CVS, Walgreens Changes Heighten Pharmacy Access Concerns in Baton Rouge

BATON ROUGE, La. —Baton Rouge residents are feeling the effects of a changing pharmacy landscape, as the state shifts some pharmacy benefit business away from CVS Health and national chains such as Walgreens close underperforming stores — developments that public officials and health researchers warn could exacerbate access to medications, particularly in Black and low-income neighborhoods.

The Louisiana Office of Group Benefits this month approved emergency contracts that split the state’s pharmacy benefit management (PBM) business between two firms: a $390.6 million deal for commercial plans with Liviniti LLC (doing business as Southern Scripts) and a larger contract for Medicare Part D coverage with SilverScript, a CVS Health affiliate. Lawmakers enacted the agreements on emergency terms for 2026 with possible extensions into 2027.

State officials have said the split is intended to increase choice for enrollees—roughly 212,000 state employees, teachers, local workers, retirees and their families covered through OGB—by making it easier for independent pharmacies to participate in state networks. The Louisiana Independent Pharmacies Association endorsed the Liviniti contract. Officials also said the new contracts should provide greater transparency about drug pricing and rebates.

But the change is not expected to lower costs in the short term. OGB leaders told lawmakers the move will cost the state “a few million dollars more” than staying exclusively with CVS Caremark and cautioned that savings are not automatic when switching PBMs. Federal rules also limited the state’s ability to find a non-CVS provider for Medicare Part D, leaving the largest Part D contract with a CVS affiliate.

Those policy fights have unfolded alongside store closures by major chains. CVS closed a Mid-City Baton Rouge pharmacy on Government Street in September 2023; the site has since been redeveloped for other uses. Separately, Walgreens has announced a nationwide plan to close about 1,200 stores over several years, and at least two Louisiana Walgreens locations have closed as part of that wave. Chain executives point to a plan to close underperforming locations, growing expenses, and declining prescription reimbursements.

The state also sued CVS over a mass texting campaign in June that warned customers that proposed legislation restricting PBMs from owning pharmacies could force store closures. Attorneys general and state officials say the texts were misleading and filed multiple lawsuits alleging deceptive practices; CVS has disputed those claims.

What this means for Baton Rouge residents

• More pharmacy choices for some state plan enrollees: By splitting PBM services, OGB officials say more independent and local pharmacies should be able to serve commercial plan members, which could expand options in parts of Baton Rouge where independents operate.

• Short-term cost pressure: The state expects to pay slightly more initially under the two-PBM arrangement than it would have by staying with CVS alone, a trade-off officials framed as prioritizing access and transparency over immediate savings.

• Fewer physical pharmacies in some neighborhoods: Corporate store closures by chains such as Walgreens—and periodic CVS downsizing—reduce the number of retail outlets where residents can pick up prescriptions, get vaccines and receive basic health services. That effect is most acute for patients without reliable transportation.

Impact on the Black community and health equity

Research and public-health analyses show that closures and shrinking pharmacy networks tend to hit Black and Latino neighborhoods harder than white neighborhoods, contributing to so-called “pharmacy deserts” that can worsen medication nonadherence and health disparities. Studies and reviews of pharmacy-closure data have found higher closure rates and greater risk of losing pharmacy access in communities of color and low-income areas. Public-health experts warn that reduced local access can mean longer travel times for prescriptions, missed doses, and fewer opportunities for preventive services such as vaccinations and screening.

In Baton Rouge, where racial and economic disparities in health already exist, further loss of nearby pharmacies or restricted in-network options could disproportionately affect Black residents who rely on neighborhood drugstores, public insurance (Medicaid), or state coverage. Policymakers and pharmacy advocates say monitoring network inclusion, transportation barriers and targeted support for independent pharmacies will be critical to preventing widening disparities.

Bottom line

The split of Louisiana’s PBM business aims to blunt CVS’s influence over both benefit management and retail pharmacy access and to open the market to local providers—but it does not eliminate CVS’s dominance of the Part D market and will likely cost the state more in the near term. Simultaneously, nationwide store-closure plans by Walgreens and past CVS store shutdowns mean fewer brick-and-mortar pharmacies in some neighborhoods. Taken together, those trends could improve competition and choice for some residents while raising short-term costs and risking reduced physical access for others—effects that are likely to be felt most strongly in Black and low-income communities unless state policy and industry practices focus explicitly on equity.