State Auditor Rob Sand, a Democrat who’s running for governor, says it’s time to “crack down” on pharmacy benefit managers or PBMs that restrict where patients may fill their prescriptions. PBMs work with insurance companies to set prescription drug prices.
“PBMs have a business plan oriented around making things as secretive and confusing as possible,” Sand said during a news conference in a central Iowa pharmacy that’s losing money filling prescriptions. “….The harder they make it for people to understand what’s going on with prescription drugs, the more money off of their backs.”
Governor Reynolds signed a bill into law last year that established new state regulations for PBMs, but major sections of the law are being challenged in court and have not gone into effect. Iowa Pharmacy Association VP Brian Wall said unfortunately more Iowa pharmacies have gone out of business in the past year and while there’s been some movement at the federal level, more state action is needed.
Sand said beyond what’s in the 2025 state law, there are other things that could be done to reign in PBM abuses, like requring more transparency about PBM contracts.