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VALLEY — Local pharmacists Kirsten Hood and Courtney Wood were guest speakers at the Monday evening meeting of the Valley Lions Club. They were there to talk about how independent pharmacies from throughout the state joined together in a common cause to help keep the small town independent pharmacies open for business. It’s hard for them to complete against the big-chain stores like CVS, Walmart and Kroger.

Before the big box stores came along, the independent pharmacies did great business, but when the big stores got to town they were able to use their influence with pharmacy benefit managers, or PBMs, to gain an unfair advantage over the smaller guys. The small-town guys were withering away at an alarming rate until they got together to take collective action at the state level.

They tried and failed to get a bill passed in the state legislature last year, but they succeeded in grand style this year. In an extremely rare event, the Community Pharmacy Relief Act passed both houses in unanimous votes and was signed into law by Governor Kay Ivey earlier this month. It passed the Senate 33-0 and the House 102-0. It did this despite the fact that powerful interests such as David Bronner of the Retirement Systems of Alabama (RSA), Blue Cross Blue Shield of Alabama, AT&T, Alabama Power Company, the Business Council of Alabama and even the Poarch Creeks came out against it.

“It just seemed like everyone with influence was against us,” said Kirsten Hood. “Even Senator
Katie Britt’s husband who’s a lobbyist for Caremart spoke to to us. He was against what we were doing.”

Chambers County pharmacists were very prominent in getting this done. Ten of them from local businesses like Hood’s Pharmacy (where the two speakers work), Valley Pharmacy, Fairfax Drug and Greene’s Pharmacy made trips to Montgomery to express their support for the legislation. Every region in the state had pharmacists backing it.

The big advantage the big stores have had can be seen in the number of independent pharmacies that have closed their doors in recent years. The number of them is down by almost 40 percent. There was one period when an average of one independent pharmacy in Alabama went out of
business every week for a six-year stretch.

The Community Pharmacy Relief Act prohibits pharmacy benefit managers from paying independent pharmacists less than what Medicaid does and from charging miscellaneous fees. PBMs are middlemen that manage prescription benefits between insurance companies and employers. They decide which drugs are covered, how much a patient’s copay is, where you can get your prescriptions filled and how much pharmacies are paid for medications and clinical services.

According to independent pharmacists, PBMs have been paying them so little that they don’t
even cover the cost of the drugs they are providing. It’s no wonder so many of them have gone out of business.

Two legislators who own independent pharmacies, State Rep. Phillip Rigsby and State Senator Billy Beasley, were influential in getting the legislation passed. Both were present at the bill-
signing ceremony with the governor.

The three largest PBMs are Fortune 50 companies CVS, Caremark and Optum. Collectively, they process more than 80 percent of the prescriptions that are filled in the U.S. every year.
Hood and Wood spent some long days in Montgomery as the bill was making its way through
the legislature.

“It was very rough for a few weeks, but in the end it was well worth it,” Hood said. “We were like David going upon against Goliath, and we won. It was the small town independent pharmacies versus billion-dollar corporations. It meant so much to us the support we had gotten from the local community. We appreciate the support we received from the Chambers County Commission.”

But the battle’s not over.

“We had to make some concessions,” Hood said. “We were against some very powerful opponents. We will be back next year to work on addressing more unfair practices that are taking place.”

Hood thanked the local legislative delegation for their support.

“Debbie Wood was so supportive,” she said. “There were some days when we rested in her office in the State House. Rep. Phillip Rigsby of Huntsville was also a big help. It was very difficult for him and his family. He closed his business to run for office.”

Getting the bill passed was a very emotional experience for him. He wiped away tears as thethe
governor was signing the bill.

“So many people had told us we were wasting our time, that there was no way we could get this
kind of legislation passed,” Hood said. “but we believed that God was with us every step of the
way in this fight. We had something to celebrate when that bill was signed.”

Other states have gone through similar fights. Tennessee and West Virginia are two states where similar laws have been enacted to protect the small-town pharmacies. One study has shown that both states have already seen millions of dollars in savings due to this. The West Virginia Bureau of Medical Services, for example, has reported a savings of almost $55 million.
Hood said she would never forget the loud ovation that echoed through the State House when
The House had its vote of 102-0.

Tony Cochran, a board member for the Business Council of Alabama, sympathized with the
independent pharmacists and said he had been embarrassed by the BCA’s opposition to the
proposed legislation. “I’ve watched Montgomery a lot,” he said, “and I have never seen a more
unfair fight. I am amazed and encouraged by what these pharmacists did in the face of such
adversity. It was like David going up against