PBM reform bill amended, advanced through Iowa Senate
The bill passed through the chamber by a vote of 36 to 14, with an amendment to the bill added that sends it back to the Iowa House.
The bill adds regulations to pharmacy benefit managers, or PBMs, requiring them to reimburse pharmacies based off of the National Average Drug Average Cost. The bill also requires PBMs to reimburse pharmacies a dispensing fee and more.
Advocates for the bill have explained that PBMs have been following a model where pharmacies are not fully reimbursed when filling a prescription for a patient. This leaves the pharmacy at a net loss on the cost to fill the prescription and what costs were reimbursed by PBMs. This in turn has seen an increased closure rate of both rural and urban pharmacies.
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'If we do not pass this bill today, we are setting them up for having no access to a pharmacy. Thirty-two of them closed last year. I lost four alone in my district and once they close, they're not going to reopen. So, this bill is a great step in the right direction to provide transparency in what's an opaque system,' said State Senator Mike Klimesh (R), District 32 from Spillville.
Those 32 pharmacies that have closed over the last year reflects concerns from owners about PBMs not reimbursing at fair rates.
The majority of Senate Democrats voted against the bill, because insurance companies have indicated if there is any change to the PBM system, the costs will be passed on to the consumer.
'We have to take seriously that the PBMs have promised they're going to pass the costs along to the consumers, and we want to shield the people of Iowa from increased costs while protecting our small town and rural pharmacies,' said State Senator Sarah Trone Garriott (D), District 14 from Waukee.
According to the Iowa Pharmacy Association, out of all the states that have passed PBM reform there has not been an increase of insurance premium prices for patients.
Iowa News:
PBM reform bill amended, advanced through Iowa Senate
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