Alabama lawmakers advance regulations on pharmacy benefit managers

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Alabama lawmakers advance regulations on pharmacy benefit managers

2025-03-21 08:04 Last Updated At：17:39

MONTGOMERY, Ala. (AP) — Two blocks from the Alabama Statehouse, a black wreath hung on the door of Adams Drugs — a symbol to draw attention to the number of neighborhood pharmacies that have closed, or are in danger of closing, across the state.

Dozens of independent pharmacies have shuttered in Alabama over the last two years, according to the Alabama Independent Pharmacy Alliance. Pharmacists said that is because of financial pressures, in part, because it can often cost more to dispense a drug than they are reimbursed by pharmacy benefit managers.

“We’re losing almost one drugstore per week going out of business because they are paid such a small amount of money from the PBM industry to fill prescriptions for their patients at their drugstore,” Sen. Billy Beasley, a Democratic senator and retired pharmacist, said.

Alabama is one of several states considering new regulations on pharmacy benefit managers, the middlemen between health insurance companies, drug companies and pharmacies. The Alabama Senate voted 32-0 Thursday to advance legislation to require minimum reimbursement rates to community pharmacists. The bill now moves to the Alabama House of Representatives.

Legislation seeking regulations on the benefit managers have also been proposed in Mississippi, Arkansas and other states. Both large retail chains and independent pharmacists have closed stores across the country as drugstores face reimbursement issues, rising costs and other challenges.

Pharmacy benefit managers leverage purchasing power with drug companies with the goal of driving down drug costs for consumers. However, independent pharmacists say the business practices of benefit managers cause them to lose money on about 20% of prescriptions.

“The biggest issue is we’re not getting paid what it actually cost to fill a prescription, including labor,” Trent McLemore, a pharmacist with Star Discount Pharmacy.

The Alabama bill would require that PBMs reimburse community pharmacies at the Alabama Medicaid Agency reimbursement rate. It would also prohibit the practice of “spread pricing” where a benefits manager charges health plans more for drugs than they pay pharmacies.

Groups opposed to the bill have said it would effectively put a new $10.64 fee on prescriptions under the requirement to match state Medicaid rates, which include a $10.64 dispensing fee. That fee, they argued, will eventually get passed down to consumers and businesses.

Helena Duncan, president of the Business Council of Alabama, told a legislative committee on Wednesday that small businesses, which might already be struggling to provide insurance to their workers, will have to either absorb the increased cost or pass it along to employees through premium increases.

“Shifting the financial burdens from pharmacies to the Alabama employers is fundamentally unfair,” Duncan told a legislative committee on Wednesday.

Republican Sen. Andrew Jones, a cosponsor of the bill, said Thursday said other states have seen drug prices go down. Jones said it is important to protect neighborhood pharmacies because they play a vital role in communities.

“You are not going to get a big box store to open in the middle of the night to get you the medication you need,” Jones said.

Sudan's army says it seized key buildings in Khartoum after retaking the Republican Palace

2025-03-23 01:53 Last Updated At：02:00

CAIRO (AP) — Sudan ’s military on Saturday consolidated its grip on the capital, retaking more key government buildings a day after it gained control of the Republican Palace from a notorious paramilitary group.

Brig. Gen. Nabil Abdullah, a spokesperson for the Sudanese military, said troops expelled the Rapid Support Forces from the headquarters of the National Intelligence Service and Corinthia Hotel in central Khartoum.

The army also retook the headquarters of the Central Bank of Sudan and other government and educational buildings in the area, Abdullah said. Hundreds of RSF fighters were killed while trying to flee the capital city, he said.

There was no immediate comment from the RSF.

The army's gain came as a Sudanese pro-democracy activist group said RSF fighters had killed at least 45 people in a city in the western region of Darfur.

On Friday, the military retook the Republican Palace, the prewar seat of the government, in a major symbolic victory for the Sudanese military in its nearly two years of war against the RSF.

A drone attack on the palace Friday believed to have been launched by the RSF killed two journalists and a driver with Sudanese state television, according to the ministry of information. Lt. Col. Hassan Ibrahim, from the military’s media office, was also killed in the attack, the military said.

Volker Perthes, former UN envoy for Sudan, the latest military advances will force the RSF to withdraw to its stronghold in the western region of Darfur.

“The army has gained an important and significant victory in Khartoum militarily and politically,” Perthes told The Associated Press, adding that the military will soon clear the capital and its surrounding areas from the RSF.

But the advances doesn’t mean the end of the war as the RSF holds territory in the western Darfur region and elsewhere. Perthes argued that the war will likely turn into an insurgency between the Darfur-based RSF and the military-led government in the capital.

“The RSF will be largely restricted to Darfur ... We will return to the early 2000s,” he said, in reference to the conflict between rebel groups and the Khartoum government, then led by former President Omar al-Bashir.

At the start of the war in April 2023, the RSF took over multiple government and military buildings in the capital including the Republican Palace, the headquarters of the state television and the besieged military’s headquarters, known as the General Command. It also occupied people’s houses and turned it into bases for their attacks against troops.

In recent months, the military took the lead in the fighting. It reclaimed much of Khartoum and its sister cities of Omdurman and Khartoum North, along with other cities elsewhere in the country. In late January, troops lifted the RSF siege on the General Command, paving the way to retake the palace less than two months later.

The military is now likely to try to retake the Khartoum International Airport, only some 2.5 kilometers (1.5 miles) southeast of the palace, which has been held by the RSF since the start of the war. Videos posted on social media Saturday purportedly showed soldiers on a road leading to the airport.

The RSF was accused on Saturday of being responsible for the deaths of at least 45 people in the Darfur city of al-Maliha.

The pro-democracy Resistance Committees, a network of youth groups tracking the war, said the RSF entered the city on Thursday and carried out attacks. The dead included at least a dozen women, according to a partial casualty list published by the group.

Al-Maliha, a strategic desert city in North Darfur near the borders with Chad and Libya, is around 200 kilometers (125 miles) north of the city of el-Fasher, which remains held by the Sudanese military despite near-daily strikes by besieging RSF.

The war, which has wrecked the capital and other urban cities, has claimed the lives of more than 28,000 people, forced millions more to flee their homes and left some families eating grass in a desperate attempt to survive as famine sweeps parts of the country. Other estimates suggest a far higher death toll.

The fighting has been marked by atrocities including mass rape and ethnically motivated killings that amount to war crimes and crimes against humanity, especially in the western region of Darfur, according to the United Nations and international rights groups.