the same no matter which pharmacy you choose. But that’s not always the case. Many insurers negotiate special deals with drugstores, offering lower out-of-pocket costs when you fill prescriptions at a preferred pharmacy.

Almost all Medicare Part D plans, and most of those offered by employers, now include preferred pharmacies, hoping consumers use them to save on out-of-pocket costs, says Stephen Buck, a former executive of the drug wholesaler McKesson and a founder of GoodRx, a website where consumers can download coupons to use in local pharmacies.

When people don’t use one of those pharmacies, they pay an average of 36 percent more for their meds, according to a 2017 survey from the Pharmacy Benefit Management Institute.

For people with Medicare Part D, it could get tougher to find a preferred pharmacy, especially among independents. Last year about 4,000 of them declined to join preferred pharmacy networks for Medicare Part D drug plans, says Adam Fein, CEO of the Drug Channels Institute, a market research and consulting firm.

CR’s tip: When choosing a drugstore, ask the pharmacist, your insurer, or your employer’s human resource department whether the one you’re considering is on your plan’s list of preferred pharmacies. If not, ask how much more you would pay at a different store.

“My first job was as a delivery driver for the same pharmacy I later purchased. This pharmacy has been owned by hometown people for a very long time.”

Benjamin McNabb

Love Oak Pharmacy, Eastland, Texas

Ask for the Best Price

Even at preferred pharmacies, how much you pay for your meds can depend on other factors, notably whether pharmacists there are willing to work with you to find discounts and other ways to save on drugs.

While that can happen in any pharmacy, it’s more likely at independents. Twenty-one percent of people in our survey said pharmacists at those stores were able to suggest a less expensive medication compared with 9 percent who said pharmacists in chain stores were able to.

That was the experience of Hanan, a recent immigrant from Jordan, when she tried to fill a prescription for her husband’s diabetes drug at Hayat Pharmacy in Milwaukee. Shocked that even with insurance she had to pay $136 out of pocket, Hanan—who preferred not to give her last name for this article—asked why they were so expensive. Bushra Zaibak, a co-owner at Hayat, offered to go online and found a discount that lowered the price to $5.

“Medications are so expensive in this country,” Hanan says. “I am just grateful that Hayat Pharmacy helped us so much. No one else at the other pharmacies offered.”

CR’s tips: CR’s shoppers have found that asking “Is this your lowest price?” at a pharmacy can save them cash even with insurance. Pharmacists used to be bound by gag clauses that prevented them from bringing up other options unless you asked.

While that restriction no longer exists thanks to legislation—long supported by CR—that was passed in 2018 by Congress, it’s a good idea for you to take the initiative. The question may prompt pharmacists to consider discount programs their drugstores offer or look into discounts offered through websites such as GoodRx and Blink Health. Or it might encourage them to look for a generic or similar drug that works just as well but costs less.

If you don’t have insurance or if you don’t want to use your insurance for reason, note that CR’s shoppers have found that out-of-pocket prices at stores like Costco and Sam’s Club can be lower than those at big pharmacy chains. Or try the online pharmacy HealthWarehouse.com, which also has low prices.

Decide What Services Matter

The range of services offered by pharmacies, including chains and independents, is growing fast. Many now offer flu and other vaccinations, including travel vaccines. Some help manage “specialty” drugs, complicated medications that require injections or infusions. Or pharmacies can monitor blood pressure or blood sugar levels.

“Patients spend a lot more time in their local pharmacy than in the doctor’s office, so I see it as a great opportunity to get their blood pressure checked,” says Michael Hochman, M.D., director of the Gehr Center for Health Systems Science at the Keck School of Medicine of USC in Los Angeles.

Some chains are adding walk-in health clinics to their stores, where you can get basic care even on weekends and at night without an appointment. The number of those clinics at chains such as CVS and Walgreens grew by 47 percent between 2014 and 2017. And CVS says that with its merger with Aetna, it plans to open even more of them.

Many chain and big-box stores have smartphone apps or websites that allow you to manage your prescription refills and schedule flu shots or other immunizations. Rite Aid, Walgreens, and Walmart even offer low-cost prescription meds for pets.

Independent pharmacies sometimes offer more niche services. For example, last year when Linda and Earl Bullock of Eastland, Texas, needed help choosing a Medicare Part D plan, they enlisted the help of Benjamin McNabb, Pharm.D., at Love Oak Pharmacy. Ben, as Linda Bullock calls him, had their drug histories, so he was able to help them choose a plan that covered all of their drugs and was affordable, too.

Love Oak Pharmacy can also help homebound patients manage complex drug regimens. “We have trained personnel who can go into the home and assist that patient directly, especially for those who take multiple medications and who have other health problems,” McNabb says.

CR’s tips: “Talk with your pharmacist and find out what they offer in services,” Linda Bullock says. “You might be surprised at all that’s on offer.” Then decide which of those services matter most to you and consider that information when selecting a pharmacy.

Experts say it’s generally okay to use a pharmacy for your vaccines or go to a retail clinic for basic health problems like a rash or sprain, but it’s still important to have a primary care physician and to keep him or her in the loop. For example, share the results of your blood pressure tests with your physician, and let him or her know you got a flu shot so that the information is noted in your medical record.

“Independent pharmacies can adapt to serve diverse communities. For example, we have staff who, together, can speak 19 different languages.”

Hashim and Bushra Zaibak

Hayat Pharmacy, Milwaukee

Consider Convenience

Independents, for all their benefits, may be less likely to be open for as many days or hours as big chains like CVS, Rite Aid, and Walgreens. Those chains have stores that offer 24-hour, 7-day-a-week service, as well as convenient locations and even drive-thru windows. And chains, along with pharmacies in grocery stores and club stores like Costco and Sam’s Club, sell a wide range of other products, so you can pick up your prescriptions at the same time you do other shopping.

Mail order is an option if you want to skip stores altogether. You can often arrange for deliveries through your insurer, an online drugstore like HealthWarehouse.com, or a walk-in store with a mail-order program, such as Costco.

CR’s tip: Convenience does matter, and the easier it is for you to fill your prescriptions, the more likely you might be to take the drugs you need. But don’t choose a pharmacy just because of its hours, especially if you have a complicated drug regimen that could benefit from the close attention of a pharmacist.

Stick With One Store

Once you settle on a pharmacy, stick with it, says Barbara Young, Pharm.D., of the American Society of Health System Pharmacists. That ensures that all of your medications—and those of your family—will be saved in a single computer system. Pharmacists can easily check for possible interactions with any new medications you start or flag other safety concerns.

At least once a year, sit with your pharmacist for a complete medication review, a 15-minute checkup of everything you take, including vitamins, herbals, and over-the-counter drugs, along with any prescription medications. That can help you eliminate duplicate or unnecessary drugs, says Chris Antypas of Asti’s South Hills Pharmacy.

CR’s tip: By having all of your prescriptions filled at a single place, the pharmacist might be able to “sync” them so that they’re refilled at the same time.

“Medication is no help if you don’t get to take it. So if you can’t get out of your house, we bring it to you. My delivery drivers know you. They know your family.”

Chris Antypas 

Asti’s South Hills Pharmacy, Pittsburgh

How to Switch Pharmacies

If you decide to switch pharmacies for any reason, follow these steps:

Get your prescriptions moved. Have your new pharmacist ask your old one to transfer them. For some meds, your doctor might need to issue a new prescription.

Provide key medical info. Give the new pharmacy your insurance information, your medical history, a list of any medication allergies you have, and a list of the prescription and OTC drugs and supplements you take.

Let your doctors know. Call their offices to provide them with updated pharmacy information.

Editor’s Note: This article also appeared in the March 2019 issue of Consumer Reports magazine.