PBM Reform Podcast

This is part one of a two part conversation with Terry Wilcox, Co-Founder and CEO of Patients Rising. Find out what Patients Rising is doing for advocacy and change to better our patients by visiting https://www.patientsrising.org/about-patients-rising

Guest: Iowa State Representative Brett Barker, PharmD — District 51

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:

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.

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.

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

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

Many pharmacy leaders focus on legislation and lobbying.

Why is strategic communication on social media equally important?

Dr. Maurice PharmD joins Breck Rice on this episode of the PBM Reform Podcast. 

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The PBM Reform Podcast, sponsored by APCI, welcomes John Vinson, PharmD, Chief Executive Officer of the Arkansas Pharmacists Association, for a timely conversation with host Greg Reybold about the management of the TRICARE pharmacy benefit.

Express Scripts administers pharmacy benefits for TRICARE, the Department of Defense healthcare program serving more than 9 million active-duty service members, military retirees, and family members. In fiscal year 2023 alone, TRICARE spent more than $8 billion on prescription medications.

Greg and John examine concerns surrounding Express Scripts’ administration of the program, including shrinking pharmacy networks, reduced patient choice, questionable contractor reporting, specialty-drug delivery oversight, and the consequences for independent and rural pharmacies.

A 2025 Government Accountability Office investigation found that:

The episode also addresses higher 2026 prescription copayments. For most non-active-duty beneficiaries, home-delivery copays are now $14 for generic formulary drugs, $44 for brand-name drugs, and $85 for non-formulary medications. At retail network pharmacies, the corresponding 30-day copays are $16, $48, and $85.

Greg and John discuss whether PBM-driven network reductions represent true savings—or simply transfer costs, inconvenience, and access barriers to military families and the community pharmacies serving them.

Important clarification: TRICARE is administered by the Department of Defense and is distinct from healthcare and pharmacy services operated by the Department of Veterans Affairs.

Sponsored by APCI — American Pharmacy Cooperative, Inc.

Sources: U.S. Government Accountability Office, TRICARE’s 2026 pharmacy-benefit update, official 2026–2027 pharmacy costs.

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PBM Reform Podcast

Momentum for meaningful pharmacy benefit manager reform is building in Washington.

In this episode of the PBM Reform Podcast, host Greg Reybold welcomes Dr. Ben Mudd, Executive Director of the Kentucky Pharmacists Association, to examine the bipartisan Pharmacists Fight Back Act, H.R. 6610, and what its advancement could mean for patients, pharmacists, employers, and the future of independent pharmacy.

On July 22, 2026, the House Committee on Oversight and Government Reform reported the legislation favorably following a committee markup. Introduced by Chairman James Comer of Kentucky and Representative Jake Auchincloss of Massachusetts, the bill would establish new requirements for pharmacy benefit managers participating in the Federal Employees Health Benefits Program.

The proposed reforms would require participating PBMs to provide fair pharmacy reimbursement, apply manufacturer rebates toward reducing beneficiaries’ prescription drug costs, prohibit patient steering to PBM-affiliated pharmacies, increase transparency, and establish penalties for noncompliance.

Greg and Ben discuss why the Federal Employees Health Benefits Program could become an important proving ground for broader PBM accountability and how federal action may influence commercial plans, state legislation, and future healthcare policy.

The conversation explores:

Dr. Mudd brings the perspective of a practicing community pharmacist and association executive who has worked extensively in pharmacy advocacy. A graduate of the University of Kentucky College of Pharmacy, he practiced in both chain and independent pharmacy settings before assuming leadership of the Kentucky Pharmacists Association.

Ben is running for Kentucky State Senate position this November. Lear more about his platform and issues most important: https://www.votemudd.com/meet-ben

PBM reform is no longer simply an industry debate. It is a patient-access, healthcare-affordability, pharmacy-choice, and community-infrastructure issue.

The Pharmacists Fight Back Act represents a significant federal effort to separate PBM compensation from practices that may increase drug costs, restrict patient choice, and financially disadvantage independent pharmacies. The legislation’s advancement is an important milestone—but pharmacists must remain informed, engaged, and vocal as the bill moves through the legislative process.

Subscribe to the PBM Reform Podcast for continuing coverage of legislation, regulation, litigation, and advocacy shaping the future of pharmacy benefit management and community pharmacy.

The PBM Reform Podcast is sponsored by American Pharmacy Cooperative, Inc., supporting independent pharmacies and advocating for a more transparent, competitive, and patient-centered prescription drug marketplace.

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In this episode of the PBM Reform Podcast, host Greg Reybold, Vice President and General Counsel at APCI, welcomes Josh Golden, Senior Vice President of Strategy at Judi Health and a nationally recognized voice in Pharmacy Benefit Manager reform.

With more than 20 years of healthcare consulting experience, Golden brings deep expertise in vendor procurement, contract negotiation, plan design, and benefit strategy for large employers, government entities, and unions. Together, Reybold and Golden examine the financial models behind today’s PBM industry and why true transparency remains so difficult for employers, plan sponsors, patients, and pharmacies.

The conversation explores how current PBM arrangements often benefit the PBMs more than the employers paying for coverage or the patients relying on their prescription benefits. Golden explains why auditing PBM contracts, rebate structures, spread pricing, administrative fees, pharmacy networks, and formulary decisions is essential to understanding the real economics of prescription drug benefits.

This episode also addresses a growing concern in healthcare: PBM steering behavior. Are patients being quietly pushed toward specific formularies, specific pharmacies, and restricted networks that operate like closed networks without being clearly disclosed? Reybold and Golden discuss how this behavior can limit patient choice, disadvantage independent pharmacies, and distort the stated goal of lowering drug costs.

The discussion also tackles the role of federal reform efforts, including whether the Appropriations Act represents meaningful PBM accountability or whether it risks becoming another layer in the broader shell game surrounding PBM reform.

Finally, the episode asks one of the most important questions in pharmacy policy today: should PBMs own pharmacies? If vertical integration is promoted as a way to lower drug costs, where is the proof — and who actually benefits?

Transparency, Auditing, and the PBM Shell Game | PBM Reform

Josh Golden is the Senior Vice President of Strategy at Judi Health (a prominent healthcare technology and benefit management firm closely associated with Capital Rx) and a nationally recognized thought leader in Pharmacy Benefit Manager (PBM) reform.

With over 20 years of healthcare consulting experience, Golden specializes in vendor procurement, contract negotiation, and plan design consultation for large employers, government entities, and unions.

Tennessee lawmakers have passed a major pharmacy reform bill aimed at pharmacy benefit managers, or PBMs, by barring companies from owning both a PBM and a pharmacy. The legislation is widely seen as targeting CVS Health, which owns Caremark and operates pharmacies across the state.

In this episode, listeners get to know the leadership of the California Pharmacists Association (CPhA), exploring their professional journeys, personal backgrounds, and the experiences that shaped their commitment to advancing the pharmacy profession.

Susan Bonilla, CEO of the California Pharmacists Association, joins Dr. Sean Kim, PharmD, Vice President of Practice & Professional Development at CPhA, to discuss California’s progress in pharmacy benefit manager (PBM) reform. As the largest state in the nation, California continues to play a significant role in shaping policies that strengthen patient access to pharmacy care and improve transparency within the prescription drug supply chain. Bonilla and Kim share insights into the reforms California has achieved, the legislative and regulatory priorities currently underway, and how these efforts may influence PBM reform conversations across the country.

The PBM Reform Podcast is sponsored by the American Pharmacy Cooperative, Inc. (APCI). APCI’s sponsorship supports the production of this program but does not imply affiliation with the individual guests, nor endorsement of the views, opinions, or insights shared by podcast hosts or guests. APCI does not endorse any statements or content discussed on the PBM Reform Podcast or across the Pharmacy Podcast Network. Please reach out to the APCI Communication's team for additional information. 

American Pharmacy Cooperative, Inc. (APCI) called on Congress on Thursday, December 11, 2025 to pass the reintroduced Pharmacists Fight Back Act, two coordinated pieces of federal legislation designed to reform pharmacy benefit manager (PBM) practices.

The Pharmacy Podcast Network provides exclusive coverage of the event held on Capitol Hill.