By DON FLETCHER
News Staff Writer
A black ribbon on the door of a home or business usually signals the death of an occupant of that home or an employee of that business. But the black mourning band that adorns the door of Atmore’s Buy-Rite Drugs signals the impending death of an entire segment of the pharmaceutical industry, unless some changes are made soon.
Cheryl Wooten, a pharmacist at Buy-Rite, explained that the ribbon is a tool for getting the word out about the problems facing Alabama’s small-town, independent pharmacies, which are rapidly becoming a thing of the past.
“We want people to ask us about the ribbon,” Wooten said. “It’s about how insurance reimbursements are causing small, community pharmacies to close. There have been 11 in our area that have closed this year. If it keeps going, small-town pharmacies will soon be out of business.”
Among the closures are the Buy-Rite location owner Danny Cottrell opened at Atmore Urgent Care and Cottrell’s Hometown Pharmacy, which he established a few years ago in East Brewton.
Cottrell agreed with his pharmacist about the severity of the problem, which stems from reimbursement policies of Pharmacy Benefit Managers (PBM). A PBM is a company that manages prescription drug benefits for health insurers, Medicare Part D plans, large employers, and other payers, acting as an intermediary between pharmacies, drug manufacturers, and insurance companies.
“PBMs have become so powerful, they’re able to do what they want to,” he said. “We filled a prescription this week and got reimbursed 34 cents; another pharmacist told me he got a 7-cent reimbursement for a prescription.”
Cottrell said the prescription drug business is ruled by three retail giants — Walmart, CVS and Walgreens — as well as three wholesalers who handle 90 percent of the market, and three PBMS who set reimbursement rates for 85 percent of prescription drug sales.
He doesn’t have a high opinion of those who work for the benefit managers, most of whom he said have “eight years of education and a six-figure salary.”
Cottrell said a different problem joined the PBMs and played a large part in the closing of the Buy-Rite pharmacy at the new urgent care facility, near Interstate 65.
“I opened that store with the intent of getting a foothold while waiting for the hospital to come,” he explained. “About 10 or 12 years ago, 90 or 100 prescriptions a day would be manageable. Now, because of the way the reimbursements are, we need about 180 a day to break even, so it just didn’t make sense to wait for the store to grow.” (The new hospital remains on the drawing board due to the Escambia County Healthcare Authority’s financial straits.)
Some help might be on the way, as the National Community Pharmacists Association (NCPA) is pushing for legislation that will help lessen the problem. State Sen. Greg Albritton recently helped get the Community Pharmacy Relief Act passed in the Alabama Senate. It has now been sent to the House for its approval, where State Rep. Alan Baker is expected to push for speedy passage of the legislation.
“The NCPA is trying to get legislation passed that will give us some relief,” Cottrell said. “Sen. Albritton voted for us, and Rep. Baker has been very supportive. The pharmacy industry is just a challenging business right now, and the PBMs have control. They are strong enough to hold the drug companies hostage. It’s getting pretty scary.”