As a pharmacist, my patients are my first priority. I am increasingly frustrated with how little known middlemen are driving up the costs for my patients. These middlemen, or pharmacy benefit managers (PBMs) manage prescription drug formularies, which gives them huge influence over what medications a patient will get, regardless of what the patient and their doctor think is best.

As these middlemen have grown, they have used their influence to leverage huge profits out of drug companies, pharmacies and patients. While everyone agrees the cost of prescriptions is too high, few people understand middlemen(PBMs) prefer them that way because it allows them to make more profits.

Besides driving up costs for their own benefit, pharmacy benefit managers also steer patients toward their own mail order pharmacies and drug stores. If you have noticed a lot of local and independent pharmacy closures in recent years, it is due in large part to PBMs. In order to improve out-of-pocket costs for patients, and to protect our struggling pharmacies, we need our elected officials to address the many unfair practices of pharmacy benefit managers.

I am grateful that Senator Grassley has introduced legislation on this issue, as has Representative Miller-Meeks. State legislatures around the country have enacted laws to rein in these middlemen and I hope Iowa will follow their lead during the next session.