Walgreens’ Prescription Monopoly is Harming Patients and Destroying Competition

I am writing to you not merely to express concern, but to demand urgent action against the dangerous monopoly — both actual and structural — that Walgreens has achieved in the U.S. prescription drug market. Walgreens’ power over prescription fulfillment, distribution, retail access, and now consolidation through private equity is actively harming consumers, eroding competition, and weakening the very fabric of our healthcare system. 1. Walgreens’ Market Power Harms Patients Financially and Practically Walgreens fills an enormous volume of prescriptions — more than 170 million per year, a business scale few independent pharmacies can match — and is aggressively automating fulfillment to cement this advantage. Their centralized micro‑fulfillment centers now handle around 40% of the prescriptions sent to supported stores, creating steep barriers for smaller pharmacies that cannot match these efficiencies. This consolidation increases corporate pricing power and squeezes patients. Walgreens recently settled a class action lawsuit for $100 million over overcharging customers on generic drugs for more than a decade, allegedly misrepresenting prices to insurers versus customers. 2. Walgreens’ Influence Has Helped Destroy Independent Pharmacies The pharmacy landscape is collapsing under the strain of chain dominance, reimbursement pressure from intermediaries, and the steep scale advantages chains like Walgreens possess: National closures of independent pharmacies continue, with about 360 independents closing last year alone — roughly one per day. Walgreens, CVS, and other giant chains are closing more than 1,200 total Walgreens stores nationwide over the next three years, disproportionately affecting underserved communities and creating pharmacy deserts. These closures funnel more prescription volume exclusively to the largest chains, making Walgreens and CVS the only choices in many communities. That isn’t competition — it’s coercion by market saturation. 3. Monopolistic Behavior Has Public Health Consequences Walgreens’ power isn’t confined to economics — it has real-world health effects: The company agreed to a federal settlement of up to $350 million over allegations it filled millions of illegal opioid prescriptions, and was accused of ignoring clear warning signs in dispensing controlled substances. Even where Walgreens denies wrongdoing, the pattern of corporate behavior gives pause: when a pharmacy that claims to serve the public interest becomes one of the largest distributors for dangerous drugs, that is a structural problem, not an accident. 4. Vertical Integration and Supply Chain Control Harms Competition Walgreens’ model — controlling supply, fulfillment, and retail — gives it outsized leverage over manufacturers, distributors, and consumers alike. Combined with the dominant power of Pharmacy Benefit Managers (PBMs), this disrupts fair pricing and competition, pushing smaller pharmacies out of markets entirely. Many independent outlets are forced out because they cannot negotiate reimbursement rates or volumes that the chains achieve through sheer scale. 5. Private Equity Ownership Magnifies the Problem With Walgreens now owned by private equity, cost‑cutting imperatives threaten further closures, layoffs, and erosion of service. Critics fear these changes will accelerate practical monopolization, reducing genuine choice for patients and cementing a corporate stranglehold on essential medications. In Summary: Walgreens does not exist in a competitive vacuum — its integration into virtually every stage of the pharmacy supply chain has choked competition, allowed anti‑competitive pricing practices, concentrated market power, and weakened patient access to essential medications. Patients are now forced to choose between a handful of giant chains rather than benefit from a vibrant, competitive pharmacy market. This situation violates the core principles of fair markets and endangers public health. I urge you to: Support antitrust investigations into Walgreens’ monopolistic practices and vertical integration. Champion legislation to protect independent pharmacies from exclusionary contracts and reimbursement abuses. Demand transparent drug pricing and prescription fulfillment data so consumers and policymakers can see the real pricing mechanics and abuses. Back oversight of PBMs and their role steering prescriptions to specific pharmacies, further reducing competition. The time for half‑measures is over. Our healthcare system should not be hostage to a corporate monopolist. I expect a substantive response outlining how you will act to restore fairness, competition, and consumer protection in the prescription drug market.