Iowa Senate Bill SF383

Iowa 2025-2026 Regular Session

• Introduced: 2/19/25

Caption

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.)

Impact

If enacted, SF383 will have a considerable impact on the practices of pharmacy benefits managers and the healthcare market within the state. The bill establishes mandatory conditions under which PBMs must operate, creating clearer guidelines for reimbursement and patient cost-sharing. This change is intended to empower patients by giving them the right to choose their pharmacy without facing higher costs, thereby promoting fair competition among pharmacies and ensuring better access to necessary medications.

Summary

Senate File 383 addresses the regulation of pharmacy benefits managers (PBMs) and establishes new requirements for their interaction with pharmacies and patients. The bill prohibits PBMs from discriminating against pharmacies regarding reimbursement rates, ensuring that they must reimburse pharmacies at least the national average drug acquisition cost or the wholesale acquisition cost for prescription drugs. This regulation aims to create a more transparent pricing structure, where patients can benefit from lower costs and improved access to medications without undue penalties based on the pharmacy they choose to use.

Contention

However, the bill has sparked discussions on its potential implications on the healthcare system. Proponents argue that it promotes fairness and transparency, allowing for better patient outcomes by making prescription medications more accessible and affordable. Conversely, critics raise concerns about the administrative burden that increased regulation might impose on PBMs and whether such measures could lead to higher overall costs for health plans. The bill’s supporters believe it balances the interests of patients and pharmacies against the roles that PBMs play in the healthcare delivery system.