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PEORIA, Ill. (WMBD) — A new Illinois law aims to bring more oversight and transparency to pharmacy benefit managers: the companies that act as middlemen between drug manufacturers, insurance plans, and pharmacies.
State Rep. Jehan Gordon-Booth (D-Peoria) and Mike Minesinger, owner of Alwan Pharmacy in West Peoria, joined "WMBD News: On the Record" to explain what the law does and what it means for your wallet.
“PBMs are oftentimes the middlemen in between the larger pharmaceutical companies and the patients that actually need access to the pharmaceutical drugs that are either lifesaving or life sustaining,” said Gordon-Booth, who played a leading role in shepherding the bill through the General Assembly.
The Peoria Democrat said the legislation requires PBMs to disclose more information about how they operate and prohibits certain practices like spread pricing and patient steering, which is when patients are pushed to use pharmacies affiliated with PBMs.
“It reduces barriers in terms of being able to get access to drugs. It increases transparency by requiring far more disclosures from the pharmacy industry than what we’ve seen before,” she said. “And those things, anytime you want to create changes within a particular system, they always say the best disinfectant is sunlight.
"So that transparency and actually knowing where costs are being shifted to that is going to force a level, a level of honesty that frankly, we just have not had to operate from," Gordon-Booth added.
Alwan’s Mike Minesinger said the law addresses many issues he’s dealt with for years.
“When I bought my pharmacy, a couple of decades ago, it wasn’t uncommon to get one prescription, maybe out of 10, where you didn’t get paid for your whole cost of acquisition,” he said. “Now its nine [out of 10]. We had to start charging for delivery for the first time since 1994, just to stay afloat. And it’s hard. We can’t do the service the way we like to.”
Minesinger worked directly with lawmakers on the bill. He advocated for reforms targeting how PBMs classify and control access to so-called “specialty drugs.”
“They would call anything with a bit of margin a specialty drug and require patients to use their own mail-order pharmacies,” he said. “That’s how we lost access to filling HIV medications for patients we had long-standing relationships with.”
Gordon-Booth acknowledged there is more work to do, but the reforms are a meaningful start for patients and providers.
“There’s a $25 million grant program to support implementation and help smaller pharmacies adjust,” she said. “But I’d say we’re not done. Like with many major pieces of legislation, there will likely be trailer bills to clean up and strengthen it further.”
When the law goes into effect in early 2026, Minesinger said its impact will depend on enforcement.
“Sometimes these companies just pay a fine and go back to doing what they were doing,” he said. “But it should improve things. We should be able to bump back up the staffing. We’re running pretty much bare bones right now."
While the law focuses on state-level regulation, Gordon-Booth said she hopes it will spark broader national interest in PBM reform.
“Congress should take a look at what it means to make prescription drugs more affordable,” she said. “This is a good first step, but it’s not the last.”
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July 7, 2025 at 09:02PM