Iowa’s PBM Reform Breakthrough: Inside Senate File 383 | PBM Reform with APCI

Guest: Iowa State Representative Brett Barker, PharmD — District 51 Guest Host: Todd S. Eury, Pharmacy Podcast Network Regular Host: Greg Reybold — on special assignment Sponsored by: American Pharmacy Cooperative, Inc. (APCI)

 

Iowa has delivered one of the most significant state-level victories in the continuing fight for pharmacy benefit manager reform.

 

On this episode of the PBM Reform Podcast, guest host Todd S. Eury sits down with Iowa State Representative Brett Barker, PharmD, a practicing pharmacist and representative of Iowa House District 51, for an inside look at the passage of Senate File 383 and what the new law could mean for independent pharmacies, employers, patients and the future of PBM regulation across the country.

 

Representative Barker brings a rare perspective to the discussion. In addition to serving in the Iowa Legislature, he is a pharmacist and pharmacy executive who understands firsthand the financial pressures facing community pharmacies. Barker served as one of the House floor managers for SF 383 as the legislation moved through the Iowa General Assembly.

 

The legislation cleared the Iowa House by a 75–15 vote after previously passing the Senate 36–14. Governor Kim Reynolds signed SF 383 into law on June 11, 2025, and its primary provisions became effective July 1, 2025.

 

SF 383 establishes substantial new requirements governing pharmacy benefit managers and their relationships with pharmacies, health plans and other payors. Among its provisions, the law addresses PBM reimbursement practices, pharmacy contracting, pass-through pricing, pharmacy appeals and disputes, network participation and protections intended to prevent discriminatory treatment of pharmacies.

 

One of the central themes of the legislation is greater transparency and accountability surrounding the flow of prescription-drug dollars. The law defines and establishes requirements involving pass-through pricing, in which payments made by a third-party payor to a PBM for prescription drugs correspond to payments made to the dispensing pharmacy, including applicable professional dispensing fees.

 

During the conversation, Todd and Representative Barker explore:

 

• Why PBM reform became such an urgent issue for Iowa pharmacists and patients.
• What community pharmacies were experiencing financially before SF 383.
• How pharmacists, pharmacy owners and advocacy organizations helped educate Iowa lawmakers.
• The political battle surrounding the legislation and what ultimately helped generate bipartisan support.
• Why PBM reimbursement methodology is central to pharmacy sustainability.
• The importance of giving pharmacies meaningful mechanisms to challenge reimbursement and contractual disputes.
• The role Representative Barker's pharmacy background played in explaining PBM economics to fellow legislators.
• The opposition lawmakers encountered while attempting to move PBM reform forward.
• What other states can learn from Iowa's strategy.
• Why pharmacists need greater representation inside state legislatures.
• Whether Iowa's legislation could become a model for broader PBM reform nationwide.

 

Governor Reynolds described the legislation as an effort to bring greater accountability to PBMs and noted when signing the bill that Iowa was joining a growing number of states pursuing similar reforms.

 

For independent community pharmacists, the Iowa experience demonstrates something increasingly important: PBM reform is no longer simply a pharmacy reimbursement debate. It is becoming a healthcare access, competition and patient-care issue being fought state by state.

 

Representative Barker's story also highlights another major theme of the PBM Reform Podcast — the importance of pharmacists becoming directly engaged in public policy.

 

When pharmacists bring their clinical knowledge, business experience and patient relationships into state government, they can help lawmakers understand how policies written hundreds of miles away ultimately affect whether a pharmacy can keep its doors open.

 

Iowa's passage of SF 383 represents a major milestone in that movement.

 

About Our Guest

 

Brett Barker, PharmD, represents Iowa House District 51. He earned his Doctor of Pharmacy degree from the University of Iowa and has worked extensively in community pharmacy. His professional background gives him firsthand insight into pharmacy operations, prescription-drug reimbursement and the challenges facing independent pharmacies.

 

About the PBM Reform Podcast

 

The PBM Reform Podcast examines pharmacy benefit manager practices, prescription-drug economics, legislation and public policy affecting pharmacists, employers and patients across the United States.

 

The program features pharmacists, policymakers, healthcare executives, legislators and advocacy leaders working to create greater transparency, accountability and competition within the prescription-drug marketplace.

 

Sponsored by American Pharmacy Cooperative, Inc. (APCI).

 

Guest Host: Todd S. Eury Regular Host: Greg Reybold — on special assignment Production: Pharmacy Podcast Network

 

PBM Reform Podcast — following the legislation, the policymakers and the pharmacists fighting to change the prescription-drug marketplace.