- Gov. Ron DeSantis announced his intent to work with state lawmakers to pass sweeping drug cost transparency laws
- The legislation will impose a range of regulations and guidelines such as consumer and small business protections and requirements that drug manufacturers must disclose proposed price increases before they take effect
- Anti-steering measures are also being drafted, which would prevent the implementation of a network that only includes Pharmacy Benefit Manager (PBM) affiliated pharmacies
- DeSantis’ legislative outline also seeks to regulate PBMs to a higher degree
Gov. Ron DeSantis, alongside state Surgeon General Dr. Joseph Ladapo, spoke at a press conference in The Villages on Thursday morning where he stated his intent to work with the state Legislature during the upcoming session to pass a series of laws to “increase transparency” in the statewide pharmaceutical industry.
According to the governor, the pieces of legislation will impose a range of regulations and guidelines including, but not limited to, consumer and small business protections and requirements that drug manufacturers must disclose proposed price increases before they take effect.
Further, the proposal seeks to enact anti-steering measures, preventing the implementation of a pharmaceutical network that only includes Pharmacy Benefit Manager (PBM) affiliated pharmacies.
“These reforms will enhance transparency and reduce the influence of pharmacy middlemen, which will help consumers as well as our small pharmacies,” said DeSantis. “I look forward to these reforms becoming law.”
DeSantis’ legislative outline also seeks to regulate PBMs to a higher degree. The governor stated that one of his chief priorities in passing these laws is to increase registration requirements, including increasing the registration fee.
Moreover, the planned legislation would require PBMs to disclose all organizations they are affiliated with, including any pharmacies or companies within their corporate umbrella.
DeSantis also intends to pursue regulation that would require PBMs to disclose any complaints or settlement agreements they’ve been involved in prior to operating in Florida.
With a stated purpose of protecting small pharmacies from corporations that utilize PBMs, like CVS Health or RightWay, the announcement drew immediate praise from the state’s pharmaceutical bodies.
“EMPOWER Patients commends Governor DeSantis for championing efforts to rein in powerful and predatory PBMs doing business in the Sunshine State. PBMs are not only anti-competition, but they are anti-patient as well,” said Helen Sairany, Executive Vice President and CEO of the Florida Pharmacy Association. “These multi-billion-dollar companies are deciding which prescription drugs to cover based on the size of the rebates they will receive from manufacturers, ultimately raising patients’ out-of-pocket drug costs by almost 30 percent. And to make matters worse, they use pressure tactics to steer patients to their affiliated pharmacies, where the prescription drug rebates they will receive are larger, rather than focusing on the best health outcomes for patients.”
Last July, DeSantis issued an Executive Order directing all executive agencies to include provisions in future contracts with PBMs to implement the prohibition of spread pricing for all PBMs, prohibition of reimbursement clawbacks, and instructions for all state agencies to include data transparency and reporting requirements.
A 2020 Florida study found that major healthcare companies using PBMs positioned themselves to pocket millions of dollars from the state’s Medicaid system which was intended to lower costs for millions of low-income Floridians.
The study found that despite processing less than half of one percent of all pharmacy claims, specialty pharmacies affiliated with PBM’s managed to collect 28 percent of the available profit margin from dispensing prescription drugs.
According to the study, vertically integrated healthcare companies – companies where the health insurance company and PBM also control their own pharmacies – have a significant advantage in prescription drug pricing and reimbursement rates over smaller pharmacy operations that only focus on dispensing prescription drugs.