What pharmacy workers unionizing could mean for CVS and Walgreens

Roughly six months since the Pharmacy Guild was formed, a handful of retail pharmacies across the US have filed to join the union.

While unionizing is common for other healthcare workers like nurses, pharmacists historically haven’t organized. In 2023, just 4.6% of pharmacists (or about 15,260 people) were covered by union contracts, the Wall Street Journal reported.

The creation of the Pharmacy Guild and the subsequent unionizations followed a series of pharmacy worker walkouts in late 2023. But Gerald Friedman, a union expert and economics professor at the University of Massachusetts Amherst, is skeptical of how much of an effect a union could have against large corporations like CVS or Walgreens.

“I can’t be optimistic here, because these are powerful companies with huge resources and the ability to withstand union worker protests,” Friedman told Healthcare Brew. “In much of the country, there’s a CVS every 10 miles or closer than that. Organizing all those stores will be difficult for the unions—it’s not an easy fight.”

Widespread interest in unionizing

So far, of the five pharmacies that have filed to join the Pharmacy Guild, three have voted in favor of unionizing, according to Lannie Duong, a pharmacist and co-founder of the union. The three pharmacies that voted to unionize were all CVS locations; one was an Omnicare facility in Las Vegas, the other two were traditional CVS pharmacy stores in Rhode Island.

Though no Walgreens locations have formally voted to join the guild, three pharmacies in the Cleveland, Ohio, area expressed interest in unionizing at the end of 2023, Axios reported. Walgreens pharmacy workers in the Chicago area, who are represented by a separate union called the National Pharmacists Association–Laborers’ International Union of North America, demonstrated in April, advocating for better wages and hours, according to Axios. The union was formed in 1968 and represents roughly 900 pharmacists at more than 400 regional Walgreens stores.

Amy Thibault, a spokesperson for CVS, told Healthcare Brew that the company “respect[s] our employees’ right to either unionize or refrain from doing so.”

“While we believe the direct, two-way relationship we have with our colleagues is the best way to resolve workplace concerns, we have professional and productive relationships with our thousands of union employees and their union representatives,” Thibault said. “We’ll continue to work closely and collaboratively with all our colleagues to address any concerns they have now and in the future and are committed to providing a positive and rewarding work environment.”

Thibault added that roughly 700 of the company’s 30,000 pharmacists are unionized, and noted steps CVS has taken to improve its pharmacy employees’ work environment, including investing roughly $1 billion in wage increases since 2021 and “enhancing recruitment.”

Walgreens spokesperson Marty Maloney told Healthcare Brew the company “respect[s] the right of our team members to choose to be represented by a union, but we continue to believe the best way to maintain a positive environment is through the direct relationship between our team members and their managers, who are striving every day to achieve our shared purpose of serving our communities and reimagining local healthcare.”

Duong said the guild has campaigns going across the US.

“We’re seeing interest in organizing efforts across all sectors and across every region of the country,” she said. “Energy for change right now is countrywide, and it’s growing.”

The guild is open to organizing all types of pharmacies, not just retail, Duong added. Both pharmacists and pharmacy technicians—workers who handle clerical tasks like collecting patient information and preparing medication labels—are eligible to join.

Why are retail pharmacy workers unionizing?

Understaffing and concerns over patient safety are the primary reasons retail pharmacy workers have cited, according to Duong.

“Decisions are being made at higher levels by people who may or may not be familiar with the work of pharmacists and pharmacy technicians, or are just completely removed altogether,” she said. “There’s a big disconnect there.”

For example, large retail pharmacy chains sometimes impose quotas that are “completely unrelated to patient care,” like the number of prescriptions filled in a day and the length of time it takes a pharmacist to answer the phone, according to Duong.

“We’re a service-based industry being treated as a product-based industry,” she said.

In 2020, the New York Times reported on how corporate performance metrics have led to concerns over patient safety at large retail pharmacy chains, including CVS and Walgreens.

“Metrics put unnecessary pressure on pharmacy staff to fill prescriptions as fast as possible, resulting in errors,” an anonymous pharmacist wrote in a survey conducted by Missouri’s state pharmacy board, the Times reported.

Maloney said that Walgreens has “eliminated all task-based metrics for retail pharmacy staff as part of team members’ performance reviews, further enabling our pharmacists to practice to the full scope of their practice while creating a differentiated work environment within our pharmacies nationwide.”

An uphill climb

Friedman said that while he expects there will be continued efforts to unionize at retail pharmacies across the US, he cautioned that their chances for success the first time around against big chains may be low.

For example, the Walgreens workers in Cleveland didn’t get enough votes to successfully unionize at the end of 2023, but filed a petition to try for a second time at the end of May, Cleveland.com reported.

If the unions are ultimately able to succeed in unionizing, then they may be able to achieve some wins, Friedman added, like improved wages or higher staffing levels.

In the case, it’s likely CVS and Walgreens wouldn’t be affected much because the profit margin on pharmaceuticals is so large, and “these companies could afford to pay more,” Friedman said. “They’re very profitable companies.”