A suggestion for an update on the status of locally owned independent pharmacies resulted in a talk with pharmacist Marty Bigner.
He owns two pharmacies in Pike County, having recently bought Corner Drug Store in Magnolia to go along with Thrift Drugs in McComb. And he is part owner of Express Care Pharmacy and Summit Express Pharmacy.
Bigner also is a board member of the Mississippi Independent Pharmacist Association. Few people in Southwest Mississippi have as much riding on the struggles of these businesses as he does.
Unfortunately, Bigner reported that the financial problems of these pharmacies are not improving.
“We’re barely surviving,” he said. “We’re just getting by. The issue is with the contracts pharmacy benefit managers make us sign. The reimbursement goes down every year. It never goes up. It hasn’t gone up in 20 years.
“Eventually there’s a point where you have to say no, and you lose that business. … We will get reimbursed even less for the work that we do now in the following years, and whenever that amount is lower than what it costs us to fill a prescription, we will have to turn those patients down.”
It will take action by the Legislature to restrict PBMs in the state. Last year, Bigner said, the state Senate passed a bill by a wide margin to do this.
The bill would have allowed pharmacies to be reimbursed, by all private health care plans, for prescriptions at cost plus a flat dispensing fee.
The bill also would have allowed businesses, which pay employee premiums, to see what rebates the PBMs are receiving from drug companies. And it would have prevented PBMs from requiring customers to get medicine from a chain store or mail-order pharmacy.
The bill did not become law, and independent pharmacists blame the state House of Representatives for that.
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“The large employers, like Ingalls for example, they are being told that this is going to increase the cost of their insurance by millions of dollars,” Bigner said. “Absolutely not. There are plenty of other states where this has been done and it has not happened.”
In fact, Bigner said all four states surrounding Mississippi, and a lot of other states as well, have set out restrictions and requirements on PBMs that are similar to the 2025 bill in Mississippi that died.
The pharmacist group plans to file a PBM bill in both the House and Senate this session. The questions are whether the pharmacists are willing to back away from anything that was in last year’s bill, and whether key lawmakers will listen to small businesses that are providing a valuable service, not to mention jobs.
“I enjoy the patient interaction part of it, taking care of people in a way that a chain pharmacy cannot,” Bigner said. “That’s why I enjoy my job. But whenever I look at the financials, I wonder if I am going to be able to help patients in this way, since I’m not being paid for the services that I offer.”
As for PBMs, he said, “I feel like they want us to be here and work for nothing. That’s what I think.
“They know that if we’re not here, there are going to be plenty of holes in the healthcare system, especially in some of the rural areas. But they want us to work for nothing.
“We’re getting paid just enough to get by. I feel it’s more that than them wanting us out of business.”
He said the pharmacist association is trying to build a better relationship with House leaders, and believes that as more people understand what’s at stake with independent pharmacies, it increases the possibility of the Legislature taking action.
“I think there were more pharmacies and more of our customers involved last year, which is why it was such a big story,” Bigner said. “The problem is becoming more known, and hopefully we can see something go forward this year.”
The long-term concern is that businesses that don’t make any money eventually fade away. But Bigner said he believes up to 15 local pharmacies closed in Mississippi last year because of the financial squeeze. So the long-term concern may be upon us.
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The world is changing, and a lot of businesses that were here 10 or 20 years ago are gone. But you would think that in a country that has so much medication, a business that dispenses it could survive.
The fact that independent pharmacies continue to struggle indicates something is wrong, and it needs to be fixed quickly.
