By Brian Burgess | The Capitolist

On Wednesday, just hours after receiving the bill from state lawmakers, Florida Governor Ron DeSantis signed SB 1550 into law, placing new restrictions on pharmacy benefit managers (PBMs), often referred to as middlemen in the healthcare system.

The new law will increase transparency and accountability for PBM practices and drug prices in Florida, allowing consumers to make more informed decisions about their health. The PBM industry has claimed that they… [more]

By News Service of Florida | NBC Miami

After lawmakers passed the changes Tuesday, Gov. Ron DeSantis moved quickly to sign a bill that will place restrictions on pharmacy benefit managers.

DeSantis held a bill-signing event Wednesday in Jupiter, with his office touting that the changes will provide more “accountability” for the business known as PBMs.

“This legislation builds a foundation of transparency for pharmacy benefit manager practices and drug prices in Florida, allowing consumers to make… [more]

By John Grant | Florida Today (Opinion)

Earlier this year, Governor DeSantis announced plans to address the role pharmacy benefit managers, or PBMs, play in the high costs so many of us are paying for prescription drugs. Floridians don’t need academic research or statistical studies to tell them that we’re paying more than we should for the medications we need. We feel it at the pharmacy counter on a regular basis and that’s why the governor’s… [more]

By Michael Diaz | Tampa Bay Times (Opinion)

Health care is complicated. But for many patients, it’s made even more complicated and challenging by middlemen called pharmacy benefit managers — or PBMs — who often manipulate the system to the detriment of patients.

Fortunately, state lawmakers have an opportunity to take a giant leap toward curbing these abuses and putting Florida patients first.

PBM middlemen insert themselves into the decision-making process between a doctor and a… [more]

By Jesse Scheckner | Florida Politics

Members of the House Health and Human Services Committee heard from a panel of experts on their thoughts about pharmacy benefit managers and the power they have over prices, access to prescription drugs and the businesses that purvey them.

To their supporters, the colossal size of the industry’s more dominant pharmacy benefit managers is an asset. Detractors say it’s turned them into an oligopoly.

Known commonly as PBMs, pharmacy benefit… [more]

By Christine Jordan Sexton | Florida Politics

Health care and health insurance lobbyists were out in force as the House Health and Human Services Committee held a meeting on pharmacy benefits managers (PBMs) and the role they play in Florida’s health care delivery system.

Committee members heard from a panel that included an independent pharmacist, a CVS Caremark representative, a representative from the Pharmaceutical Research and Manufacturers of America (PhRMA), a pharmacist with Publix, a pharmacist… [more]

By Caden DeLisa | The Capitolist

Earlier this month, Gov. Ron DeSantis laid out his plan to work with state lawmakers during the upcoming Legislative Session to pass a series of laws to “increase transparency” in the 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… [more]

By Drew Wilson | Florida Politics

A coalition of independent and community pharmacists and pharmacies praised Gov. Ron DeSantis and the state House for bringing attention to pharmacy benefit managers and the impact they have on prescription drug prices.

Pharmacy benefit managers, or PBMs, negotiate with drug manufacturers on behalf of insurance companies to purchase drugs at reduced prices or promise additional rebates.

They have been pejoratively referred to as “middlemen” due to “spread pricing”… [more]

By Jared Willis | Orlando Sentinel

As the COVID-19 pandemic continues to affect Floridians’ health and income, it is more important than ever for health care to be affordable, especially for those with chronic conditions. Unfortunately, a cost-saving strategy utilized by many health plans and third-party payers may end up costing patients thousands of dollars rather than lowering costs.

Often for expensive specialty drugs (which in many cases are prescribed for the management of… [more]

By Brian Burgess | The Capitolist

Recent efforts by President Donald Trump to reduce prescription drug costs for seniors on Medicare have garnered widespread support, but voters still want the president to go further by allowing pharmaceutical companies to provide copay assistance.

Last month, Trump signed four Executive Orders on drug pricing designed to deliver lower costs on prescription drugs, including insulin and epinephrine, and ensure Americans are getting the lowest price possible for their drugs.

But a … [more]

By Staff Reports | Florida Politics – Last Call

Last Call — A prime-time read of what’s going down in Florida politics.

First Shot

Ed. note — Sunburn, the morning read of what is hot in Florida Politics, is taking a well-deserved post-primary day off and will not be in mailboxes Friday morning. Never fear; Sunburn will return on Monday morning. Thanks to all our readers for your support.

___

Floridians overwhelmingly want President Donald Trump to… [more]

TALLAHASSEE, Fla.—Poll results released today show overwhelming, bipartisan support among Florida voters for efforts by President Trump to reduce prescription drug copays for seniors on Medicare during this public health crisis by allowing pharmaceutical companies to provide copay assistance.

Floridians for Attainable and Innovative Rx (FAIRx) unveiled results showing that more than 77% of Florida voters believe President Trump should allow drug companies to provide financial help to seniors through private copay coupons to those on Medicare,… [more]

By Brian Burgess | The Capitolist 

A new Florida study, released last week, found that major health care companies using pharmacy benefit managers (PBM’s) have positioned themselves to pocket millions of dollars from the state’s Medicaid system that were 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… [more]

By Rachel E. Yount | The National Law Review

Drug prices continue to be a hot button issue in American politics.  While many of the Trump Administration’s efforts to curb increasing drug prices stalled in 2019, a number of state legislatures have adopted drug price transparency laws in recent years.  Since 2015, Vermont, Nevada, California, Maryland, Louisiana, New York, Oregon, Colorado, Connecticut, Maine, Texas, and Washington have all adopted drug pricing transparency laws. … [more]

By John Haughey | The Center Square

Florida Reps. Randy Fine, R-Palm Bay, and Jackie Toledo, R-Tampa, have filed a 2020 bill they say would increase Floridians’ access to prescription drugs, lowering costs while also clamping down on “predatory practices” by Pharmacy Benefit Managers (PBMs).

House Bill 961, filed Dec. 16, had not been assigned a committee Monday afternoon. Eight House co-sponsors have signed on, including four Democrats, most notably three from Orlando –… [more]

By Christine Sexton

The proposal, HB 961, would create a new law called the “Prescription Drug Cost Reduction Act” and make clear that certain practices, such as directing patients to pharmacies owned in whole or in part by pharmacy benefit managers should be prohibited.

In an attempt to lower health care costs for Floridians, a Tampa Republican and other lawmakers want to crack down on the role of pharmacy benefit managers.

Rep. Jackie Toledo held… [more]

By Andrew Siddons

A House committee on Thursday approved a Democratic bill designed to limit drug prices, a top priority for the party, as another panel’s debate on the measure was poised to last for hours.

House leaders produced the 141-page bill after months of deliberations among various party factions, as progressives urged their colleagues to be bold despite GOP criticisms that the measure could hamper research into future cures. The bill, numbered HR 3, includes requirements for… [more]

By Briona Arradondo

TAMPA, Fla. – A Florida lawmaker is pushing to make your next trip to the pharmacy easier and less expensive under a proposed bill to cut price gouging for drugs and give you more choice on where to get prescriptions filled.

Loretta Boesing will never forget the day something went wrong with her son’s medication.

“My son, Wesley had a liver transplant at the age of 2. And after they shipped his medications in only a… [more]

By Harry A. Waxman | Health Affairs

As Americans, we like to think of ourselves as number one in everything, but in some cases — health care costs prime among them — it’s a dubious distinction. The fact that we spend twice as much on health care as the average for wealthy industrialized countries while having the lowest life expectancy and the highest infant mortality rates is a national disgrace.

While fixing this toxic combination of… [more]

By Mark Miller | The New York Times

Every fall, the 60 million Americans who use the health plan can compare options and save money. Here’s what to consider.

If you’re enrolled in Medicare but worry about the cost of health care, your chance to do something about it is here.

Most people enroll in Medicare when they become eligible at age 65. But every fall, they have the opportunity… [more]

By Jasmeen Abutaleb

House Speaker Nancy Pelosi unveiled her long-awaited drug pricing measure on Thursday, an ambitious bill that would allow the federal government to negotiate the prices of up to 250 brand-name drugs in Medicare.

Designed to help Democrats address voter concerns about drug prices and replicate their 2018 success winning House control by championing health care concerns, the measure faces wide opposition from congressional Republicans. However, President Trump’s strong desire… [more]

By Chuck Carmen | Herald-Tribune

When seniors, especially those on a fixed budget, lack access to needed medications — simply because they cannot afford them — they often end up in the hospital, increasing the burden on society.

In the end, it makes life harder on everyone: the individual, his or her family, and the taxpayer. This problem needs to be, and can be, solved.

Recently there has been progress in Washington toward passing… [more]

By Yasmeen Abutaleb | The Washington Post

The Senate Finance Committee released an ambitious bipartisan drug-pricing proposal Tuesday that would cap seniors’ out-of-pocket costs and limit price increases in Medicare, but the legislation faces stiff opposition from the pharmaceutical industry and conservative groups.

Committee Chairman Charles E. Grassley (R-Iowa) and the committee’s top Democrat, Sen. Ron Wyden (Ore.), spent the past six months hashing out the proposal, which… [more]

By The Editorial Board l The Wall Street Journal

One feature of the political moment is that ideas that first appeared on the left (tariffs) are gaining support on the populist right. The latest example is a GOP plan in Florida to import prescription drugs from Canada, which is impractical, unsafe and unlikely to reduce prices at the pharmacy.

The Florida Legislature has been moving on a plan pushed by Republican Governor Ron DeSantis that directs the… [more]

By Peter Schorsch l Florida Politics

The Legislature has tried to address the PBMs in the past with some success, but more action is needed.

We aren’t even 100 days into Gov. Ron DeSantis’ administration, and already he has proposed a revolutionary solution to Florida’s high drug prices: import drugs from Canada.

Our Drew Wilson echoed a sentiment expressed in a recent Senate Committee on Health Policy hearing when he pointed out that Canadian imports may be a… [more]

By Guest Author l Florida Politics

On Thursday, the Florida House Health & Human Services Committee approved a bill to allow prescription drug imports from Canada. It now heads to House floor for a full vote.

As a practicing pharmacist in Tampa, I understand the motivation behind this legislation.

Every day, I see the negative impact of high prescription drug prices. I’ve often seen customers walk away from the pharmacy counter because they can’t afford their prescriptions.

… [more]

By Kenneth “Mac” McCall, Guest Columnist l Florida Today

As someone who has worked as a pharmacist and trained others in the field for many years now, I have a great deal of concern for my colleagues and the patients they serve throughout Florida. I see the Florida Legislature working to legalize the importation of prescription drugs from foreign sources, and I worry that there is not enough discussion or understanding of the clear dangers… [more]

By Sall C. Pipes l The Orlando Sentinel

lorida’s House budget panel this week greenlit a bill that would allow the state to buy drugs from Canada. Lawmakers are poised to debate a companion bill in the Senate in the coming weeks. If the bill becomes law, officials would almost certainly need permission from the U.S. Department of Health and Human Services to move forward. And to receive that permission, they’d need to prove that drug importation would… [more]

By Brian Burgess l The Capitolist

A bill that would establish programs in Florida to “import prescription drugs from Canada and other foreign nations” is slowly making its way through the Florida legislature. The Florida House Subcommittee on Health Quality approved HB19 this morning. But it will be a long time before Floridians can expect to see any impact from the bill.

Governor Ron DeSantis called for lawmakers to pave the way for foreign prescription drugs as a way… [more]

By Thomas Burton l The Wall Street Journal

WASHINGTON—The Food and Drug Administration sent a warning letter to CanaRx, a Canadian company that makes low-cost prescription drugs available to employees of as many as 500 U.S. towns, cities and school districts.

Through the action, the FDA is venturing deeper into a debate over the high cost of prescription drugs in the U.S. The agency said that CanaRx’s “activities cause the introduction of unapproved new drugs and misbranded drugs… [more]

By Shelia Kaplan l The New York Times

The Food and Drug Administration on Thursday said a major Canadian drug distributor was selling unapproved and mislabeled medicines to unsuspecting Americans looking to save money on prescriptions, and warned it to stop.

The company, CanaRx, sells many common prescription medicines at a lower cost to hundreds of public and private employer programs in the United States. Many of… [more]

By Katie Thomas | The New York Times

An increasingly popular culprit in the debate over high drug prices is the pharmaceutical rebate, the after-the-fact discounts that form the heart of the nation’s arcane — many would say broken — market for prescription drugs.

Now, a growing chorus wants to get rid of them, or at least change the way they are applied after drug companies have already set their prices. Rebates, critics say, have pushed up… [more]

By Wayne Drash | CNN

(CNN) California’s insurance commissioner has launched an investigation into Aetna after learning a former medical director for the insurer admitted under oath he never looked at patients’ records when deciding whether to approve or deny care.

California Insurance Commissioner Dave Jones expressed outrage after CNN showed him a transcript of the testimony and said his office is looking into how widespread the practice is within Aetna.

“If the health insurer is making… [more]

Despite the ongoing opioid epidemic, insurers are restricting access to treatment alternatives that have a lower risk of addiction. Their reason: it’s cheaper. Patients must now make a choice between high out-of-pocket-costs or high-risk treatment. Read more, courtesy of The New York Times.

As the national debate over health insurance rages in the halls of Congress, everyone should be able to agree – no matter your political affiliation – that the benefits consumers select and pay for should be the benefits that they receive.

Yet across our state, health insurers are abruptly reducing the prescription benefits they offer to customers, raising out-of-pocket costs, requiring people to jump through additional hoops for the same medication, or removing coverage of certain treatments… [more]

Over my 28 years as a practicing rheumatologist, I have progressively been denied my authority to prescribe the best medicines for my patients. The problem is a process called “step therapy,” which allows insurance plans to force physicians to prescribe less effective – and cheaper – drugs before they can use the medications they had in mind all along. This is a bad idea, and the Florida Legislature should correct it immediately.

I treat individuals with severe… [more]

By Erin Clark | Florida Politics

Some of the largest states in the union are considering legislation that would block insurers and pharmacy benefit managers from dropping covered drugs outside the normal sign-up period.

In Florida, HB 95 was introduced by state Rep. Ralph Massullo to prevent a drug being dropped from a formulary, or moved to a higher-priced tier, in the middle of the insurance plan year. Similar bans are under consideration in Illinois and New York, among… [more]

By Daylina Miller | Health News Florida/WUSF

Two Florida lawmakers want health insurance companies to stick by their contracts when it comes to prescription medications.

Currently, no law prevents health insurance companies from increasing a member’s out-of-pocket prescription costs or changing the drugs they cover after the contract is signed.

Michael Ruppal is the Tampa-based executive director of The AIDS Institute, which leads Floridians for Reliable Health Coverage. That’s a coalition of consumer and provider groups that… [more]

By Daylina Miller | Health News Florida

No law in Florida prevents health insurance companies from changing the cost of a patient’s prescription drugs -or from dropping coverage all together of that drug – in the middle of a 12-month contract.

But a bill filed in the Florida legislature forces insurers to stick by those contracts.

Last October, just before her next delivery of mail order asthma medication, Tampa resident Helen Almack got a notice from her… [more]

By Wayne Winegarden | Forbes

Imagine if you never had to directly pay for your morning cup of coffee again. Instead, a coffee insurer guaranteed that, for a small co-pay, you could enjoy a cup of coffee every morning.

Sounds good?

The catch, and there is always a catch, is the caveat “directly pay.” In this bizarre world, you would still be paying for your cup of coffee every morning, but instead of paying your favorite barista,… [more]

By Alan G. Rosenbloom | Morning Consult

Amid the public uproar surrounding skyrocketing drug prices, pharmacy benefit managers — the pharmaceutical industry’s primary middlemen — are attracting new scrutiny from key members of Congress increasingly disturbed by benefit managers’ complex array of surreptitious pricing practices and protocols. But it was always just a matter of time until consumers’ growing outrage incentivized lawmakers to shine a spotlight on the systemic reasons behind pricing volatility, and the various players… [more]

By Kate Wedell | Dayton Daily News

While high-profile stories of price increases for life-saving prescription medications have earned negative attention for pharmaceutical manufacturers, many in the public are unaware of the role played by a less visible piece in the drug supply chain — pharmacy benefit managers.

While these companies say they save employers millions by using their collective buying power to negotiate rebates from drug makers, critics of these middlemen say their opaque tactics are… [more]

By Kate Wedell | Dayton Daily News

An unnamed Dayton man is at the center of a $15 billion lawsuit that pits two often vilified segments of the health care system against one another over the cost of prescription drugs.

John Doe One is an HIV/AIDS patient whose bills for the life-saving drug Atripla — even with insurance coverage — have been more than $1,200 a month, according to the class-action federal lawsuit in which he’s a… [more]

By Peter J. Pitts | Investor’s Business Daily

Express Scripts, the largest pharmacy benefit manager, has increased its profit per adjusted prescription 500% since 2003. (Express Scripts)

When Christie Tucker’s son Preston was diagnosed with diabetes, his insulin prescription cost just $40. Now, two years later, Christie is paying $650 for a six-week supply of the medicine. Many people reflexively blame drug companies for Christie’s dilemma. But the firms producing Preston’s insulin aren’t making more money. Insulin… [more]

Our partners at the AIDS Institute recently wrote a letter to Florida Insurance Commissioner David Altmaier about discriminatory health policies by Florida Blue. Specifically, Florida Blue is not following guidance set by the Affordable Care Act or by the insurance commissioner’s office. That noncompliance is directly resulting in the discrimination against beneficiaries living with HIV.

Click here to read the full letter — and be sure to sign up to join FAIRx to hold insurers accountable for discriminatory… [more]

PR Agency Contact: Beth Dozier, bethdozier@rational360.com

FOMA Contact: Jena Glantz, jena@foma.org

Florida Health Care Groups Launch “FAIRx” Campaign to Fight Discriminatory Insurance Practices in Florida

FAIRx Urges Florida Insurance Regulators to Limit Discriminatory Out-of-Pocket Costs for Insured Floridians Living with Chronic Diseases

Tallahassee – (Sept. 19, 2016) – Fifteen of Florida’s… [more]