Support PBM reform

Friends and Neighbors,

Last week, the Osceola Sentinel-Tribune reported the Iowa Senate passed SF383 to bring meaningful PBM reform to Iowa. Thank you to Senator Sinclair for voting for this bill and moving it forward to the next stage. Our legislators don’t hear than you enough, so please thank her yourself. The Iowa House can now support local and independent pharmacies by passing this bill. It’s important you and I act now to let the House know how important this issue is to us. Let me share why it’s important to you.

Most of us don’t know what Pharmacy Benefit Managers (PBMs) are or what purpose they serve in the pharmaceutical supply chain. PBMs are drug middlemen who negotiate with insurance companies. Over the years, PBMs have created a marketplace where pharmacies are being run out of business. A survey of Iowa pharmacies found up to 40% of prescriptions paid the pharmacy less than the cost of medications. In addition, PBMs routinely create exclusive networks that force patients to receive their medications from mail order pharmacies. This breaks the longstanding and trusted relationship patients have with their local pharmacists.

The PBMs are huge corporations with huge profits. They are spending a lot of money to prevent patient and pharmacy centered reform in our state. They are spreading false information claiming this bill will keep your premiums higher. We know that isn’t true because the dozens of other states that have blazed the trail for us haven’t seen those increases.

Today, PBMs are allowed to operate without transparency. Pharmacies are sending multiple complaints to the Iowa Insurance Commission (IIC). The IIC has received over 70,000 complaints related to paying a pharmacy less than the cost of the medication. The Commission investigates, but current regulations prevent them investigating behind the PBM veil of secrecy. The bill that passed the Senate requires PBMs to reimburse fairly, let Iowans choose where they fill their prescriptions without penalty by prohibiting PBM exclusions, requires reimbursement at a fair cost, allows a pharmacy to decline to dispense medications when the reimbursement is less than cost and strengthens the appeal process.

For patients, there are three key advantages of this legislation. First, you get to choose your pharmacy and pharmacist and aren’t forced to have all medications mail ordered. Second, any rebates received by the PBM must be passed through to the insurance plan to lower your premiums. Finally, any copay you pay must be applied to your deductible.

It is well past time to pass these reforms. The PBM practices have led to the closing of over 30 Iowa pharmacies in the last year and over 200 in the past decade. This reform is needed to save the health connection Iowans count on with their local pharmacy and their familiar, trusted, local pharmacist.

We are fortunate to have excellent, caring, skilled and patient focused pharmacists all around us in south central Iowa. I’m proud to be an Osceola pharmacist and serve patients in our area. This week, please take a moment to tell your State Representative how important your local pharmacy is to you. Share your stories about why you value our local pharmacies. Let’s get PBM reform moved forward together.

While I work in healthcare, the opinions presented are personal and do not represent Clarke County Hospital or any affiliated organization.