Three Companies Control 80% of the Prescription Market. AlignRx Built a Public Benefit LLC to Push Back, and Tells the Story on "All Access with Andy Garcia"

LOS ANGELES, Oct. 1, 2026 /PRNewswire/ -- A forthcoming feature on the public television series All Access with Andy Garcia goes behind the counter at community pharmacies, exploring the vital role pharmacists play as some of the most accessible and trusted healthcare providers—and the growing fight for fair reimbursement needed to keep these neighborhood cornerstones open.

The feature examines not only the importance of local pharmacies to an individual's health, but also what happens behind the counter after the conversation between pharmacist and patient ends. That includes navigating complex systems of insurance contracting and claims reimbursement, particularly when a pharmacy is reimbursed less than the cost of the medication it dispenses. Against this backdrop, the feature highlights the role AlignRx plays in helping community pharmacies navigate these challenges and advocate for a more transparent and sustainable reimbursement environment.

AlignRx is the nation's largest independently owned Pharmacy Services Administrative Organization (PSAO), working with community pharmacies in all 50 states and Puerto Rico. Founded in 2021 as a Public Benefit LLC—the only PSAO organized under this structure—AlignRx works to protect the future of community pharmacy by advocating for increased transparency, fair competition, pharmacy choice and patient access.

Last year, three pharmacy benefit managers—CVS Caremark, Optum Rx, and Express Scripts—processed roughly 80% of U.S. prescription claims, and this market consolidation has led to a vertically integrated system where patients can face higher out-of-pocket costs and lack of choice, potentially severing existing relationships with their trusted local pharmacists. Melanie Maxwell, president of AlignRx, describes the imbalance between community pharmacies and larger industry players as a modern-day "David and Goliath" story.

For Maxwell, the fight is personal. During the final months of her parents' lives, Maxwell found herself spending more time at a pharmacy counter than in a physician's office, asking questions someone needed to answer that day. That experience turned into a 35-year career in pharmacy and is the thread running through the forthcoming short-form documentary distributed to Public Television stations across the country.

The pressure on community pharmacies is at an all-time high and is leading to critical gaps in care for some of the nation's most vulnerable populations. Research shows pharmacies serving communities with higher concentrations of Medicaid and Medicare patients have closed at greater rates, contributing to the spread of pharmacy deserts across rural counties and urban neighborhoods alike.

"The relationship across the patient, the physician, and the pharmacist is like a three-legged stool," said Maxwell. "If you remove one of those legs, the patient—the one sitting on the stool—gets hurt. When we weaken the community pharmacy, we're not just affecting a business, we're affecting the patient who depends on that pharmacist for access, answers and care." 

About "All Access with Andy Garcia": All Access with Andy Garcia is an award-winning short-form documentary series produced by a veteran team of producers and distributed to Public Television stations nationwide. The program examines the topics, industries and community institutions shaping daily life, with educational features intended for a general audience. More information is available at allaccessptv.com

About AlignRx: AlignRx is the nation's largest independently owned PSAO, representing nearly 5,300 community pharmacies across the USA and Puerto Rico. The company empowers pharmacy businesses with comprehensive, data-driven solutions built to streamline operations. At AlignRx, every pharmacy selects their own wholesaler or buying group. Its mission is to ensure the vitality and growth of community pharmacy. Learn more at alignrx.org

SOURCE All Access