(Radio Iowa) – A coalition that includes patient advocacy groups and the Iowa Pharmacy Association is launching what they’re calling an accountability project focused on Pharmacy Benefit Managers. Pharmacy Benefit Managers are companies that manage prescription drug benefit plans for insurance companies and Medicare Part D as well as large companies. Some large businesses say they’re concerned P-B-Ms promote higher priced medications when lower cost alternatives are available.

Drug companies accuse P-B-Ms of pocketing the discounts they provide on some medications. Brett Barker is a pharmacist in Nevada. “It’s really increased the list price of the drugs,” Barker says, “and that’s a problem for uninsured patients, for high deductible plan patients because they’re not seeing the benefits of those rebates that are then captured.” And pharmacists like Barker say the reimbursement rates P-B-Ms establish are driving pharmacies out of business, particularly in rural Iowa.

“Pharmacies and pharmacists have been really sounding the alarm about the PBM business model now for decades,” Barker says. “The Iowa Pharmacy Association first took legislation to the legislature in the mid-2000s and so what’s encouraging now is there’s a broad stakeholder group across the industry and with employers, with unions, private sector companies and pharmaceutical companies that all are on the same page, that something needs to be done to reform the system.”

The three P-B-M corporations handle 80 percent of the prescription claims in America and Barker says they use the pharmacy networks they control to drive independent pharmacies out of business. “If something’s not done, there will be more and more communities in Iowa that are going to lose access to pharmacy services because of basically the monopoly take-it-or-leave-it business practices of these PBMs,” Barker says. “They’ve found ways to siphon money out of the entire supply chain and what started as prescription claim processors, those big three are now Fortune 15 companies. They’re three of the 15 largest companies in the United States.”

The goal of the P-B-M Accountability Project is to educate Iowans about the industry and to urge state and federal lawmakers to require more transparency about the actual costs of medications and ban unfair pricing schemes. Pharmacy Benefit Managers say they help improve patient outcomes and control prescription drug costs, which lowers insurance premiums.