In his March 25 op-ed for Alabama Daily News, Eric Hare issued a warning about SB 252 that doesn’t hold up under scrutiny. While it’s no surprise that the pharmacy benefit managers (PBMs) and their cronies oppose reform, Alabamians deserve facts — not fear.
Senate Bill 252 is a bipartisan bill designed to ensure pharmacies are reimbursed fairly for the medications they dispense and the services they provide. It is not, as Mr. Hare claims, a “cash grab” nor did his “Big Pharma” bogeyman have any input on the bill. In short, SB 252 is a long-overdue fix to a broken system that allows PBMs to underpay local pharmacies and overcharge patients and employers.
Let’s start with the most important point: patients will not be charged a new fee under SB 252.
The bill clearly states that the dispensing fee—a standard professional fee paid to pharmacies for safely filling prescriptions—is to be paid by the PBM or insurer. The dispensing fee is not new, either. It mirrors what Alabama Medicaid already uses, and that program is often cited as a national model for transparency and efficiency.
The claim that SB252 will cost Alabama $340 million a year is not supported by any independent analysis. That number comes from big PBM special interests. And while the PBMs like to use imaginary numbers (the same way they do when they charge employers thousands of percent above cost for prescriptions), the facts tell a different story entirely. In one instance, the state of West Virginia recently announced that its PBM reform efforts resulted in millions of
dollars in savings and lower premiums for patients. Other states, including Arkansas, Kentucky, and Ohio, have passed meaningful PBM reform legislation with similar results.
The truth is this: PBMs profit from manipulating drug pricing behind the scenes. They decide what drugs are covered, what pharmacies patients can use, and how much pharmacies are reimbursed for medications. They often pay local pharmacies less than the actual cost of the medications being dispensed. No other business would survive being forced to sell products at a loss—and yet that’s exactly what’s being asked of independent pharmacies in Alabama.
These are not just small businesses. In many communities, especially rural areas, the independent pharmacy is the only healthcare provider for miles. In 11 Alabama counties, an independent pharmacy is the only pharmacy in the county. When these pharmacies close—because PBMs refuse to pay fairly—it’s the patients who lose. Access to medication is delayed, restricted, or lost altogether.
Mr. Hare suggests Alabama should wait for federal action. But Alabama doesn’t wait for Washington to fix its problems. Our state motto is “We Dare Defend Our Rights”—and that’s exactly what SB252 does. It defends the right of patients to affordable medications. It defends the right of pharmacies to be treated fairly. And it defends the right of our state to stand up to billion-dollar corporations when they take advantage of Alabama families.
SB 252 passed the Alabama Senate without opposition and is supported by Republicans and Democrats alike. That kind of unity is rare, and it speaks volumes. These lawmakers have listened to their constituents, studied the issue, and acted accordingly.
Let’s be clear: this bill doesn’t raise premiums. It doesn’t create new taxes. And it doesn’t reward “special interests.” It simply ensures that PBMs play by the rules and that the people who actually serve patients—pharmacists—aren’t forced out of business.
Alabamians aren’t buying the scare tactics, and neither are their elected officials. It’s time to pass SB 252 and put patients, pharmacies and fairness first.
A. Richard Kirby is the Director of Communications for Bessemer-based American Pharmacy Cooperative, Inc., and has been involved with independent pharmacy and PBM reform since 2013.