Over 100 Alabama pharmacies will close today at 1 p.m. as pharmacists walkout in support of legislation regulating pharmacy benefit managers or PBMs.

Desak Hicks, owner and pharmacist of Frisco City Pharmacy, said the walkout is due to pharmacies trying to do something to, “survive.”

Hicks said he opened his pharmacy in Monroeville County about 15 years ago and in that time span five pharmacies have closed in the county.

Hicks added that his pharmacy gets ton of business from citizens of neighboring rural cities like Excel, Uriah and Repton because they lack pharmacies.

However, Hicks said his pharmacy still struggled to return a profit on the medications that were bought and dispensed.

“One day last week we filled, I think it was, 247 prescriptions and 48 of them were at a loss,” Hicks said.

“Meaning you spent $500 on a bottle of medicine and you got paid $480.”

Hicks blamed the greed of pharmacy benefit managers for the financial hardship facing many independent pharmacies.

PBMs act as intermediaries between pharmacies and health insurance companies while setting reimbursement rates on the medications that pharmacies dispense.

The Alabama Pharmacy Association said pharmacies are struggling to remain open due to PBMs offering reimbursements, “at a price lower than their cost of dispensing the medication to the patient.”

According to the Alabama Independent Pharmacy Alliance, roughly 13% of pharmacies in the state have closed since 2018.

“It’s like they got greedy over the years, and now they just, you know, they’re making billions of dollars, and they’re posting record profits,” Hicks said.

“Meanwhile, one pharmacy a day closes in Alabama, and it’s just, it’s time for some legislation to protect not just my business, but to protect my patients.”

The legislation that Hicks and other pharmacists are supporting in their walkout is SB93, sponsored by Sen. Andrew Jones, R-Centre.

The bill would prohibit PBMs from reimbursing pharmacies less than the cost of a medication or imposing miscellaneous fees on pharmacists. It would also give the Commissioner of Insurance more power to enforce any violations committed by PBMs.

Opponents of Jones’ legislation and another bill targeting PBMs, SB99, assert they will pass dispensing fee costs onto consumers, according to Alabama Daily News.

The Alliance of Alabama Healthcare Consumers contends that SB99 will add a $10.64 “dispensing fee” on all prescriptions in the state, amounting to an annual cost of $900 per individual or $3,600 for a family.

But Hicks said this notion was just a “scare tactic” pushed by pharmacy benefit managers and the legislation only ensures pharmacies reimbursed properly.

Several states, like Kentucky and West Virginia, have reported saving over $50 million after enacting PBM reforms.

Last year a PBM reform bill introduced in the legislature did not advance in the House.

Hicks said that if neither bill passes pharmacists will continue pushing for reform but will remain weary of PBMs impacting his business.

“They just slowly squeeze you to the point where, it’s not profitable to stay open,” Hicks said.

“This volume is higher so to this point I’m still able to stay open. But again, half the pharmacies in our county have closed in the last 10 or 15 years. And I don’t think they’re closing because they’re making a bunch of money.”