Pharmacy workers at eight CVS stores across Rhode Island, Arizona, and California voted this week in favor of a strike sanction, a move that puts unionized employees one step closer to walking off the job over what they describe as chronic understaffing and burnout. The vote is the first of two approvals needed before workers can actually strike, and it comes after two years of stalled contract talks between the company and The Pharmacy Guild.
The eight locations include four stores in Rhode Island — CVS's home state — along with sites in Arizona and California, according to The Boston Globe. The Pharmacy Guild, an initiative launched under IAM Healthcare, organized these CVS workers roughly two years before this week's vote. CVS has said there will be no interruption of pharmacy service at affected stores if union members ultimately approve a work stoppage.
Sara Martin, a 43-year-old CVS pharmacist in Westerly, R.I. who has worked for the company since 2008, is typically the only pharmacist on duty during her shifts. She told the Globe that in 2020 she took a two-month mental health leave, and described an incident in which she became incapacitated at work and called her manager for backup — but the manager never came, so she stayed at the pharmacy to keep it open for patients.
Workers Describe a Widening Gap Between Duties and Staffing
Pharmacists are expected to move prescriptions quickly while simultaneously handling vaccinations, insurance issues, patient questions, physician calls, and technician supervision, per the same Globe account. The Pharmacy Guild has alleged that pharmacists sometimes spend less than a minute reviewing each prescription, a claim CVS spokesperson Amy Thibault called false.
Christopher Eggeman, a 36-year-old unionized CVS pharmacist in Wakefield, R.I. who has worked for the company for 16 years, said the amount of help available on the floor has declined even as demand has grown, including a rise in GLP-1 prescriptions. He said pharmacists are constantly having to do more with less, and that CVS stores go through technicians who burn out and leave. Eggeman said the outcome of the standoff depends partly on whether CVS bargains in good faith.
Shane Jerominski, another figure with the union effort, said CVS Guild pharmacy professionals are willing to fight for patient care and that the strike-sanction votes represent workers' next step toward safe staffing and respect. Unionized pharmacists do not want to go on strike, according to the Globe's reporting, but feel forced to take action to secure a first contract that has eluded the Guild for two years.
CVS Points to Investments as Union Points to Corporate Profits
CVS has acknowledged it faced staffing strain in the years following the pandemic, and Thibault said the company regularly invests in pharmacy locations to support its teams. The company says it is strengthening recruitment and hiring, enhancing training programs, adding support scheduling, and rolling out workload-sharing and pharmacy phone-system tools. CVS also says it tailors pharmacist and technician staffing levels to each individual store and has previously promised to allow teams to schedule more people per shift while boosting recruitment of pharmacists and technicians.
Those promises land against a backdrop of soaring corporate performance. CVS Health reported record full-year total revenues of $402.1 billion for 2025, up 7.8% from $372.8 billion in 2024, according to CVS Health's investor relations announcement. In the second quarter of 2026, the company generated $106.1 billion in revenue and nearly $3 billion in net profit — triple its quarterly net profit from the same period in 2025 — as reported by Becker's Payer Issues. CVS Health also controls Caremark, a pharmacy benefit manager that negotiates drug prices, and Aetna, a health insurer, and has spent billions of dollars in recent years transforming into a broader health care conglomerate.
Federal and State Scrutiny Adds Pressure
The organizing drive traces back to informal walkouts in 2023, when Walgreens, Rite Aid, and CVS pharmacy workers staged a three-day walkout seeking better working conditions in a movement dubbed “Pharmageddon.” Hoodline reported at the time that the grassroots protests forced CVS to temporarily close as many as 22 retail locations over two weeks, prompting the company to promise emergency staffing support and overtime. Those walkouts became the immediate catalyst for the formation of The Pharmacy Guild, which launched in late 2023 and has since organized 15 pharmacy workplaces across five states, according to Healthcare Brew. Organized CVS employees still represent only a fraction of the company's roughly 90,000 pharmacy workers nationwide, but their shift into formal, legally protected collective bargaining marks a significant escalation from the earlier, informal walkouts.
Regulatory scrutiny has mounted alongside the labor organizing. In December 2024, the U.S. Department of Justice filed a federal civil lawsuit against CVS in Providence, alleging that corporate-mandated performance metrics and understaffing forced pharmacists to fill unlawful controlled substance prescriptions in violation of federal law. California, meanwhile, enacted Senate Bill 362 in 2021, becoming the first state to bar large chain pharmacies from setting sales, volume, or prescription-filling quotas for pharmacists and technicians, and followed up with Assembly Bill 1286 in 2023, which gives pharmacists-in-charge statutory authority to adjust staffing to prevent fatigue. A 2021 California State Board of Pharmacy workforce survey found that 91% of retail pharmacists reported insufficient staffing to ensure safe patient care, and 83% said they lacked adequate time for safe patient consultations.
Whether CVS and The Pharmacy Guild can reach a first contract before any work stoppage occurs remains an open question, as does how operational disruptions might be handled in the affected regions if a strike ultimately proceeds. For now, this week's vote leaves workers one authorization away from that possibility.
