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Legislators wary of prescription benefit managers

DES MOINES — A proposal approved by the Iowa House would direct a state agency to investigate whether prescription drug industry middlemen are overcharging Iowa’s Medicaid program.

Representative John Forbes, Democrat from Urbandale, is a pharmacist. He says the State of Ohio found these pharmacy benefit managers — or P-B-Ms — overcharged that state’s Medicaid program by more than $200 million. “There is a need for more transparency within the PBM industry and I think the state of Iowa with doing this is taking a lead across the country in making sure that the PBM industry’s not taking advantage of people here in the state of Iowa,” Forbes said.

Representative Joel Fry, a Republican from Osceola, says Forbes has unearthed concerning data from Ohio’s experience with prescription benefit managers. “We look forward to the opportunity to make sure that the payments that he is suggesting are off, that we understand those better and figure out if we need to do something for oversight,” Fry says.

The proposal passed the House unanimously. It’s included a larger bill that outlined spending for five state agencies.

A separate bill that cleared the Senate this week calls for an annual report on the fees prescription drug benefit managers charge the state’s Medicaid program. That bill also seeks an accounting to determine if the prescription drug managers pass along all the savings from the rebates offered by manufacturers of prescription medications.



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