Prescription drug price relief proposal
-Reining in the middleman

Governor Ron DeSantis

By Tami Stevenson

In an effort to lower prescription drug prices in Florida, Governor Ron DeSantis announced a legislative proposal last Thursday to help protect consumers and small pharmacies against the “middlemen” also known as Pharmacy Benefit Managers (PBM’s) through accountability in Florida’s drug market. The PBM’s management practices are something that has been an ongoing contention and complaint for years by small pharmaceutical businesses. The Governor said he plans to make this legislation a priority in the upcoming 2023 legislative session, that begins in March.

Governor DeSantis is proposing the following:

CONSUMER PROTECTIONS
Prohibit PBMs from mandating consumers use a mail-order pharmacy while allowing consumers to opt-in to this service. Ensure no Florida-registered PBM mandates a narrow network that only includes PBM affiliated pharmacies. Preserve the ability for an in-person pharmacist/patient relationship within their own community.

SMALL BUSINESS PROTECTIONS
Protect small businesses against surprise bills and clawbacks from PBMs, months after prescriptions are filled. Prohibit spread pricing where PBMs charge customers more for a prescription than it costs, then keep the difference.

REINING IN PHARMACY BENEFIT MANAGERS (PBMs)Increase PBM registration requirements to be more comprehensive and aligned with other types of health benefits. Require PBMs to disclose all organizations affiliated with the applicant, including any affiliated pharmacies or companies within their corporate umbrella. Require PBMs to disclose any complaints or settlement agreements they’ve been party to prior to operating in Florida. Direct the Office of Insurance Regulation to take action against PBMs which violate state law and hold them accountable.

PRESCRIPTION DRUG PRICE TRANSPARENCY
Institute a series of consumer protections to ensure drug manufacturers disclose proposed price increases prior to their going into effect. Require all licensed manufacturers to submit an annual report outlining and justifying any increases over the past year. Post reports online to ensure transparency and accountability.

The National Association of Chain Drug Stores President and CEO Steven C. Anderson said, “Governor DeSantis is right to stand up for Floridians by leading on pharmacy benefit manager (PBM) reform.

Patients deserve the best value of care from the pharmacy and pharmacist they choose, and accountability from middlemen who interfere with their choice and access to care. We look forward to working with Governor DeSantis and with the legislature to maximize this moment for the benefit of Floridians and for the viability of the pharmacies that serve them.” The Florida Small Business Pharmacies Aligned for Reform board member Ben Levene said, “On behalf of Florida’s small business pharmacies and patients, we thank Governor DeSantis for taking decisive action to lower prescription drug prices and remove barriers to quality healthcare and affordability for Floridians. Governor DeSantis’ willingness to take on the large, shadowy pharmacy benefit middlemen who’ve been profiteering off Florida for years is a clear demonstration of his leadership and commitment to the people of our great state.”