The House on Wednesday passed a bill aimed at increasing regulation and transparency of pharmacy benefit managers, an issue advocates argue is critical to protecting patients and independent pharmacists in Mississippi against the risk of rising drug costs. 

The legislation, authored by House State Affairs Chairman Hank Zuber, a Republican from Ocean Springs, passed by a 76-38 vote. It requires pharmacy benefit managers — the middlemen between drug manufacturers, insurers and pharmacies — to reimburse pharmacists at least their cost of acquiring a drug. Among other provisions, it would also outlaw requiring a patient to use a specific affiliate pharmacy and prohibit spread pricing, the practice of paying insurers more for drugs than pharmacists in order to inflate pharmacy benefit managers’ profits. 

Joe Mohamed, the president of the Mississippi Independent Pharmacies Association, said he welcomes the bill and looks forward to working with the Senate to strengthen transparency, ensure fair reimbursement and support local, independent pharmacies across the state.

Independent pharmacists have warned that if legislators do not pass reform legislation, pharmacies may be forced to close. They say the companies’ low reimbursements to independent pharmacies and unfair business practices have left them struggling to break even. 

Mohamed said 54 independent pharmacies have closed in Mississippi since 2021. 

“When a local pharmacy closes, patients lose access, especially in small towns and rural communities,” said Mohamed, who is also the co-owner and pharmacist of G&P Pharmacy in Belzoni. 

Lawmakers in Mississippi have proposed bills to regulate pharmacy benefit managers unsuccessfully for the past several years. A pharmacy benefit reform bill last year made it further in the legislative process than in years past, but died in the House after a lawmaker raised a procedural challenge. 

Crafting a successful reform bill is daunting due to the competing demands of independent pharmacists and the business community, Zuber said to fellow lawmakers Wednesday. 

“I’m just going to be very blunt with all of you up front, you can not make everybody happy with this bill,” he told fellow lawmakers. 

Still, he said, his measure would provide significant benefits for independent pharmacists and their patients. The bill would move the regulation of pharmacy benefit managers from the Board of Pharmacy to the Commissioner of Insurance. He also noted that it is the lone bill remaining this session aimed at pharmacy benefit manager reform after several bills failed to meet Tuesday’s committee deadline.

“This is the only game in town,” he said. “The Senate, for whatever reason, does not have a bill.”

Sen. Rita Parks, a Republican from Corinth, authored a bill that died Tuesday. Parks, who has spearheaded pharmacy benefit manager reform efforts in the Senate, told Mississippi Today she was disappointed that Public Health and Welfare Chairman Hob Bryan, a Democrat from Amory, did not bring up the bill for consideration. But she said she remains hopeful that the House’s legislation would allow room to continue advancing reform efforts.

“Our independent pharmacists will suffer,” Parks said. 

Rep. Stacey Hobgood-Wilkes, a Republican from Picayune, offered an amendment on the floor Wednesday to strike the bill’s text and replace it with the language of a bill authored by Rep. Donnie Scoggin, a Republican from Ellisville.

“This is the bill that would actually help our independent pharmacists and help our constituents lower their drug costs,” Hobgood-Wilkes said. 

She said the proposal would require pharmacy benefit managers to reimburse pharmacists at no less than the Medicaid rate for dispensing drugs, which includes set acquisition costs. It also keeps the regulation of pharmacy benefit managers at the Board of Pharmacy, the agency that has overseen them for years.

Zuber opposed her proposal. “Let’s send it over to the Senate and get this over with,” he said. 

The amendment failed in a 64-52 vote. 

Hobgood-Wilkes served as chairwoman of the House Drug Policy Committee last session, but she was removed from her post last June. She told Mississippi Today her removal was a direct result of her advocacy for reforming pharmacy benefit manager practices.

Fair Jones, the co-owner and pharmacist of Sav-Mor Drugs and Gifts in Grenada, said though she originally supported Scoggin’s bill, the legislation that passed the House Wednesday is “a good starting point” for lawmakers to hammer out the details of pharmacy benefit manager reform this year. 

She said she has watched as several independent pharmacies have closed since last year, when she came to the Capitol to advocate for reform, underscoring the urgency of passing legislation this year. 

“You feel like time is running out,” she said.