Lawmakers, advocates and opponents converged for a public hearing today on a controversial topic in the Alabama Senate today over two competing bills proposing to reform pharmacy benefit managers (PBMs) within the state.
Independent pharmacists and supporters of reform flooded the State House today advocating primarily for SB99.
No vote was held today, but members of the Alabama Senate Banking Committee heard from independent pharmacists themselves and opponents from employer groups one after another.
Bobby Giles of the Alabama Pharmacy Association told lawmakers, “A pharmacy cannot sell a medication at or below cost and continue to serve patients. That is as simple as it gets.”
Giles and other advocates argued that reform is needed to enhance transparency and fair reimbursement, preventing PBMs from paying their own pharmacies more than they pay independents. For Giles, SB93 specifically is the correct way to accomplish that.
SB93 is sponsored by State Sen. Andrew Jones (R-Centre) while SB99 is backed by State Sen. Larry Stutts (R-Tuscumbia), both attempting to overhaul how PBMs operate in Alabama.
However, their approaches differ, and the battle lines were drawn as pharmacists, business leaders, and lawmakers were curious to hear their merits.
SB99 is backed by a larger group of 21 senators and takes a tougher stance: Requiring PBMs to reimburse pharmacies based on the National Average Drug Acquisition Cost (NADC) plus a mandated dispensing fee.
Despite some disagreement over which bill best accomplishes the goal, all pharmacists advocating for reform each argued that the need is urgent.
Anna Nugent, a second-generation pharmacist, fought back tears as she described the dire state of independent pharmacy in Alabama. “We are in a crisis, and our time is running out. Many will close their doors if help isn’t granted this legislative session.
Greg Raybould of the American Pharmacy Cooperative showed legislators a chart that demonstrated how PBMs reimburse independent pharmacies less than they pay themselves through their mail-order services. “They are forcing patients to their own mail-order pharmacies, and then charging thousands of dollars more. It’s price manipulation,” he said.
RELATED: Alabama healthcare group pushes back against pharmacy reform bill, citing costs
Representatives of major employers and business groups pushed back against both bills, particularly SB99, which includes a $10.64 dispensing fee per prescription — a provision they say unavoidably will drive up healthcare costs for consumers and businesses.
Robin Stone, director of the Alliance of Alabama Healthcare Consumers cited an analysis estimating $347 million in new prescription spending in the first year alone if either bill passes.
“These fees will be passed down,” he said. “Employers will have to pay more, and ultimately, employees will see higher premiums and out-of-pocket costs.”
RELATED: Independent pharmacies continue push for reforms to combat PBM practices in 2025
Senators wrestled with competing data, arguments and emotional testimonies.
State Sen. Chris Elliott (R-Josephine) pressed opponents on their claims that PBMs save money, pointing to the independent pharmacists’ data showing the opposite. State Sen. Rodger Smitherman (D-Birmingham) pushed back against the idea that businesses would simply absorb higher costs, saying, “We want our pharmacists to survive. But we also have to ask: Where does this cost land?”
State Sen. Dan Roberts (R-Mountain Brook) challenged business leaders to propose a real solution instead of just opposing reform: “We know independent pharmacies are getting crushed. What do you think the solution is?” he asked opponents.
State Sen. Merika Coleman (D-Birmingham) requested to see hard data from opponents. “We have data from pharmacists showing their losses. You’re citing $347 million in new costs — can you provide the breakdown of that?” Stone promised to send it to her office.
At the end of over an hour-long hearing, Stutts urged passage of his version of the legislation, and said he was confident the committee should be in a position to do so next week. If passed, that bill would go to the floor of the Alabama Senate.
Wednesday was day eight of the 2025 state legislative session.
Grayson Everett is the editor in chief of Yellowhammer News. You can follow him on X @Grayson270.
