Jim Kenyon: Closing of Eastman’s Pharmacy Is a Bitter Pill to Swallow

When mega retailer CVS opened a drugstore in Hanover 10 years ago, I figured it was only a matter of time before Eastman’s Pharmacy ran up the white flag.

But against overwhelming odds, the small independent pharmacy, a fixture in Hanover’s downtown since the late 1930s, refused to surrender. Owners Mark and Melissa Knight carved out a niche. They offered free home delivery of prescriptions three days a week, with Mark sometimes doing the delivering himself. The couple took advantage of Melissa’s special talents as a compounding pharmacist. She concocted customized medications, including foot creams, which doctors prescribe but aren’t available on most pharmacists’ shelves.

And as Jan Bent, who has been getting her prescriptions filled at Eastman’s for 50 years, told me, “I can call here and a real person actually answers the phone.”

After Wednesday, there will be no one at 22 South Main St. to pick up on the other end. The Knights are selling their pharmacy business to CVS, which will close it. Warner Pharmacy in Warner, N.H., is taking over Eastman’s compounding prescription business.

The Knights’ decision to close up shop now wasn’t because they suddenly lost their appetite for competing against the larger CVS down the street.

Dartmouth-Hitchcock forced their hand.

In the interest of reducing health insurance costs, D-H is no longer allowing its 8,700 workers to choose their own pharmacy. Some retirees, depending on their type of prescription coverage, will see their choice of pharmacies become severely limited, too.

Since Eastman’s isn’t on D-H’s short list (and believe me, it’s extremely short) of “preferred pharmacies,” hospital employees would have to chip in a larger co-pay to continue getting prescriptions filled at the downtown Hanover drugstore. “Dartmouth-Hitchcock was a big part of our business,” said Melissa Knight.

To receive their insurance plan’s maximum benefits, employees are being urged (you might even say forced) to fill their short-term prescriptions at D-H’s mother ship, Dartmouth-Hitchcock Medical Center in Lebanon, which has its own in-house retail pharmacy. So-called maintenance medications for chronic illnesses, such as diabetes and high blood pressure, will be purchased via D-H’s or CVS’ mail order.

Why CVS?

CVS is not only the nation’s second-largest drugstore chain, with 7,600 outlets, it also manages pharmacy benefits plans for employers, including D-H.

I wanted to talk with someone at D-H who was involved in the decision. I guess they were all too busy. A D-H spokesman asked me to put my questions in writing. The next day, I received his reply.

“Like a lot of other employers, D-H has transitioned to a mail-order program for maintenance medications, and is encouraging employees, retirees and their families to obtain care, both medical and pharmacy, within the D-H system whenever possible,” wrote the media relations manager. “This is consistent with D-H’s ongoing efforts to improve population health and lower the cost of high-quality care.”

The people running D-H make a big deal of patients being allowed to pick their own doctors without being dictated to by insurance companies. Apparently, they don’t feel the same way about pharmacists.

Along with having their choices limited, D-H workers have another reason to be concerned. A worker who takes prescription medications for a mental illness, for instance, might prefer to deal with a pharmacist not on D-H’s payroll. But with more employees’ prescriptions being filled in-house, D-H could have access to private information that it didn’t have before.

“Some people don’t feel comfortable” having their prescriptions filled by their employer, said Mark Knight, who is not a pharmacist but ran the business side of Eastman’s.

The Knights heard about the changes in D-H’s prescription benefits plan from a customer — I guess the people at D-H were too busy to give them a call, either — in December.

During the nine years that they’ve owned the drugstore, the Knights have rejected feelers from CVS and other pharmacy giants. But with the threat of losing its D-H customers looming, Mark Knight called CVS’ headquarters in Woonsocket, R.I. “The writing is on the wall,” he said. “We can see it.”

The Knights have spent the last week breaking the news to their customers the same way they took care of their prescription needs — face to face. On Thursday morning, a steady stream of customers made their way to the pharmacy counter at the back of the store.

“You’re breaking my heart,” said Toni Jeffery, a retired nursery school teacher who started coming to Eastman’s in 1964.

“Thank you for your business all these years,” replied Mark Knight. Other than Melissa working part-time at the pharmacy in Warner, the Knights aren’t sure what’s next. The check they’re receiving from CVS isn’t enough for them, at the age of 43, to “hit the beach,” said Mark. The Eastman’s building, which they don’t own, is for sale.

With Eastman’s closing, the Family Pharmacy in Enfield is the last independently owned drugstore in Grafton County, said Ed McGee, co-owner of Family Pharmacy.

McGee, president of the New Hampshire Independent Pharmacy Association, recently talked with a D-H official about its decision. “Every penny of mail-order prescriptions is leaving the Upper Valley and doesn’t get spent here,” said McGee.

The buy local argument didn’t seem to have much sway, he told me.

I’m not surprised. D-H is a health care behemoth. It doesn’t spend a lot of time sweating over what its decisions might mean to a small independent pharmacy in Hanover.

A few years ago, D-H began using the slogan, “A Culture of Caring.” And that’s the bottom line.

Jim Kenyon can be reached at jkenyon@vnews.com.