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Mississippi lawmakers propose bill targeting pharmacy benefit managers

Mississippi hospitals aren’t the only ones in need.

According to Robert Dozier of the Mississippi Independent Pharmacies Association, pharmacies across the state are being forced to cut back on both hours and staff due to monopolies induced by pharmacy benefit managers (PBMs).

“If we don’t do something to protect the community, we will have a health care problem in Mississippi,” Dozier said on The Gallo Show. “You will start seeing pharmacy deserts all across the state.”

Dozier explained his belief that PBMs, which act as middlemen between drug manufacturers and insurance companies, have been selling the business community a false bill of goods for decades. While pharmacies are reliant on PBMs to work with insurers, inadequate reimbursements and excessive fees have forced some pharmacies to shut down.

“The employer’s cost is steadily going up. The employee’s monthly premium, yearly premium, and their co-pays are going up,” Dozier said. “And that pharmacy’s reimbursements are steadily going down. So, where is the problem? The problem is the man in the middle.”

In response, Mississippi lawmakers have proposed a bill that would change the way pharmacies are reimbursed, transitioning from average wholesale price (AWP) to national average drug acquisition cost (NADAC).

AWP, which Dozier said is an outdated metric, can be compared to the “sticker price” of a drug while NADAC calculates the average prices pharmacies pay for prescription drugs.

“Pharmacies’ total reimbursement is made up of two components: the cost of the drug plus the dispensing fee equals the total reimbursement,” Dozier explained. “What we’re saying is let’s move to a more and much needed transparent reimbursement methodology. Let’s use NADAC, which is the pharmacy’s cost for the drug.”

According to Dozier, forcing PBMs to reimburse pharmacies according to NADAC, plus an $11.29 dispensing fee, would bring down drug prices by nearly 5 percent. Opponents of the legislation argue that doing so will increase health insurance premiums.

Watch the full interview with Dozier by clicking here.

Reporter: Kelly Bennett



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