By O. Kay Henderson (Radio Iowa)

The Iowa House has sent the governor a bill that supporters say offers rural pharmacies financial relief by reigning in pharmacy benefit managers.

PBMs negotiate drug prices. The bill requires that small pharmacies be paid a dispensing fee and sets up restrictions on PBM strategies that steer patients to fill prescriptions at certain pharmacies.

A group of pharmacists were in the House balcony, watching as the bill passed on a 75-15 vote. Michael Schweitzer, a pharmacist in Bedford, said the bill will be a lifeline for Bedford Drug, the business his dad launched 60 years ago. “I was thinking of the time last year when I told him I was going to have to close the pharmacy and he looked at me and said: ‘If you can’t make it work, nobody can make it work. This has been a painful four years for us getting to this point,” he told Radio Iowa. “…We’ve been ripped off, we’ve been treated poorly, we’ve been basically abused by the PBMs and this was a day I wasn’t sure we were going to see.”

As Schweitzer’s voice broke, other pharmacists standing nearby wiped away their own tears. During House debate, Republican Representative Brent Barker, a pharmacist from Nevada, said over 200 Iowa pharmacies have closed in the last decade.

“For far too long Pharmacy Benefit Managers — powerful middlemen in the pharmaceutical supply chain — have manipulated a system full of perverse incentives,” Barker said, “and have stacked the deck against consumers, pharmacies, employers and taxpayers.”

Representative Shannon Lundgren, a Republican from Peosta, called pharmacies  access points for health care in Iowa. “When we start to lose those access points and people start getting their drugs by mail order, there is nobody in that town to talk to about whether there are interactions or contradictions in that drug,” Lundgren said.

Representative Helena Hayes, a Republican from New Sharon, said Iowans have waited too long for these reforms. “No longer will PBMs be able to exploit the perks and the patients, manipulate the system and walk all over our local pharmacies,” Hayes said.

The bill prohibits PBMs from forcing patients to use mail-order pharmacies.