More than a hundred local pharmacies walkout, asking for PBM reform in Alabama
DECATUR, Ala. (WHNT) — More than a hundred locally-owned Alabama pharmacies turned off the lights, shut their doors and closed Tuesday afternoon.
The unprecedented walkout is meant to call attention to proposed state reforms that would increase how much independent pharmacies are paid.
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Neighborhood pharmacies are disappearing from communities across Alabama. Pharmacists say they are not being reimbursed as much as their corporate counterparts, and the profit gap is hitting them hard.
Change could come from the state legislature this year.
Two introduced bills would create reforms for pharmacy benefit managers (PBMs). PBMs are the intermediaries between pharmacies and insurance companies, and they negotiate how much the pharmacy makes when you pay for your prescription.
Chase Arrington, the owner of River City Pharmacy in Decatur, said many independent pharmacies are not making enough to survive.
'I think if something doesn't happen this legislative session, probably within a year or two there, there may not be any local pharmacies,' Arrington said.Arrington is asking state lawmakers to take on the system led by PBMs, who generally pay higher rates to corporate pharmacies. They are often affiliated with these pharmacies under the same company's ownership.
CVS Health is the largest PBM with 21% of the U.S. market, followed by Optum RX, which is owned by United Health Group. Blue Cross, owned by Prime Therapeutics, has 10% of the market.
'Patients are already being steered to corporate-owned pharmacies or mail order and a lot of times that's not even what they want to do, that they're kind of forced that way,' Arrington said.
Currently, PBMs can deny coverage for certain drugs at small pharmacies, and prescriptions are sometimes more expensive at a local drugstore than they would be at a large chain. Two Senate bills, SB 93 and SB 99, look to address these issues.
SB 99 would offer more regulatory power to the Department of Insurance so it could set benchmarks for reimbursement. Both bills would require PBMs to pay pharmacies for the cost of dispensing drugs, and they call for those payments to come from PBM profits, not from consumers.
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'The healthcare system in this country is broken,' Arrington said. 'We all know that we're worried that the cost for health care for patients is continuing to climb and pharmacies are closing in every week. We just feel like PBM reform is important this legislative session to keep our patients' access to care there.'
As a part of Tuesday's walkout, many local pharmacies are asking their customers to contact state lawmakers and tell them they support PBM reform.
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