How the League of Independent Pharmacists stopped losing members

Noor Haddad-Ellison, chief membership officer at the League of Independent Pharmacists in Raleigh, spent four years watching her organization's membership shrink before she reversed the trend between 2023 and 2025.

The League represents 3,600 independent pharmacy owners and pharmacists, a membership base under sustained financial pressure from chain competition and shrinking reimbursement rates. Haddad-Ellison said the decline wasn't a single bad year — it was a slow bleed that made each year's renewal numbers a little worse than the last, until pharmacy owners running lean operations started treating their League dues as one of the first things to cut.

"Nobody ever told us they were quitting because of us," Haddad-Ellison said. "They quit because the pharmacy was barely making payroll, and dues looked optional compared to rent."

Haddad-Ellison rebuilt the League's renewal process around a simple premise: reach out before a member lapses, not after. She pulled every pharmacy owner's renewal date into a single calendar and assigned staff to make a personal call, not an email, 60 days before each one, asking specifically what value the member was or wasn't getting.

The League's membership decline, which had run continuously since 2023, reversed by 2025 — the first year-over-year gain Haddad-Ellison could point to since she took the role.

The League also joined NANA's Dues Model Study pilot in its second phase, testing whether a different dues structure might ease the pressure independent pharmacy owners feel most acutely. Haddad-Ellison said the League's flat-dues structure, unchanged for years, had started to feel like a flat tax on members who could least afford it.

"We're not waiting for NANA's results to fix our own renewal process," she said. "But if the pilot tells us a different model helps members like ours specifically, we'll move on it."

Executive directors and membership staff facing their own declines should:

• Call lapsing members before they lapse, not after — a call 60 days out gives time to address a real complaint

• Ask what value a member is or isn't getting, rather than assuming price is always the reason for non-renewal

• Watch dues-pilot results for structures that might fit a financially stressed membership base better than a flat fee

Haddad-Ellison said the hardest part wasn't the calls themselves but convincing her own board that the decline was fixable rather than a permanent feature of representing an industry under financial pressure. Board members had grown used to explaining the numbers away by pointing at chain-pharmacy consolidation and reimbursement cuts — real pressures, Haddad-Ellison said, but ones that didn't explain why members who stayed in business were still letting their League dues lapse.

NANA staff have started pointing to the League's turnaround when other small associations in financially pressured sectors ask whether a renewal process overhaul is worth the staff time. Haddad-Ellison said she's fielded calls from two other association membership directors since the turnaround became known within the chapter network, both asking for a copy of her 60-day call script.