By Bryce Covert
This article was produced by Capital & Main. It is republished here with permission
At least once a week, Aisha Torres arrives at her job as a technician at a CVS specialty pharmacy in Redlands, California, only to find that she’s already behind. The company’s network of specialty pharmacies serve patients with complex and chronic conditions who often need rare or expensive medications delivered to their door. But due to staffing shortages across the country, she said, an increasing number of patients from the East Coast and Midwest get forwarded to her pharmacy.
When her CVS opens at 7 a.m., the pharmacy staff is therefore often already working at full capacity, forcing new patients to the end of the line and, in some cases, delaying their service until the following day. During one week in mid-August, this happened almost every day.
“Our patients have rare, fatal diseases,” she said. “If they’re having an attack or a bleed, they need their medications shipped immediately.”
Torres has worked for CVS Specialty for seven years. “I love being able to help these patients that have these rare diseases,” Torres said. But, she added, the understaffing means that that sense of satisfaction, of a job well done, is often out of reach.
CVS is the largest pharmacy in the country, earning a quarter of all prescription dispensing revenue nationwide and employing 90,000 pharmacists and technicians. Now Torres has joined employees in California and two other states in taking the company’s staffing and pay practices head on. In early August, the 150 members of the Pharmacy Guild/IAM in six stores held a vote to authorize a strike. Members voted yes by huge margins: 100% in Arizona, 96.7% in favor in California and 90.3% in favor in Rhode Island. They’re demanding that the company come to the bargaining table and agree to hire more employees and pay them better.
They’re not the only pharmacy employees who are readying to go on strike: In-house California pharmacists at grocery stores Ralphs, Vons, Albertsons and Pavilions voted to authorize an unfair labor practices strike in July. Those workers are represented by United Food and Commercial Workers.
Given the particular needs of the patients served by Torres’ store, it can take 30 minutes to an hour to fill one prescription. The backlog forces her to rush, and she’s constantly worried that she’s going to make a mistake. For a year, she said, she’s been telling her boss that more staff need to be hired so that all of the medications can get out the door on time. On days when she and her team can’t fill all of the prescription needs of their patients, “It stresses us out,” she said. “We’re furious. Why are we not able to help our patients?”
Amy Thibault, a CVS spokesperson, said the company was “committed to ensuring there are appropriate levels of staffing and resources” at CVS pharmacies, adding, “Our pharmacist staffing levels, supported by pharmacy technicians, are tailored to unique store-specific attributes and hours of operation to provide care in our communities.”
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Yet understaffing is a trend that’s affecting pharmacies across the country. Letters to at least two dozen state pharmacy regulatory boards reviewed by the New York Times in 2020 found numerous complaints from pharmacists about understaffing that kept them from effectively and appropriately doing their jobs. In a 2024 survey, three-quarters of pharmacists rated their workload as “high” or “extremely high,” up from two-thirds in 2014. A quarter said they were likely to leave their job in the next year.
While workers wait for the company to respond to their demands, the union notched another victory: Late last month, pharmacy technicians at a CVS in Henderson, Nevada, voted to unionize with the Pharmacy Guild, becoming the only active unionized pharmacy in the state.
Torres, who has never been a member of a union before, voted to authorize a strike. “We don’t want to strike, but we are united and prepared to do so,” she said.
Torres thinks CVS will quickly feel the impact if workers do go out on strike, particularly in her pharmacy. She said that it takes months of training to be able to do her job. “We do specialized work, and you can’t come in one day and do what we do,” she said. “When we do strike, they’re not going to have anyone there experienced to work these orders.”
Asked about a strike’s potential impact on customers, CVS’ Thibault said in her email, “We have contingency plans in place to help ensure patients continue to receive the care and support they need in the event of a disruption.”
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Chris Eggeman has been working for CVS in Rhode Island, where the company is headquartered, since 2010, when he was a pharmacy school student intern. CVS was his first-choice employer when he graduated in 2014, and he’s been employed there ever since. In that time, he said he’s watched workloads increase as staffing levels decline. As the industry consolidates, with chains like CVS buying up independent pharmacies, more prescriptions land on his desk, he said. It’s not uncommon for him to handle 600 prescriptions over a 10-hour shift — one each minute.
Ever since the pandemic, he’s also been expected to give patients yearly flu and Covid vaccines. That’s on top of consultations from patients who are taking new medications or have questions. “You’re constantly doing six things at once,” he said. “It’s just more responsibility getting added on with less help over time, and that has just been the trend for the last decade.”
That harms patients, he argued, who almost always have to wait in long lines. He also worries about overworked pharmacists making mistakes when they fill prescriptions. Medication errors affect 1.5 million Americans a year and kill anywhere between 7,000 and 9,000 people. “You want to sleep easy at night knowing you’ve done everything you can,” Eggeman said. But, instead, “You might leave thinking, ‘Did I make a mistake, did I have time to check all of these, did I provide the best care I possibly could for this patient?”
“Patient safety is our highest priority, and any claims otherwise are untrue,” Thibault said.
The pressure on pharmacists to work faster with fewer staff has landed CVS in hot water before. In late 2024, the Department of Justice filed a nationwide lawsuit against the company accusing it of unlawfully filling controlled substance prescriptions due in part to staffing policies and performance metrics that “prioritized corporate profits over patient safety.” In 2024, the company settled a $1.5 million fine from the Ohio Board of Pharmacy for having too little staff to handle prescriptions and help patients.
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While increasing staffing levels is the union’s highest priority, CVS pharmacy employees are also demanding higher pay. Low pay for technicians is directly linked to high turnover rates, which exacerbate understaffing, said Eggeman, who is a pharmacist. Technicians require less education and are typically paid significantly less than pharmacists.
“If you can fix those conditions, you can make it a place where it’s no longer a revolving door. It’s a place people want to stick around,” he said. “You can develop a team that can better deliver care to patients.”
Torres earns $21.90 per hour after working at CVS Specialty for seven years. She had been receiving annual raises of just 25 cents an hour, but even those evaporated recently. Unionized CVS employees say the company has been withholding all raises from them for the past two years, saying it will give them out only after a contract is signed. CVS’ Thibault didn’t respond to a question about whether this is the company’s practice.
The union has also accused the company of slow walking the negotiations and not bargaining in good faith; it’s filed multiple unfair labor practice charges with the National Labor Relations Board. On Aug. 5, the board found that CVS had violated federal labor law by failing to recognize and bargain with the union in three locations. Thibault, however, maintains that the company has “been engaged in good-faith negotiations with the Pharmacy Guild” for over a year.
It’s been hard for Torres to go without a raise. A single mother of two kids, she is solely responsible for $1,500 in monthly rent on top of her other bills. She believes she is due a promotion, given that she’s trained everyone on her team and developed a set of standards for how technicians should operate at her CVS. She said she’s been told she can’t be promoted until a contract is signed.
“I feel like we’re just not getting respected. We’re having to demand them to see us,” Torres said. “We really just want CVS to bargain fairly, and we want our first contract to hurry up and be signed.”
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