On top of that, some insurance companies are forcing their customers to order drug refills through mail order services, taking more business away from local drug stores.

Customers with prescriptions or refills are being denied insurance coverage on medications and are being forced to use a mail order service owned by the insurance companies, according to K.C. West, co-owner of Mountainair Meds and More.

Customers aren't notified in advance that refills are not allowed and are only told at the time the local pharmacist submits the claim, West said. The prescription refill might be for a medication vital to management of a chronic condition like diabetes, she said. Mail order pharmacies are able to purchase medications at far less than retailers, she said, and are driving small retailers out of business.

May Pharmacy has also been affected, according to pharmacist Kenneth Romp.

Romp explained that some insurance companies sent out a letter requesting customers designate whether they'll get their prescriptions by retail or mail order. For those who didn't return the form, customers were automatically sent to mail order, Romp said.

It causes a hassle when pharmacists have to call the insurance company to override the denial, but even more unsettling to the pharmacies is lost business.

Romp and West agreed it didn't seem like a fair business practice.

"The insurance companies are taking business as it is," Romp said. "Why can't they offer the same deals to retail pharmacies as mail order? A lot of times they're owned by the same company. In my opinion, it's a little underhanded."

Romp is also worried about plunging reimbursement rates.

"Small retails won't be able to keep up," Romp said. "If they continue to cut rates to us I don't know what could happen. We already operate on borrowed money."

Romp explained May Pharmacy fills prescriptions, but doesn't get reimbursed for 30 to 60 days, forcing the retailer to replace medications before it gets paid for them.

The threat of losing the pharmacy in Mountainair has pushed West to take a stand, presenting information at the October Partnership for a Healthy Torrance County (PHTC) meeting. PHTC recently sent a letter to state and federal legislators and other stakeholders in the situation. West's goal is to fight the factors threatening the community pharmacy.

Small, local pharmacies are vital in rural areas, West said.

"I think people, especially in rural areas, appreciate somebody who knows your medical history when you walk in the door," West said. "If mail orders have their way customers will hear a recording saying 'your call is very important to us.' "

She said that if claims are denied because of this formality, customers may take a stand and say they want to use their local pharmacy. West had some advice for local residents who may be affected.

"I think basically just the message is for people to support their community pharmacies," West said. "People need to stand up and say 'no, we're not going to take this.' "