DES MOINES, Iowa — A state representative, who is also a pharmacist, is advocating for a bill aimed at reforming practices that have led to increasing pharmacy closures across the state.

The bill, House File 852, is seeing bipartisan support and it aims at changing the way Pharmacy Benefit Managers (PBMs) operate. This legislation is the succession that was previously introduced this session.

PBMs are the middlemen between pharmacies and insurance companies. They determine the total drug costs for insurers, shape patient’s access to medications, and determine how much pharmacies are paid.

In 2024, 31 pharmacies in 22 counties have closed in the state of Iowa, according to the Iowa Pharmacy Association (IPA). This is an updated statistic from the 29 closures that were previously reported.

These closures occurred in rural and urban communities alike, and in big chain and independent pharmacies. Three pharmacies closed in Polk County last year.

These closures are largely the result of PBM practices, including not being reimbursed at fair rates. PBMs often pay pharmacies less money than it cost for the pharmacy to purchase drugs and distribute prescriptions. This was the case for an Oskaloosa pharmacy that foresaw its closure and a Minden pharmacy that closed its doors in 2024.

The Minden pharmacy that closed left behind a pharmacy desert, an area without adequate access to pharmacies, in the community forcing residents to travel farther to receive healthcare services. The nearest pharmacy to Minden residents is now 25 miles away.

The IPA estimates that 955,000 Iowans have been affected by these closures.

State Representative Brett Barker of District 51 has championed bills to support pharmacies in the past, and continues to advocate this session. Barker graduated from the College of Pharmacy at the University of Iowa and managed a pharmacy in Nevada for many years.

He said Iowa has been one of the leading states on PBM reform in the country, having passed reform bills in 2014 and 2022. However, he said that 100% of the complaints going through the Iowa Insurance Division aren’t covered by the existing legislation, which is why House File 852 is necessary.

The legislation would require PBMs to reimburse pharmacies their cost and enable patients to choose the pharmacy they want to receive care from.

“We talk about bolstering rural Iowa, I mean you need a pharmacy in order to do that. We have pharmacy deserts in this state. We have a whole county that doesn’t have one anymore. We used to be proud of having one in all 99, and now we’re getting these areas where there’s no pharmacy in the area, and that’s just going to continue to get worse,” he said.

The IPA has already confirmed one pharmacy closure so far in 2025.

Critics of the bill say it will cause premiums to increase. However, similar legislation has been passed in several other states across the country, and data collected in these states does not suggest an increase in the cost of premiums.

Data collected by the IPA indicates that 80% of Iowans are in favor of PBM reform.

The second funnel deadline for this legislative session is scheduled to take place next Friday, April 6th.