The writing has been on the wall for a decade. That’s how long it has been since CVS purchased Campagna’s, Bristol’s last remaining independent pharmacy. At the time, that left Delekta’s as Bristol County’s only independent pharmacy, though in the last decade, they have stopped offering prescriptions (though an argument could be made that their delicious coffee cabinets have medicinal properties). In fact, a statewide search revealed only a handful of independent pharmacies remain, all in Providence and the West Bay.

After CVS took over the Campagna’s location in 2010, they briefly attempted to retain the small town vibe of Campagna’s, offering their take on the house charge: cards that carried no balance, conferred no benefits, and could only be used at the former Campagna’s. Processed through a financial services company in the Midwest, it didn’t take locals long to realize there was nothing “small town” about the new system, and they soon abandoned it.

The only surprising thing about the closure of this little downtown CVS outpost is how long it’s taken to execute.

Reached for comment, Matt Blanchette, manager of Retail Communications for CVS, said: “We have made the difficult business decision to close the CVS Pharmacy store located at 174 State St. on Dec. 14. The closure of this store is not a reflection of the hard work and dedication of our employees. In fact, all employees were offered roles at other CVS locations nearby, including our other location in town.”

CVS has been aggressively acquiring small pharmacies for years, but more recently, they’ve really put their thumb on the scale, leveraging their in-house pharmacy benefits manager, CVS Caremark, to gain an advantage over their competition.

Pharmacy benefits managers oversee prescription drug benefits on behalf of health insurers, employers, and some Medicare recipients, negotiating with drug manufacturers and pharmacies to control drug spending. Their ability to determine the amount of the reimbursement a pharmacy will receive has led CVS Caremark to reimburse CVS Pharmacies at a more favorable rate, relative to other pharmacies. As a result, financially-strapped independent pharmacies have become even more open to acquisition by CVS.

CVS continues to accelerate this process of “vertical integration” — when one company controls multiple parts of a supply chain — with the recent purchase of health insurance company Aetna. Legislative relief has been somewhat effective in some states, notably Arkansas and Ohio, and it may be the only hope for mom and pop pharmacies in those states. Given the fact that CVS is one of Rhode Island’s great corporate success stories — and is poised to play a key role in the dissemination of the COVID vaccine — Rhode Island’s remaining independent pharmacists probably shouldn’t expect relief to come from the General Assembly.

According to Mr. Blanchette, prescriptions at the State Street location will automatically be transferred to the CVS Pharmacy at 400 Metacom Ave.

“We understand the disappointment of our closing store’s neighbors and customers,” he said. “We are committed to the East Bay area and will continue to provide the community with outstanding service at our other stores nearby.”