Alabama healthcare group pushes back against pharmacy reform bill, citing costs

The Alliance of Alabama Healthcare Consumers is already pushing back against attempts by some groups and lawmakers to pass certain legislation that is aimed at reforming the Pharmacy Benefit Manager (PMB) system in the Yellowhammer State.

State Rep. Phillip Rigsby (R-Huntsville) introduced a pharmacy reimbursement bill last session, but was unable to get it through because of strong opposition.

House Bill 238 would have required pharmacy benefit managers (PBMs) to reimburse in-network pharmacies for the cost of acquiring medication and also adds a dispensing fee set by the federal government and used in programs such as Medicaid.

Wednesday on WVNN’s “The Yaffee Program, Robin Stone, the Executive Director of AAHC, discussed why he believes that kind of PBM reform is not good for consumers in Alabama.

“Pharmacy benefit managers are used by every employer in the state of Alabama to administer their pharmaceutical healthcare benefit programs,” Stone explained. “They are a tool. They may not be a perfect tool, but there are the tool that helps monitor costs and keep down costs. But the thing about Rigsby’s bill, it did nothing to examine the real cost of health care in the state of Alabama, which is the skyrocketing cost of health care benefits, and that accounts for about 25% of all all health care costs in state. So we were very much much opposed to that specific piece of legislation.”

Stone said he’s specifically against a “dispensing fee” like what was proposed in the previous legislation.

“But what these pharmacists are asking the legislature to do is to demand a $10.64 cent dispensing fee for every prescription that comes across their counter, for every prescription that you pick up,” he said. “As an example, if a family of four picks up four prescriptions, that’s $42.56 that’s going to be dragged back to the pharmacy benefit managers, which will, of course, be immediately sent back to employers for their health care benefit.”

“That didn’t mean that somebody pays it at the counter there,” he added, “but that cost is going back, and as I mentioned, the pharmacy benefit managers are so prevalent the state of Alabama that once that fee goes back to PBMs, it will immediately be passed back down the consumer food chain and be paid by employers who provide those benefit costs and eventually to the employees who help in their co pays at their their companies, it will come back to consumers. Nobody’s going to eat this cost to pay pharmacist $10.64 for every prescription. It’s going to be it’s going to be paid by consumers.”

While AAHC is arguing against the need for this type of reform, The Alabama Independent Pharmacy Association (AIPA) is arguing that it’s needed to protect smaller independent pharmacies.

Yaffee is a contributing writer to Yellowhammer News and hosts “The Yaffee Program” weekdays 9-11 a.m. on WVNN. You can follow him on Twitter @Yaffee