Iowa Senate Bill SSB1207

Iowa 2025-2026 Regular Session

• Introduced: 3/5/25
• Refer: 3/5/25

Caption

A bill for an act relating to pharmacy benefits managers, pharmacies, and prescription drugs.

Impact

The bill's provisions aim to enhance the accountability of PBMs by prohibiting them from requiring customers to exclusively use mail order pharmacies for their medications. This regulation is designed to promote access to medications through local pharmacies, particularly in areas defined as 'pharmacy deserts', where residents may have limited access to pharmaceutical services. By ensuring that local pharmacies remain viable, the bill seeks to improve overall healthcare delivery in underserved regions.

Summary

Senate Study Bill 1207 (SSB1207) addresses critical issues related to pharmacy benefits managers (PBMs), pharmacies, and prescription drug pricing in Iowa. The bill introduces several definitions crucial for understanding its provisions, including 'pass-through pricing,' 'spread pricing,' and 'pharmacy desert'. One of the key changes proposed in the bill includes mandating that all rebates received by PBMs be passed entirely to health carriers or employers in order to reduce premiums, aiming to improve cost transparency in prescription drug pricing.

Contention

Debate surrounding SSB1207 has been significant, particularly in the context of how the regulation of PBMs might affect healthcare providers and consumers. Critics of the spread pricing model argue that it can lead to inflated drug prices for consumers, whereas supporters of SSB1207 believe that reducing such practices will ultimately lower costs for patients. The bill seeks to amend existing contracts between PBMs and health insurance providers by prohibiting spread pricing and ensuring fair reimbursement practices, which has raised concerns among some stakeholders regarding the potential impact on PBM profitability and service provisioning.