A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See SF 383.)
Impact
The bill is expected to significantly alter existing practices governing pharmacy benefits and the relationship between PBMs, pharmacies, and health care providers in Iowa. With its implementation, beginning July 1, 2025, it will restrict PBMs from engaging in certain discriminatory practices against pharmacies and ensure that pharmacies cannot be reimbursed at rates lower than their acquisition costs. This legislative measure aims to promote fair competition and access to necessary medications for patients while also safeguarding the financial interests of pharmacies.
Summary
SSB1074 aims to regulate pharmacy benefits managers (PBMs) and improve the pricing and reimbursement processes related to prescription drugs. The bill introduces definitions for 'pass-through pricing' and 'spread pricing', intending to eliminate the unfair pricing strategies that PBMs might use, which can negatively impact both pharmacies and patients. By mandating that PBMs use transparent pricing models that reflect actual costs, the bill seeks to create a more equitable healthcare system whereby pharmacists receive fair compensation for their services.
Contention
Despite support from various stakeholders, the bill has faced contention regarding the potential impact on business operations for PBMs. Supporters argue that SSB1074 protects consumer choice by preventing PBMs from imposing penalties on patients who choose pharmacies based on personal preferences. Conversely, opponents warn that the bill could lead to higher prices for consumers if cost pressures force PBMs to adjust their business models, potentially impacting the available choices for patients and their access to medications.
Replaced by
A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions. (Formerly SSB 1074.) Effective date: 07/01/2025. Applicability date: 07/01/2025.
Replaced by
A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(Formerly HSB 99.)
Related
A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs and including applicability provisions.(See HF 852.)
Health occupations: pharmacists; pharmacists to prescribe and dispense certain contraceptives; allow. Amends secs. 17703, 17704, 17707, 17708, 17709, 17744, 17751 & 17757 of 1978 PA 368 (MCL 333.17703 et seq.) & adds sec. 17744g.