Dothan, Ala. — Lawmakers in Alabama are considering a new bill that could potentially raise prescription costs for consumers in an effort to provide relief to rural pharmacists struggling with increasing financial pressures. The bill seeks to address concerns about Pharmacy Benefit Managers (PBMs), who play a central role in the state’s healthcare system by negotiating prices between drug manufacturers and pharmacies.
PBMs are essentially middlemen that determine how much pharmacies receive for dispensing medications. These entities have come under scrutiny from independent pharmacists who argue that PBMs are often under-reimbursing pharmacies, particularly in rural areas where resources are already limited.
Anna Noojin, a second-generation pharmacist at Boaz Discount Drugs in Boaz, Alabama, voiced her concerns about the current state of the pharmacy industry. Serving over 13,000 patients, Noojin explained that the financial pressures placed on her business by PBMs have made it increasingly difficult to stay afloat. “We just need the help of our elected officials to keep us afloat. And maybe, get us afloat—keep us going—and they can fix the drug cost issue. Cause we know that’s a problem, too. We have to pay those bills,” Noojin said.
To address this, State Senator Andrew Jones introduced a bill that would require PBMs to reimburse pharmacies at a fairer rate, which would include the average cost of the drug plus an additional $10.64 per prescription. This is the same reimbursement amount that pharmacies receive from Medicaid.
“We want to take care of them, and our families. And we want to continue being that seed, and that presence in our surrounding areas,” Noojin added, emphasizing the importance of local pharmacies to communities in rural Alabama.
Jones, a strong supporter of the bill, stressed the value of independent pharmacies in times of need. “When you have an emergency in the middle of the night. When you are waiting for a prescription. When you have a relative that’s on hospice. You need to be able to go to someone you know and trust immediately to get help. And that’s your independent, local pharmacy,” Jones said.
However, the proposed bill has faced opposition from groups like the Alliance of Healthcare Consumers. Robin Stone, a spokesperson for the Alliance, argued that the proposed fee would ultimately be passed down to consumers. “The only thing that it does, is it directs it back to employers. If you’re going to be assessing that fee, that fee has got to go somewhere. And it’s gonna wind up in the premiums that are paid by the people of Alabama,” Stone explained.
Jones, however, maintains that the bill ensures the costs will not fall on Alabama residents. Stone contends that the issue of pharmacy reimbursements should be handled at the federal level, rather than through individual state efforts that may not lead to lasting change.
“We think that’s the solution. Not some patchwork solution created in Alabama—or other states—that doesn’t resolve the entire issue,” Stone said.
With two similar bills currently being considered by the Banking and Insurance Committee, Alabama lawmakers are expected to vote on the bill they believe will most effectively support the state’s pharmacies. That vote is scheduled for next week, and it could lead to significant changes in the way pharmacies are reimbursed for dispensing prescription medications.
As the debate continues, many rural pharmacists in Alabama remain hopeful that the proposed bill will provide the relief they need to stay in business and continue serving their communities.
