Despair and Hope: Is the retail community pharmacy workforce in danger of becoming a monopsony labor market?

BACKGROUND: Mergers of big chain retail community pharmacies can impact the competitiveness of the pharmacy workforce to negotiate better wages and work conditions. However, it is unclear whether these types of mergers are generalizable to the US pharmacy workforce. We should observe this effect when comparing annual wage trends between retail community pharmacy workers to non-retail community pharmacy workers. In the absence of this effect, annual wage trends would be similar.

OBJECTIVE: To examine this theory, annual wage trends for retail pharmacy workers were compared to hospital pharmacy workers between 2012 and 2022.

METHODS: A serial cross-sectional study was performed to compare the annual wages between retail community pharmacy workers and hospital pharmacy workers between 2012 and 2022 using data from the US Bureau of Labor and Statistics (BLS). Pharmacy workforce was categorized as pharmacists, pharmacy technicians, and pharmacy aides (clerks) and grouped into retail or hospital pharmacy settings based on the North American Industry Classification System. Pharmacy workers' annual wages were based on the US BLS Quarterly Census of Employment and Wages data.

RESULTS: Between 2012 and 2022, significant annual wage reduction was greater among pharmacists in the retail compared to pharmacists in the hospital setting by -$1974; 95 CI: -$2921, -$1026 per year. However, these trends were not significant among pharmacy technicians and pharmacy aides. Pharmacy technicians in the retail and hospital settings had a 3.4% and 7.0% increase in average annual wages, respectively. Pharmacy aides in the retail and hospital settings had a 16.8% and 21.6% increase in average annual wages, respectively.

CONCLUSIONS: Although pharmacists' annual wages decreased, it is unclear whether this was due to the monopsony labor market. These findings suggest that there may be inefficiencies in the retail community pharmacy labor market, which may stimulate policies to improve pharmacy workforce conditions and patient safety.