"We can't survive another 12 months until the next session for them to try and pass it again," Spring City Pharmacy owner Brad Magg said about the state's bill.
COLFAX, Iowa — Over two dozen pharmacies in Iowa were forced to close down last year, and the Iowa Pharmacy Association said more could come this year as well.
Spring City Pharmacy in Colfax says the three main pharmacy benefit managers (PBMs) in the U.S., which collectively control a large portion of the market’s prescription costs, are behind the closures.
Now, there could be a solution, as the House and Senate have a proposed bill to prohibit a PBM from reimbursing a pharmacy an amount less than the drug acquisition cost's national or state average.
But both chambers placed those bills on their "unfinished business" list, meaning they are on pause for now, but could be reintroduced later this session.
Until then, the way rural pharmacies are being reimbursed for prescriptions has many, including Spring City Pharmacy, questioning whether it can stay open through the end of the year.
“We’re not getting paid the full amount of what that drug costs us," said pharmacist Brittney Van Houweling. "So we could be eating a $1, $5, $50, $300.”
It's a similar situation to many other pharmacies in Iowa, and across the country.
Spring City Pharmacy added PBMs paid them less than it costs to buy the medication on 9,790 prescriptions over the past three years since they re-opened under new ownership. It also reports losing over $100,000 from a deficiency in drug reimbursements.
Owner Brad Magg told Local 5 News: “Truly, we get nervous every time a patient walks in because we don’t know how much money we’re going to lose on that patient. And so it’s sad to not want new business because we can’t afford to lose more money.”
The three major PBMs (CVS Caremark, Express Scripts and OptumRx) have claimed previously that reform to the payout process will increase prescription drug costs.
However, Magg said that’s not true, adding that rural healthcare deserts may continue to develop if no action is taken by state lawmakers.
The state's proposed bill, House File 852, would also allow pharmacies to decline dispensing prescriptions to people if the pharmacy would be reimbursed less than the acquisition cost for that drug by a PBM.