Overview

Florida patients, particularly those living with chronic conditions, require consistent and reliable access to prescription drugs to manage symptoms and treat their illnesses. However, many health insurance companies and pharmacy benefit managers are coming between patients and their physicians by impeding the availability of the medications they need and driving up prices for their own bottom line.

Pharmacy benefit managers, or PBMs, are middlemen between health insurers and pharmaceutical manufacturers. They decide which therapies health plans cover, and assign restrictions and out-of-pocket costs for insured consumers.

Often, PBM decisions are based not on the best interest of Florida patients, but on what’s best for health plans in the name of cost containment. PBMs are for-profit businesses that pocket much of the negotiated discounts and rebates, and pass cost savings onto the health plans they represent instead of the patients struggling to afford needed medications.

Florida lawmakers should prioritize reforming a system that continues to allow health insurance companies and PBMs to profit off Florida patients. Gov. DeSantis is advocating for truth and transparency in PBM practices to help patients access and afford the prescription drugs they need. Bringing transparency into the PBM system will improve access to needed medications, ensuring physicians can provide high-quality care based on the patient’s needs, not the needs of health insurance company administrators.