Lowering prescription drug prices for Iowans

By Rep. Mariannette Miller-Meeks:

Americans are struggling under the burden of skyrocketing prescription drug prices, and one of the biggest culprits behind these costs is the unchecked power of Pharmacy Benefit Managers (PBMs). These middlemen have amassed excessive control over drug pricing, driving up costs for patients while squeezing out local pharmacies. It’s time to change the system.

As a physician, I have seen firsthand how rising drug costs impact patients, forcing them to choose between essential medications and other basic needs. As a State Senator, I was the first to introduce and pass a PBM reform bill in Iowa and I have been fighting to reform PBMs and bring down prescription drug prices since 2019. That’s why I’ve reintroduced the Delinking Revenue from Unfair Gouging (DRUG) Act, a bipartisan bill to rein in PBMs. This legislation removes the perverse incentive that allows PBMs to charge a percentage of a drug’s price, encouraging them to favor high-cost medications. Instead, the DRUG Act requires PBMs to operate on a flat-fee structure, ensuring they can no longer profit by driving up drug prices.

In Iowa and across the country, independent pharmacies are closing at an alarming rate due to PBM tactics that limit competition and dictate unfair reimbursement models. In 2024 alone, 29 Iowa pharmacies shut their doors, with 2,300 closures nationwide. PBMs’ opaque business practices have created an unsustainable system that forces patients to pay more at the pharmacy counter while limiting access to essential medications.

The DRUG Act will put downward pressure on drug prices and insurance premiums by breaking this cycle. It will increase transparency in the drug pricing process, protect local pharmacies from unfair reimbursement policies, and ensure that PBMs focus on serving patients rather than padding their own bottom line.

This isn’t a partisan issue, it’s about standing up for patients, small businesses, and taxpayers. That’s why I’m proud to have co-led this effort with a strong bipartisan coalition, including Reps. Nannette Barragán (D-CA), Nicole Malliotakis (R-NY), Brad Schneider (D-IL), Rick Allen (R-GA), and Donald Norcross (D-NJ). Together, we are committed to ensuring that every American has access to affordable prescription medications without being exploited by middlemen.

Congress must act now to pass the DRUG Act and stop PBMs egregious, profiteering opaque practices. Iowans and all Americans deserve a system that prioritizes transparency, fairness, and affordability. I will continue fighting to make that a reality.