As class-action lawsuit continues, advocates say Johnstown stuck in 'pharmacy desert'

JOHNSTOWN, Pa. – On a cold winter morning, a Martella’s Pharmacy driver made a usual medication delivery to a resident of the Valley Pike Manor independent living apartments in Johnstown.

The family-owned pharmacy’s flagship location at 1079 Franklin St. is located less than 600 feet from the manor, where more than half of the 70 residents have Medicare coverage through UPMC.

Kimberly Helman, the manor’s property manager, said she was glad to see the delivery Wednesday. But for the residents of the manor with Medicare coverage through UPMC, as well as hundreds more people – including her parents – living across the Johnstown region, the dependable Martella’s service has been blocked.

An emergency injunction to restore Martella’s Pharmacy services to UPMC- and Highmark-insured patients has been filed for about two months in federal court without a judge’s determination to grant or deny it.

It was filed as a temporary measure to maintain the pharmacy’s status quo until a class-action lawsuit filed on behalf of 500 Martella’s customers is decided.

The suit is against UPMC, Highmark and pharmacy benefit management company Express Scripts, which has removed Martella’s from those insurers’ in-network coverage.

The lawsuit makes claims of unfair competition and patient steering against Express Scripts, which not only manages drug plans for insurers, but also owns a chain of mail-order pharmacies that compete with the dwindling number of independent pharmacies in the Johnstown community.

Aside from Martella’s, the remaining pharmacies are big-boxes, including Walmart, which now serves Helman’s mother and father since Express Scripts pulled Martella’s from its network Oct. 21.

‘Burden on families’

Over the weeks since Express Scripts’ decision, customers said Martella’s has covered the increased cost coinciding with the out-of-network status change for UPMC and Highmark patients.

However, the long shadow of financial pressure that has led to the closure of other local pharmacies – including Mainline Pharmacy locations and Westmont Rexall – looms over Martella’s.

“My parents got a couple prescriptions filled by Martella’s out-of-network, but I got them switched quickly to Walmart because I knew what was going on,” Helman said.

It was a difficult transition for the family. Neither of Helman’s parents is able to drive.

“My parents can’t get delivery from Walmart,” she said. “Now it’s all on me to get it scheduled.”

After work in Johnstown, she picks up her parents’ medications at Walmart in Richland Township and then drives to her parents’ home in Windber. After delivering her parents’ prescriptions, she drives back toward Johnstown, to her home in Westmont Borough.

“Not having delivery from Martella’s is putting a burden on families – not just me, I’m sure, a lot,” she said.

Due to a contractual stipulation with Express Scripts, Martella’s Pharmacy owners are prohibited from making public comments about the fallout of Express Scripts’ decision.

‘What will be done?’

Business leaders of the Greater Johnstown Regional Partnership nonprofit, organized for community betterment, have been working to bring awareness of what they call Johnstown’s “pharmacy desert” – which is affecting not only employees of company health plans, but especially Medicaid and Medicare recipients who depend on Martella’s delivery service and its customized “Medi-Pacs” of multiple prescriptions organized by dosage and prescribed time for consumption.

So far, the Pennsylvania Department of Human Services has not taken issue with Express Scripts’ decision to remove Martella’s from networks serving Medicaid and Medicare patients.

In Pennsylvania’s Medical Assistance program or Medicaid, under the Department of Human Services, pharmacy contracts are negotiated between individual pharmacy benefit managers and “Medicaid Managed Care Organizations” such as UPMC and Highmark.

The department reviews contracts for adherence to law, and the approval of those contracts is completed by staff in the Department’s Bureau of Managed Care.

“The DHS has previously determined there were enough nearby pharmacies to absorb former Martella’s customers and allow for continuity of care for Medicaid recipients,” a DHS spokesperson has said in an email to The Tribune- Democrat.

The DHS review determined that people who receive pharmacy benefits through Express Scripts have more than 55 other regional options.

However, a majority of those are in Westmoreland County. DHS identified 12 alternate options to Martella’s in Cambria County and six in Somerset County – and those include both brick-and-mortar and mail-order pharmacies, such as Amazon Pharmacy for home delivery services.

Mark Pasquerilla, president of the Greater Johnstown Regional Partnership, said the organization has authorized him to draft a letter to Gov. Josh Shapiro that attempts to show him the Johnstown region would be woefully underserved without Martella’s.

“You wouldn’t understand it unless you lived in Johnstown,” Pasquerilla said.

Downtown Johnstown is home to many people without personal vehicles, because of either disability or age, who live in public housing towers and senior housing. Martella’s main retail flagship location on Franklin Street is central to populations with Medicaid and Medicare coverage.

With the recent closures of Rite Aid stores, there is one other pharmacy aside from Martella’s within the city of Johnstown – at a Giant Eagle supermarket in the West End neighborhood.

“I’d say we are in an official pharmacy desert,” Pasquerilla said. “This is not pro-access for customers. It’s hurting the poorest and oldest folks in the city. The question is: What will be done to remedy it?”

With the class-action lawsuit yet to budge toward a resolution, Pasquerilla said the state should act to quickly restore Martella’s access for Medicaid and Medicare patients.

‘I was heartsick’

Darlene Bowers, of Ebensburg, is a Medicaid and Medicare recipient through UPMC. She said she has been a customer of Martella’s for 50 years.

“I love UPMC, but I don’t know what I’d do without Martella’s,” she said. “When this all started, I was heartsick over it.”

Express Scripts has made public statements that its decision to remove Martella’s from UPMC and Highmark plans was based on a breach of contract. The company said Martella’s did not properly disclose a long-settled 2018 violation in which pharmacist Joseph Martella was accused of unlawfully dispensing pills to a doctor’s son.

Martella has kept his pharmacy license, and his family’s company has operated since without regulatory issues.

Martella’s Pharmacy has six locations, including its Parkhill location at 1932 William Penn Highway. From that location, Joseph Martella continues to fill prescriptions for customers, including Bowers.

“He was cleared of all of that (past accusations),” Bowers said. “He’s not going to give up on this.”

Express Scripts continues to send Bowers letters that Martella’s won’t fill her prescriptions at in-network prices, she said.

“Joe said, ‘Don’t worry about it,’ ” she said. “I still get my Medi-Pac delivered. I’ve had so many health problems, and I’m handicapped with no transportation. My prescriptions are always changing. As soon as they do, Joe makes sure I have them.”

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