Legislation protecting independent pharmacies goes into effect
BY JOHN BRICE
THE LAFAYETTE SUN
ALABAMA — Both houses of the Alabama legislature unanimously passed Senate Bill 252 during their session this past spring, with the goal of protecting independent pharmacies from what have been described as predatory business practices by healthcare industry middlemen known as Pharmacy Benefit Managers, or PBMs.
Valley Pharmacy owner and Alabama Independent Pharmacy Alliance President Craig Moore helped to organize and lead community drug stores in their support of the bill during the 2025 legislative session. With the critical payment provisions of the newly passed legislation set to take effect as of Oct. 1, Moore provided an update on where things stand for independent pharmacies in Chambers County and around the state.
Moore shared details of how independent pharmacies have fared in the interim period since the legislation was passed this past spring.
“For the vast majority of community pharmacies, it has been a struggle,” he said. “The first thing that the PBMs did after passage was cut reimbursement further below cost on most generic drugs. So the financial strain and cash flow got even tighter, resulting in borrowing to make ends meet. The financial requirement of cost plus the $10.64 was scheduled to go into effect on Oct. 1, 25. The remainder of the regulation was scheduled to go into effect on April 15, 2025. To date, most, if not all, of the PBMs have completely ignored compliance with any part of the law. Violations and complaints have been filed to the Department of Insurance and to the Attorney General’s Office, but little or nothing has come from it. In fairness to DOI, they are building a team and are trying to put forth a game plan for enforcement. We don’t have a public statement or any sort of plan of action from the AG’s Office as to their intent on enforcing the law.”
October is to be designated as American Pharmacists Month, and Moore said it is important for pharmacists to continue this fight.
“The pharmacist is ranked as one of the most trusted professions by the citizens of this country,” he said. “I think that there are two schools of thought on this: 1) Some believed that it was a good first step. The bill was actually named CPR, or the Community Pharmacy Relief Act. Cost plus a $10.64 dispensing fee was never the final fix, but it was a start. So this group was hopeful that the additional revenue would certainly help. 2) Others believed that the PBMs would simply not comply. That has been a trend in other States. Those States were then forced to take them to court, which is a lengthy process. My position would be that I am thankful for those PBMs that are complying, very few, but the fight has only begun.“
With many independent pharmacies operating at steep losses due to what have been characterized as burdensome business practices by PBMs, Moore addressed the urgency of their survival.
“If the payments do go into effect, it will definitely help most pharmacies, but there is still a significant amount of the mountain to climb,” he said. “So many pharmacies have overextended their financial position in an effort to stay open. Those financial institutes demand to be paid, and if the PBMs continue to drag things out in court or through loopholes, then the strain continues and they know that.”
Taking a look at the long-term prospects for independent pharmacies, Moore shared what he sees as the path forward.
“I am hopeful that the plight of the community pharmacy is one that is favorable for both the pharmacies and the patients,” he said. “In the end, it is the patients that will suffer the most. The goals of the PBMs have not changed. The end game continues to be to drive the patient to out-of-state mail order processors and to move completely away from brick and mortar sites. If you look at the state and federal landscape, access to care is diminishing on all fronts. Hospitals are closing and filing bankruptcy, private practice physicians are almost a thing of the past. Most physicians have been forced to close their practices and sell out to conglomerates. All of these examples are a result of the government allowing vertical integration to rule the day. By vertical integration, I mean the insurance company or mega providers are allowed to own the hospital or buy up the smaller hospitals and shut them down; the doctors have to work for the insurance company or mega providers. The insurance companies are allowed to own their own pharmacies, their own PBMs and control what the reimbursement is to everyone, including what the customer and employers pay. As long as accountants and/or Wall Street profiteers are allowed to game the system, I don’t know what the future holds for healthcare in general.”
