Pharmacy Benefit Managers, essentially the middlemen in negotiating drug prices, will now face new restrictions following Governor Kim Reynolds signing a PBM reform bill into law.
"Seeing that we actually, finally got that signature means a lot for pretty much everyone in the pharmacy world," said Dr. Nevin Radechel, the managing pharmacist at Medicap Pharmacy in Beaverdale.
Pharmacists have spent years pushing for changes. how PBM's operate in Iowa.
They point to low drug reimbursement rates as the cause for Iowa pharmacies shutting their doors, with about 34 closed just last year.
"Still, about 11-12% of our claims are underwater, meaning they result in a loss; this happens when we make less money than it costs us to provide the medication, and we have to absorb those losses because we want to take care of those people," Dr. Radechel said.
Now, they're hoping to see a change since PBMs will be required to reimburse at the national or state average cost for those medications.
However, not everyone agrees.
I mean it was a really tough vote," Senate Minority Leader Janice Weiner (D- Iowa City) said. "That’s why we had a split vote.
Senator Weiner said that rural pharmacies are in crisis and they need a solution but she isn't convinced this is the way to go.
ABI is disappointed in today’s action," said Iowa's Association of Business and Industry. "ABI testified at every turn in favor of legislation that would support small independent pharmacies in Iowa. The bill that the Governor signed today is not that. Senate File 383 includes expensive, unneeded provisions that are going to drive up the costs of pharmacy services in Iowa without any discernable improvement in patient care. Iowans – including businesses and employees – will bear these costs at the pharmacy counter and in the structure of their health care plans. This is an additional headwind in an already challenging business environment. Now law, ABI will take every opportunity to mitigate the increased costs on our members and their team members throughout Iowa.
After hearing those concerns, Sen. Weiner said she would have preferred a different bill and expects lawmakers will address any problems next session.
"There was a solution that would have helped all these rural pharmacies as well as independent pharmacies, smaller independent pharmacies in urban areas and would not have jacked up premium costs for workers," Sen. Weiner said.
Yet, pharmacists don't believe that will be a problem.
"We are not the pioneers of this," Dr. Radechel said. "In most states, we've even seen the opposite where it's actually leading to savings for premiums and saving for plans and Iowans."
The bill would also prohibit PBMs from restricting the pharmacies that Iowans want to use, along with a new way for pharmacies to appeal a PBM's decision.
Governor Kim Reynolds said that signing the bill was a difficult decision, but she stated that it's not the end of the conversation. She claims this will continue her efforts to improve healthcare in Iowa, but she said her team will stay on top of this issue to ensure there are no unintended consequences.
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