By Lindsey Frazier and Kaitlin Hoskins
Local pharmacies joined forces with about 100 others across the state for a staged walkout on Tuesday, February 25, to raise awareness of patient access and Pharmacy Benefits Managers (PBMs) reform.
Pharmacists and their employees closed their doors and headed to Montgomery to meet and speak with representatives about the struggles they are facing, according to Hodges. Legislatures are working to combine two bills, Senate Bill 93 and Senate Bill 99, to push back against third-party negotiators between pharmacies and the manufacturer of the drugs. According to Senate Bill 93, the third-party negotiators, also known as PBMs, determine the amount pharmacies are reimbursed for dispensing the prescriptions.
Pharmacists like Abby Hodges, a third generation pharmacist at Super Bee Pharmacy in Rainbow City, dimmed the lights at the pharmacy and displayed a black wreath and black balloons to raise awareness about the unfair practices of companies such as these.
“I don’t think I’m wrong to say that every independent pharmacy in town participated in some form or fashion,” Hodges said. “I know Rick’s closed. I know that us, Southside and Gadsden City did a similar thing with the wreath and turning out the light.”
State Senator Andrew Jones for Alabama District 10 sponsored Senate Bill 93 and said local pharmacists in Etowah County brought the issue to his attention.
“Our pharmacies need to be paid a fair pay to cover their costs,” Jones said. “No business can stay open if they charge the same amount for an item that they pay for it, much less if they are charging less than what they paid for it.”
State Representative Mack Butler said he was shocked to learn about some of the practices of the PBMs such as issuing non-disclosure agreements in their contracts with pharmacies about their drug costs.
“My dad’s pharmacist said he has to pay $40 under his cost,” Butler said. “It’s so devastating, even [President Donald] Trump is talking about it. Everyone doesn’t get reimbursed the same amount. And the independent pharmacies, not every prescription, but a number of prescriptions, they’re being reimbursed below their cost.”
Some of the benefit managers, such as CVS Caremark, own pharmacies determining their own prices of drugs and the prices for other pharmacies, including local pharmacies like Super Bee.
“My dad started this business 53 years ago,” said Debbie Adams, Abby’s mom and Super Bee Pharmacy owner. “My brother and my sister were pharmacists as well. They have both passed away, and my dad a couple years ago too, but we want to continue his legacy.”
Adams said they are a part of the community, and they want to continue serving the community
“They have been wonderful to support us,” Adams said. “And we want to continue supporting the community.”
The Alabama Pharmacy Association (APA) hosted a lunch on the South Lawn at the State Capital to raise awareness of their cause.
“I think it’s fabulous,” said Ginger Barron, pharmacist at Cornerstone Family Pharmacy. “There were over 170 pharmacists at the APA lunch, that’s not including legislation. It was pretty phenomenal to speak with local leaders.”
Last year, Barron said the issue was brought up but was never presented to legislators. The pharmacists have momentum this year, according to Butler, he believes they have made a difference with all the information they have spread over the last year.
The Alliance of Alabama Healthcare Consumers announced its opposition to Senate Bill 93 and Senate Bill 99, claiming both measures would impose an additional $10.64 dispensing fee on every prescription filled in the state. According to AAHC, the new fee would result in an estimated annual increase of $900 per person or $3,600 per family in prescription costs.
Jones said the opposition’s claims that costs will be passed on to consumers is a “total fabrication” and a “scare tactic.”
“The bill specifically prohibits the costs being passed to consumers,” Jones said.
He also mentioned that the pharmacies have “gag clauses” used against them, courtesy of the PBMs.
“These PBMs prohibit pharmacies from telling their customers that the PBMs are responsible for rising costs,” Jones said.
A pharmacist who spoke to The Messenger under the promise of anonymity said the PBMs do not allow pharmacists to tell customers anything negative about them. They gave an example of them not being able to stock a certain medicine because they were filling prescriptions for it at a loss, but they had to tell customers that they could not get more of the medicine instead of saying they could not afford to stock it.
Jones said those “gag clauses” would be illegal under the proposed bills and that the “multi-billion-dollar PBMs can afford to pay pharmacies fairly.”
According to Jones, just over 160 “mom and pop” pharmacies have closed in Alabama in last five years.
“Think about how much you need your local pharmacy,” Jones said. “Who is going to open their store in the middle of the night to help you get medication for a loved one?”
