More than 100 independent pharmacies across Alabama are shutting their doors today at 1 p.m. in a bold stand against pharmacy benefit managers (PBMs)—the powerful middlemen controlling drug pricing and reimbursement rates.
For Desak Hicks, owner of Frisco City Pharmacy, this isn’t just about business. It’s about survival.
A Daily Struggle to Stay Open
“We’re just trying to survive,” Hicks said.
For nearly 15 years, he’s served the Monroeville County community, watching as five neighboring pharmacies closed their doors for good. His customers come from small towns like Excel, Uriah, and Repton, where pharmacies are few and far between. But despite the steady demand, staying afloat has become nearly impossible.
“There are days when we fill close to 250 prescriptions, but dozens of them actually cost us money,” Hicks explained.
The math simply doesn’t add up.
“You buy a bottle of medicine for $500, but when you get reimbursed, it’s only $480. How do you keep a business running like that?”
PBMs: The Hidden Force Behind Closures
Like many independent pharmacists, Hicks blames PBMs for the crisis. These companies act as intermediaries between pharmacies and insurance providers, dictating how much pharmacies get reimbursed for dispensing medications.
According to the Alabama Pharmacy Association, PBMs often reimburse pharmacies at rates lower than the actual cost of the drugs, forcing small businesses into financial distress.
The numbers are alarming—since 2018, 13% of Alabama’s pharmacies have shut down, according to the Alabama Independent Pharmacy Alliance.
“It’s greed, plain and simple,” Hicks said. “These PBMs are making billions while an independent pharmacy closes almost every day in Alabama. We need laws that protect small businesses and, more importantly, our patients.”
Pushing for Legislative Change
Pharmacists participating in today’s walkout are demanding action on SB93, a bill introduced by Senator Andrew Jones (R-Centre).
If passed, SB93 would:
✔ Prevent PBMs from reimbursing pharmacies below the cost of medication
✔ Ban hidden fees that cut into pharmacy profits
✔ Give the Commissioner of Insurance more authority to regulate PBMs and enforce penalties
Another proposed bill, SB99, has faced pushback from certain groups who claim it could increase prescription costs. The Alliance of Alabama Healthcare Consumers argues that SB99 might add a $10.64 dispensing fee per prescription, which could cost individuals an extra $900 per year or $3,600 per family.
Hicks dismisses this as a scare tactic pushed by PBMs.
“This isn’t about raising costs for patients,” he said. “It’s about making sure pharmacies are reimbursed fairly so we can continue serving the communities that rely on us.”
Other states like Kentucky and West Virginia have already passed PBM reforms, saving more than $50 million in healthcare costs.
The Fight to Protect Local Pharmacies
Last year, a similar PBM reform bill failed to pass in the Alabama House. Now, independent pharmacists are fighting harder than ever to push for change before more businesses are forced to close.
“They keep squeezing us until there’s nothing left,” Hicks said.
“I’ve managed to stay open for now, but half the pharmacies in my county have shut down in the last 10 years. And let’s be real—they didn’t close because they were making too much money.”
For independent pharmacists across Alabama, this is about more than business. It’s about protecting access to healthcare in rural communities—before it’s too late.
The fight continue.
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