Rep. Brett Barker R-Nevada

Some Marshall County residents have been burdened with the price of their prescriptions. Rep. Brett Barker (R-Nevada), who represents residents to the north and west of Marshalltown in House District 51, is working on a bill he hopes will bring some relief.

“The issue is affordable prescription drugs and giving patients access to choice,” he said. “As written, this bill should solve most of the problems. It should make a meaningful difference and we should not have to do anything for a while.”

Barker, who is the vice president of operations for NuCara Pharmacy and vice chair of the Health and Human Services Committee, is referring to House Study Bill 99 (HSB99). Earlier this week, committee members gave it unanimous approval.

“This is a really strong bill,” he said. “It will provide transparency, additional choices for patients, ensure money flows to patients and pharmacies and ensure pharmacies are paid and can dispense drugs.”

HSB99 was recently passed by the House Commerce Committee, and Barker expects it to stay alive during this legislative session.

“I expect it will move on the Senate side, and hopefully will be up for debate,” he said. “We’re going to do everything in our power to get this on the governor’s desk. Hopefully we are successful. If not, twice the pharmacies will close, and we can’t have that in 2025.”

The purpose of the bill is to place regulations on pharmacy benefit managers (PBMs), which its supporters say will lower prescription prices and prevent closures of pharmacies in Iowa, especially in rural areas. Under the bill, a PBM cannot:

• Give pharmacies a lower reimbursement for the cost of a drug. That practice has resulted in Iowa pharmacies operating at a loss;

• Prohibit a person from choosing a certain pharmacy;

• Deny a pharmacist the right to participate in a contract;

• Require that pharmacists obtain certain accreditations not required by the state;

• Designate a prescription a specialty drug to prevent someone from acquiring it;

• Require a person only purchase prescriptions through the mail and;

• Impose additional fees on someone for choosing a certain pharmacy.

As a pharmacist, Barker has had numerous encounters with PBMs, and it only continues to get worse, he said.

“They find ways to siphon money,” Barker said. “Last year, 29 pharmacies closed because of PBMs. That is a high rate of closure, and it leaves portions of the state without pharmacy access.”

One type of prescription that PBMs are having a huge impact on are glucagon-like peptide-1 receptor agonists, such as Ozempic. According to Barker, pharmacies providing the drugs are operating at a loss.

“Pharmacies lose money for every one they fill, and some are choosing not to stock it because of the amount of money they lose,” he said. “We now have something that is bending the obesity curve down, but the pharmacies are losing money.”

In those situations, pharmacy owners are faced with a choice — enter a PBM contract and potentially lose one-third of their customers or not enter the contract and lose money which will eventually turn the lights off and close the doors forever.

“It’s like a death from 1,000 cuts,” Barker said.

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Contact Lana Bradstream

at 641-753-6611 ext. 210 or

lbradstream@timesrepublican.com.