What a crackdown on pharmacy benefit managers means for your prescriptions in Alabama

MONTGOMERY, Ala. (WIAT) — Under a new law regulating PBMs, or pharmacy benefit managers, you could be paying an extra $10 for your prescriptions.

Blue Cross and Blue Shield of Alabama, among others, explained what a new drug dispensing fee means for out-the-door totals at pharmacies.

“It’s a simple lifeline. It’s not a complete solution,” said Anna Noojin, pharmacist at Boaz Discount Drugs. Noojin said that lifeline is a new law requiring PBM’s to pay drugstores acquisition costs, plus a dispensing fee of $10.64. That’s the Medicaid reimbursement rate.

Noojin said pharmacies like hers have been under pressure from PBMs. “We’ve lost a pharmacy a week, on average, over the last several years,” she said. “So, by getting this legislation into effect it gave everyone a hope and a reason to hang on to see if it will help.”

On the insurance side, Blue Cross and Blue Shield of Alabama said drug costs now include that dispensing fee. Sophie Martin, director of corporate communications, said customers could see that change reflected in their prescription costs, but only if that cost is less than their copay.

“Customers will pay the lesser of the drug costs that includes the new dispensing fee, or their designated copay that they can find in their plan,” explained Martin. “This change did not come from Blue Cross, or our PBM partner—this was legislation that was put into place. We are simply complying with the law.”

Sen. Andrew Jones (R-Centre) said that law states the reimbursement cost cannot be passed on to the consumers. “PBMs [are] making billions of dollars annually — then that fee can come from their profits,” said Sen. Jones. “That’s the way I see it. It’s black and white in the bill, it will not be passed on to consumers.”

Jones said the fee is a big deal for rural pharmacies. “If that community pharmacy goes under then folks are not gonna be able to travel, you know, an hour, two hours to a chain pharmacy to get their prescriptions filled,” he said.

Martin said Blue Cross and Blue Shield will continue to advocate for the lowest prescription drug prices possible on behalf of its members.