WEST LAFAYETTE, Ind. (WLFI) —All Custom Plus Pharmacy owner Ben Rachwal wants is transparency and fairness.
"Let's just uncover this story," said Rachwal. "Let's see where the money is going."
He's talking about the money Pharmacy Benefit Managers or PBM's make. They control the cost of insurance company prescription claims. However, PBM aren't regulated and they aren't licensed.
"Nobody knows what they're doing, it's the black box of the whole equation," said Rachwal.
He said this secrecy would allow PBM's to pocket rebates from drug manufacturers to get on the preferred list.
It's estimated that PBM's cost Hoosiers roughly 120 million dollars in Medicaid expenses. The practice is affecting taxpayers, prescription users and pharmacy owners.
"We're losing money to fill prescriptions," said Rachwal. "That's the summary and that's not a good business model."
In order to keep local pharmacies afloat and prices for consumers low, Rachwal said something needs to be done.
U.S. Senator Mike Braun is proposing bills to help on the federal level but he knows it won't be easy.
"I think there's going to be resistance and foot dragging but that's why I'm there," said Braun.
"We have to thank him for taking up this cause," said Rachwal. "Because not a lot of people are aware that this is happening behind the scenes."
Rachwal wants state lawmakers to get involved too. There's still hope for something to pass this session.
"We're only asking for licensure and we are asking for transparency through annual reporting," said Rachwal.
He doesn't think that's a lot to ask.
"And if the estimates are correct, the state of Indiana is going to have a huge win!" said Rachwal.
He encourages people to contact their state lawmakers.
There are currently two house bills that are getting a hearing in the Senate next week that could contain PBM language.
State Senator Ron Alting said he is already in support of transparency in this industry. He said he would likely vote yes on the bill.
