Signed, sealed and delivered

After weeks of waiting, community pharmacists across the state rejoiced as Gov. Kim Reynolds finally signed legislation reforming practices of pharmacy benefit managers (PBMs). Senate File 383 introduces comprehensive oversight of PBMs, ensuring greater transparency, accountability and fairness in a system that has operated without adequate regulation and to the detriment of those trying to serve the community: pharmacists.

“The passage of SF 383 is truly a lifeline for Spring City Pharmacy and for the patients we serve,” Spring City Pharmacy owner Brad Magg said. “As the only pharmacy in Colfax — and the only locally owned pharmacy left in Jasper County — this new law helps level the playing field with the monopoly of pharmacy benefit managers (PBMs) who have made it nearly impossible for pharmacies to survive.”

With the passage of this legislation, the pharmacy will no longer be reimbursed less than the cost of the drug. They will also be paid a $10.68 dispensing fee for each prescription, which is the state average of what the state average of what the overhead costs to fill a prescription.

“In simple terms, it gives us a fighting chance to keep our doors open, continue caring for our neighbors and keep local healthcare local,” Magg said.

While some opponents claim it will put too much money in pharmacy pockets, feedback from those entities showed without the reform many could be closing their businesses within the next year.

“To be clear, this new legislation only provides enough to break even by covering the cost of the goods sold, plus labor and expenses to fill that prescription,” Magg said. “We’re ecstatic about it and very appreciative, but we’re still going to have to work our butts off slinging ice cream, greetings cards, band-aids, etc. to help pay off the almost $1million in debt we’ve accumulated since we started in 2022.”

In signing the bill, Reynolds said she consulted with employers and stakeholders on all sides of the complex issue and decided that SF 383 in an effort to continue improving the state’s healthcare system.

“PBM play a central role in the pharmaceutical supply chain, negotiating drug prices and access for millions of Americans,” Reynolds said. “Over time, consolidation has led to three major PBMs controlling 80 percent of the market and a close affiliation with both insurers and pharmacies. This vertical integration gives them out-sized power over which medication patients receive and what they pay — often resulting in unaffordable drug costs, difficult choices for families and reimbursement below pharmacy acquisition cost.”

It took until two days before the bill expired for Reynolds to put pen to paper, leaving everyone on edge about if it would actually happen. Magg said the Colfax community and beyond have been extremely supportive of the pharmacy’s efforts to see this legislation go through.

“This community has been nothing short of amazing. Folks in Colfax and beyond spoke up, signed petitions, called our lawmakers and almost 30 community members traveled to Des Moines for a rally at the State Capitol to stand beside us,” Magg said. “Several new patients made an extra effort to transfer their prescriptions to our local pharmacy to help keep it viable.”

From community members overhearing the need for a new air fryer for the staff and gifting a brand-new appliance to the pharmacy to others who brought sweet treats as soon as they heard the bill was signed to celebrate, people came together to fight for the pharmacy and shop that means so much to the downtown.

“It was truly the support like this that has kept us all going over the last few months, from things like being on credit hold with our supplier while we continued to take on more debt, to the roller coaster that is the bureaucracy of trying to get legislation passed,” Magg said. “It’s humbling and powerful to see our community come together not just to protect access to hometown pharmacy care, but also to show their appreciation for all of the work and money we’ve invested to make sure that Colfax continues to have a pharmacy. It truly made a difference in getting this legislation across the finish line.”

While Magg is still waiting on clarification on the exact parameters and doesn’t expect to see the full effect of the new law until January, he thinks this will be the first time in a very long time the pharmacy in downtown Colfax will again be able to fill the prescriptions of every single person who walks in the door.

“No longer will patients be required to go use specific pharmacies and mail-order services, while also knowing that they will pay the same price, regardless if they fill at a chain big box store or at an independent like us,” Magg said. “The PBMs will no longer be able to offer incentives to fill at one pharmacy over another, so patients will be able to support local and know that they’re getting the best price without having to drive out of town.”