Where Does the Pharmacy Guild Stand in Its Effort to Build a National Pharmacy Union?

A little over a year ago, the Pharmacy Guild launched in an effort to create the first national pharmacy union in the U.S. The organization was formed in response to working conditions at large retail pharmacies like CVS Health and Walgreens, including low pay and heavy workloads.

Now, 13 pharmacies have filed to join the Pharmacy Guild, 11 of which have won their election with the National Labor Relations Board (NLRB) while the other two are waiting for their election date, according to data shared with MedCity News. The election will determine if there is support from employees to form a union in that location. Once the election is over — and assuming the result indicates the location wants to join — a contract will need to be signed between employees and pharmacy management. So far, none of the locations have a contract in place with their employer, but many are in the negotiation process.

Of the 13 stores that have filed to join the Pharmacy Guild, most happen to be CVS locations, while one is a Walgreens and one is a Safeway Pharmacy. Of the 11 CVS locations, most are in CVS’ home state of Rhode Island. 

“If CVS can’t maintain stores that feel safe and appropriately staffed in their backyard where their corporate headquarters are, then just imagine what pharmacists feel like across the country,” said Shane Jerominski, a pharmacist and co-founder of the Pharmacy Guild.

While there are just 13 stores that have filed to join the Guild, there is interest in every state, according to Jerominski. But the organization is trying to move slowly and wants to be confident that any store that is interested in unionizing will win an election before they file for an election. In addition, they have to find leaders at each store who can spearhead the effort, which isn’t always an easy task.

When asked if this is where he envisioned the Pharmacy Guild being over a year after its formation, Jerominski responded that “we can always be doing better” but that he’s proud of the work the Guild has done so far.

“Even if we don’t get the recognition for organizing thousands of stores five years from now, if I know that the work that we’ve done has allowed people to be paid appropriately and more commensurate with their skill set, … [then] that will be a victory,” he said in an interview.

Jerominski noted that the union’s success isn’t only measured by the number of members it has. The organization has also been working with students and professors to encourage future pharmacists to find work at pharmacies that are already unionized, even if it’s not the Pharmacy Guild.

Some regional pharmacy unions include the Guild for Professional Pharmacists in California and Teamsters Local 727, which represents workers of CVS pharmacies in the Chicago area.

Jerominski added that after a third CVS Rhode Island store filed with the Guild, the starting rate for pharmacy technicians in all of Rhode Island went from $16.50 an hour to $18 an hour. Technicians help prepare and refill prescriptions, pack medications and process insurance claims.

“That is directly related to the unionization efforts of the Pharmacy Guild,” he said.

Why stores are unionizing

The Pharmacy Guild has several demands of pharmacy chains, including better pay and secure hours for pharmacy technicians and a lighter workload for pharmacists, Jerominski previously told MedCity News. 

Workers at some of the stores that have filed to join the Guild shared similar demands.

For example, Aisha Torres, a technician at a CVS in California that has won its election, would like to see better pay increases. California recently passed a law that will gradually increase the base minimum wage for healthcare workers to $25 an hour. However, CVS said that technicians don’t count as healthcare workers, according to Torres, who is currently making $20 an hour. She would like to see her pay increased to $25 an hour in the next year or two.

“They’re trying to say that we’re not healthcare workers,” she said in an interview. “We’re dealing with medicines and pharmaceuticals. How is it not healthcare?”

Another issue is that the store has a lot of remote technicians working from out of state who are unable to help close the store at the end of the work day. This means those working in the store are often left having to close more often than they signed up for. Torres said she was hired to close every two weeks, but is now having to close every week because people have quit. That requires her to stay later than usual. Typically, she works 7:30 a.m. to 4:30 p.m., but has to work 10:30 a.m. to 7:30 p.m. on days that she closes.

Meanwhile, a pharmacist at a CVS who requested anonymity in order to speak freely said he’s constantly juggling multiple tasks at once, such as counseling patients, verifying prescriptions and addressing drug interactions. Sometimes stores will only have one pharmacist there at a time. Managing all of this can make it difficult to take time with patients and ensure safety. This pharmacist’s store has won its election.

“We would like to see many changes, most importantly of which is ensuring that patient care is always prioritized over profits, metrics, volume, or speed,” the pharmacist said. “We as pharmacy professionals know what our patients’ needs are and when they aren’t being met. No one deserves to feel rushed at a pharmacy.”

At some CVS stores, the company is arguing that pharmacists are managers and therefore, can’t unionize, according to Jerominski.

“That’s not the case,” he argued. “There are pharmacists across the country in many practice settings that are unionized. That’s just a way of slowing down the process and preventing momentum in an area.”

CVS Pharmacy’s lead director of external communications, Amy Thibault, said the company respects its employees’ “right to either unionize or refrain from doing so. We believe the direct, two-way relationship we have with our colleagues is the best way to resolve workplace concerns and we continually listen to their feedback to help inform our programs and policies.”

Thibault added that since 2021, CVS has made about $1 billion in wage increases and other investments. In 2024, it awarded tens of millions of dollars in bonuses for pharmacists and technicians.

Walgreens’ director of media relations, Marty Maloney, made similar comments. 

“We respect 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,” Maloney said in an email.

The company also said that it’s taken several steps to improve the working conditions of its pharmacy staff, including using centralized support centers to triage patient inquiries and outreach. Walgreens also brought 17 pharmacy school deans together through its Deans Council to find ways to support pharmacists and future pharmacists.

Unforeseen challenges

The Pharmacy Guild knew that forming this union would be a tough task, but it didn’t anticipate how “frightened” pharmacists and technicians would be of unionizing due to concerns of getting fired or replaced, Jerominski said. 

“It’s hard to convince people that are so used to the way things are that they have any ability to change their workplace for the better, make it safer for patients, make it a place that healthcare professionals deserve to practice in,” he said. “We’re given all of this responsibility to the American public to do our job correctly. We’re not given the time and adequate resources to safely practice and that’s the reality in so many retail pharmacies across the country.”

He added that in the one Walgreens location that has filed to join the union, the workers won their election unanimously. However, he said that Walgreens decided to fire the pharmacy manager and the technician manager, believing that they were involved in the organization process, though Jerominski argued that they weren’t.

The store ran the election again and passed unanimously a second time, but Walgreens isn’t responding to correspondence to start negotiations, according to Jerominski.

Another challenge is that organizing under the Trump administration is more difficult. The administration fired some people at the National Labor Relations Board, including board member Gwynne Wilcox. Without Wilcox, the NLRB can’t have a quorum, meaning they can’t issue final decisions on unfair labor practice complaints, delaying unionization efforts.

Despite these challenges, Jerominski is confident about the Pharmacy Guild’s future. In five years, he hopes to have about 1,000 stores unionized, including almost every pharmacy in Rhode Island. He added that he hopes to touch every major pharmacy chain in the U.S., as well as every specialty, including hospital pharmacists and interns.

No doubt there is a tough road ahead given the challenges of the next four years with the Trump administration, which Jerominski doesn’t envision being pro-worker. But he hopes the union grows despite that.

Photo: Irina Devaeva, Getty Images