Alabama PBM legislation protects patient choice

NCPA February 23, 2021

Alabama SB 227, introduced by Sen. Tom Butler (R), is a pro-patient, pro-local community pharmacy bill. The legislation will help put an end to PBM conflicts of interests that raise costs for patients and payers and limit access to local community pharmacies. This bill:

  • Protects patients from PBM conflicts of interest. PBMs own their own pharmacies, and they often force patients to use those pharmacies, many of which are out-of-state mail-order pharmacies with no face-to-face interaction with a pharmacist. SB 227 will protect a patient’s right to choose the in-network pharmacy that is right for the patient, not the PBM.
  • Protects local pharmacies from anticompetitive PBM practices. PBMs arbitrarily refuse to allow local pharmacies to participate in provider networks, which makes it easier for PBMs to steer patients to PBM-owned pharmacies. SB 227 will require PBMs to give pharmacies the opportunity to compete with those PBM-owned pharmacies for patients’ business.
  • Creates transparency between PBMs and payers. PBMs use complicated pricing schemes to their benefit, but at the expense of the ultimate payers — the health benefit plans and those enrolled in the plans. SB 227 will require PBMs to act as the health benefit plan’s fiduciary, benefitting all those enrolled in the plan.

SB 227 provides much-needed transparency for the patients. Link to the bill can be found here.