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NATCHEZ — A Natchez pharmacist is applauding legislation being considered by the Mississippi House and Senate that would help regulate the actions of pharmacy benefit managers.

Larry McManus, who runs the pharmacy operation at Ernst Pharmacy in Natchez, said pharmacy benefit managers, known as PBMs in that industry, are a relatively new phenomenon and serve as a price negotiator for insurance companies.

“PBMs are kind of like an intermediary. They won’t pay for drugs a lot of times or will pay less than it costs for us to purchase the drugs,” McManus said.

He said PBMs’ negotiating practices hit small, independent pharmacies the most because they lack the economies of scale to negotiate that large, chain pharmacies do.

“The reimbursement rates to pharmacies for drugs have gotten really bad,” he said. “It’s sad to think that they (insurance companies) make billions of dollars and on the bottom end of it, people can’t get the medication they need because these companies won’t pay the pharmacist what it costs the pharmacy to buy the medication.”

Ernst is the only independent pharmacy operating in Adams County.

McManus said in many instances, the rate the PBMs are willing to pay for drugs isn’t enough to cover the cost of the bottle the drug will be dispensed in.

“That’s the reason so many small pharmacies are going out of business. We spend hours every day searching for where we can find a drug that’s priced in a way to allow us to sell it,” he said. “You’ve got to be able to make a little bit of a profit to stay in business.”

The Mississippi House and Senate each have bills that would regulate PBM practices. In January, the House passed HB1126, which would require PBMs to report what they are paying for drugs to the state board that regulates pharmacists in Mississippi.

However, operators of small pharmacies are saying that the House bill does not go far enough. They prefer the bill being considered in the Mississippi Senate — SB2677 — which would prohibit PBMs from reimbursing a pharmacy or pharmacist in Mississippi for a prescription drug or pharmacist service in a net amount less than the national average drug acquisition cost (NADAC) for the prescription drug or pharmacist service in effect at the time the drug is administered or dispensed. The bill would also require prompt payment to the pharmacy. According to reports, the Senate bill died in committee.

“It all comes down to fair reimbursement. Like anyone would pay their bills, pay it properly and on a timely basis,” McManus said.

He said physicians are in the same situation as pharmacists.

“Doctors are not being reimbursed properly. They (insurance companies) control everything they want to do,” McManus said. “They need to just do it right. Like everything else in the country, we need to just do it right.”