New executive order to reduce prescription drug prices in Florida

A new executive order is planned to help Floridians pay less for prescription drugs, adding more rules for pharmacy and manufacturer intermediaries known as pharmacy benefit managers.

Governor Ron DeSantis released the new directive on Friday to reduce the markups passed on to consumers. State leaders have said Floridians are paying too much and part of the reason is Pharmacy Benefit Managers or PBMs and some unfair practices they may have.

“Spread pricing is a deceptive practice where PBMs collect payment from the individual and retain the remaining funds after already reimbursing the pharmacy for the prescription and service charge,” said Gov. Ron DeSantis, R-Florida.

A pharmacy benefit manager’s goal is to get the best price for consumers, but DeSantis said that doesn’t always happen. Thus, the new executive decree now obliges them to be more transparent.

“We require our state agencies to review all of their contracts with PBMs and ensure that all costs to the State of Florida are justified,” DeSantis said.

Health advocates said the business model has driven prices up, hurting doctors like Clearwater rheumatologist Robert Levin.

“As rheumatologists, we’re stuck between trying to get our patients access to the medicines they need to change their lives,” said Levin, who is also president of the Alliance for Transparent and Affordable Prescribing (ATAP ). . “[PBMs] impact on which drugs can be prescribed and at what price, and their effect has been that they have actually caused major inflation in list drug prices. »

Levin said generic drugs can be branded with specialty drugs. ATAP advocates for more transparency with PBM practices that allow kickbacks or discounts, resulting in overcharging consumers.

“The bottom line is that the manufacturers had to raise their prices so they could pay more bribes so they could access the formulary, and the patient pays their share of the full list price of the drug. which has been pushed up by both the manufacturers but also the PBMs,” Levin said. “So all of the generic drugs that have been subject to this staggered pricing and grossly inflated pricing will now cease, according to Decree.”

The high prices prompted billionaire investor Mark Cuban to open his own online pharmacy for low-cost generic drugs direct from the manufacturer. Others seek drugs outside the United States.

“I would also caution against going out of the country or engaging in prescription drug tourism, especially on the internet,” said Katherine Drabiak, an associate professor at the USF College of Public Health who specializes in health law, public health law and medicine. ethics. “There could be public health and safety concerns, that consumers may think they’re getting a particular product, and they may not be getting it.”

FOX 13 reached out to the Pharmaceutical Care Management Association, a group that represents pharmacy benefit managers. Spokesperson Greg Lopes released this statement:

“The Pharmacy Benefit Managers have a proven track record in using proven tools to generate significant savings for Florida’s Medicaid program and the state’s group insurance division. We look forward to working with the Governor DeSantis’ administration to ensure that all Floridians have affordable access to their prescription drugs.”

The goal is to help people like Dr. Levin’s patients save on the medications they need.

“Potentially it could cost hundreds to thousands of dollars a month, potentially depending on what they find and what the state is going to do about it once they actually get the data,” said said Levin.

DeSantis said the state will now require audits from drug benefit managers to help them stay accountable.

“They have a right to be paid for their work. But that means it’s fair payment and an accurate representation of the work they do and they don’t give that kind of fake discount,” Drabiak said, explaining the impact of the executive order to Floridians.

Healthcare advocates Florida Voices for Health said the executive order is progress, but they also hope the state will consider reducing deductibles for all Floridians.

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