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First in Fox: A bipartisan group of legislators is pressing to reform the incentive structure for pharmacy benefits managers (PBMS), arguing that it increases patient costs by encouraging them to favor the highest price medicines while retaining possible savings.
Directed by the doctor and the representative of Iowa, Mariannette Miller-Meeks, the group introduced the “delegation income of the Law of Injusta (drugs)”, requiring that PBMs in the commercial market only charge a fixed rate for their services related to a specific prescribed medication, versus let them continue charging a percentage of the price of the medication.
PBMs are external intermediaries between insurance companies, drugs and pharmacies that serve to control the prices and access of medicines. The current incentive structure for PBMS, according to the sponsors of the drug law, encourages them to increase the list of medicines to increase profits.
“Pharmacy Benefits Managers (PBM) have excessive influence on the prices that patients pay at the pharmacy counter,” said Miller-Meeks. “Local Pharmacies of Iowa are closing due to greedy PBM practices, impacting the proximity and access to medicines for Iawans. The drug law will exert a downward pressure on the prices of prescription medications and insurance premiums by eliminating PBM incentive to increase the price of the list of medications.”
A group of bipartisan legislators, led by the representative Mariannette Miller-Meeks, R-Iowa, wants to change the incentive structure for pharmacy benefits administrators, which argue that costs have increased for patients because they encourage them to promote more price medications. (Istock/Getty)
According to him Iowa Pharmacy Association, PBMs have been using opaque refund models that often pay pharmacies less than the cost of the list of a medication and the services provided to dispense it.
As a result of these practices, pharmacies in Iowa and throughout the country have been forced to close, said the association in a January report. Twenty -nine pharmacies of Iowa and 2,300 pharmacies throughout the country closed their doors in 2024, according to the association.
While PBMs have played important papers in making drugs more widely available, through decades of mergers and acquisitions, The largest three PBM now handle almost 80% of all recipes completed in the US, according to 2024. report of the Federal Commerce Commission.
The reforms of the Drug Law serve to address this anti -competitiveness, which according to the sponsors of the bill will also help reduce costs.
PBMS now manages almost 80% of all recipes completed in the United States, according to a 2024 report by the Federal Commerce Commission. (Getty images)
“Pharmacy Benefits Administrators (PBM) contribute to the high costs of medicines because they encourage patients to medications that are more profitable for PBMs, but they can be less clinically effective for consumers “ Representative Nannette Barragán, D-Calif., said one of the copatrokers of the bill. “This broken system disproportionately harms low -income people, older people and those with chronic diseases that depend on recipes that save lives to administer their health.”
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Representative Donald Norcross, Dn.J., another copatocator of the Drug Law, said families in their district “are crying for the relief of high prices of prescription medications.”
“Americans deserve access to quality medical care and affordable prescription drugs,” Northcross said. “The drug law reigns the prices of prescription medications by eliminating the incentive for pharmacy benefits managers to increase costs, increase transparency and prioritize patients on profits.”
