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White coats filled the Alabama State House this week as independent pharmacies spearheaded by Valley Pharmacy and Hood’s Pharmacy pushed for Senate Bill 99. The bill has gained support in the Senate with over 20 co-sponsors. 

“Chambers County is where the movement started, and we’ve spread out all over the state now,” said Craig Moore, co-owner of Valley Pharmacy. “And this week, I think we caught everybody off guard in the legislature when we had white coats down there roaming those halls and demanding change.”

According to Moore, Alabama’s independent pharmacists are calling for fair reimbursement, transparency with the public and more enforceable language for PBMs (Pharmacy benefits managers) through their Senate bill sponsored by State Senator Larry Stuts.

In October, the grassroots alliance created the Alabama Independent Pharmacy Alliance to represent over 100 independent pharmacies in the Alabama State House. SB 99 was introduced in the legislative session this month with 22 sponsors in the Senate. 

The legislature will have a public hearing on Feb. 19 about the bill. Moore is hopeful that the bill could be passed by the end of February when the legislative session closes. 

With hundreds of independent pharmacies closing across the state, Moore said large companies like CVS Caremark, United Healthcare and Blue Cross Blue Shield of Alabama have gained control over drug insurance plans. The top 3 PBMs control over 80% of prescription claims in the US, according to Moore.

PBMs, which serve as an intermediary between health insurance plans and their network pharmacies, decide how much prescriptions cost, what is or isn’t covered and how much pharmacies are paid for the prescriptions.

According to the bill, “PBMs also deal directly with drug manufacturers to negotiate discounts or rebates on drug prices and may also be affiliated with particular pharmacies that also participate in the network.”

In Chambers County, all of the independent pharmacies have been involved in the movement, including Valley Pharmacy, Hood’s Pharmacy, Fairfax Drug, Greene’s Pharmacy and Lowe’s in LaFayette. All of them have been threatened like hundreds of others across the state by the impact of PBMs.

“Your local pharmacist is somebody that you can trust. It’s somebody that you know, somebody that you go to church with, somebody that if you need something after hours, you can call them. They’re gonna come down here and do it,” Moore said. “They’re gonna go that extra mile for you.”

Moore said former state Senator John Rice has helped them navigate through the legislature. Moore also commended Alabama House Representative Debbie Wood for her help. 

“She is a champion of her people,” he said. 

According to the bill, it would:

• Expand oversight by the Department of Insurance by setting benchmarks for the amounts that PBMs reimburse pharmacies, and by regulating how they process claims, determine payment amounts, and use manufacturer rebates.
• Prohibit PBMs from requiring or influencing health insurance beneficiaries to purchase a particular variant of a prescription drug or only use certain pharmacies within a health plan network. 
• Authorize a health insurance plan, a plan beneficiary, or a pharmacy to bring a cause of action against a PBM for damages due to a violation of this act. 
• Further regulate the audit of a pharmacy by a PBM under The Pharmacy Audit Integrity Act by specifying the circumstances under which a PBM may recoup funds from a pharmacy that was overpaid for claims.
• Bans spread pricing more clearly and mandate 100% rebate pass-through. 
• Prohibits PBM retaliation explicitly, ensuring pharmacies can push back against unfair practices.