My formative years in Tallahassee were filled with a front row seat to the legislative process. My mother served as an Assistant Secretary of the Senate, and every year for 60 days I watched legislators come to the Capitol to work together toward common sense policy solutions for all Floridians. Health care remains a major topic of conversation in Tallahassee as lawmakers work to ensure access to high-quality and affordable health care for their constituents.
For too long, Floridians have struggled to afford their medicines. Medicines are an important tool for patients to fight diseases. As such, medicines should fight for patients, patients should not have to fight for their medicines. That’s exactly why America’s biopharmaceutical companies are eager to work with the Florida legislature on real solutions to the challenges Floridians are facing at the pharmacy counter.
One way to do this is by sharing already negotiated discounts with patients. On average, 40 percent of the list price of a medicine is given as rebates or discounts to health insurance companies, the government, pharmacy benefit managers (PBMs) and other entities in the pharmaceutical supply chain. Yet, consumers in health plans with deductibles and coinsurance for prescription medicines often pay out-of-pocket costs that are based on the undiscounted list price of a medicine, rather than on the discounted price negotiated by their health plans or PBMs.
These rebates and discounts exceeded $166 billion in 2018 and are growing each year. But too often these discounts aren’t shared with patients at the pharmacy counter.
And there is no reason why they shouldn’t be. A recent report found that sharing already negotiated discounts with certain commercially insured patients in plans with high deductibles and coinsurance could save these patients between $145 and $800 annually and would only increase premiums by about one percent or less.
Simply put: Floridians share the cost of their medicines – they should also share in the savings. Passing on these savings to Floridians at pharmacy counter is one of the most obvious things health plans and middlemen can do to provide immediate relief to patients, which is probably why some of them are beginning to step up to do just that.
OptumRx’s recent announcement to require all new employer-sponsored plans, beginning in 2020, to provide discounts directly to patients at the pharmacy is a step in the right direction. Sharing negotiated rebates with patients is important to improving medicine affordability and ensuring patients can access the medicines they need.
There are many solutions being discussed by state and federal leaders to ensure their constituents are able to access quality health care and affordable medicines, but policies like drug importation are not viable and could expose Americans to substandard, unsafe drug products.
Patients share the costs—and we encourage Florida’s Legislature to pursue policies that will ensure patients in Florida also share in the savings.