DeSantis Signs Bill Aiming to Lower Prescription Drug Costs

Florida Gov. Ron DeSantis delivers remarks during the New Hampshire GOP's Amos Tuck Dinner in Manchester, N.H., on April 14, 2023. Scott Eisen/Getty Images

Florida Gov. Ron DeSantis has signed legislation designed to lower prescription drug prices by, among other things, curbing the power of industry middlemen, the pharmacy benefit managers (PBMs).

Those third-party administrators typically process and pay drug claims of health plans, and negotiate discounts with drug manufacturers and pharmacies.

In a signing ceremony on May 3, DeSantis said the Prescription Drug Reform Act prevents those companies from requiring consumers to use their mail-order services.

It also installs new regulations creating public price lists for drugs. It also bans pricing practices that boost the customer’s co-pay above the total cost of the drug.

The new law also requires rebates to go to consumers, rather than being pocketed by the middlemen, as has been a common practice in the past.

And it requires pharmaceutical manufacturers to report big price hikes.

Prices were raised on more than 1,400 drugs in 2022, more than in any year since 2015, DeSantis said at the ceremony at Florida Atlantic University’s MacArthur Campus in Jupiter.

Other states have already done this, DeSantis said, “and it’s made a positive difference.”

A pharmacy staff member fills prescriptions at Rock Canyon Pharmacy in Provo, Utah, on May 20, 2020. George Frey/AFP via Getty Images

The Republican governor is widely expected to announce his intention to run for president after his state’s legislative session is scheduled to end on Friday.

Lawmakers United

At the ceremony, DeSantis praised Florida lawmakers for standing up to intense lobbying to pass the bipartisan measure. Both the state Senate and the House passed the bill unanimously.

The bill expands and enacts actions he took by executive order in July 2022.

DeSantis acknowledged the right of companies to make money when they create a groundbreaking new treatment or procedure and to raise prices sometimes to meet demand.

But “I think a lot of these price increases are just taking advantage of the convoluted system to be able to raise prices and make more money on folks,” he said.

“In a good economy, you make money by providing value to consumers. That’s really what you’re supposed to do. But in so much of our health care system, people are making money, making life more difficult for consumers, and making the system less transparent.”

Bottles of prescription drugs are filled as they move down an automated line at the central pharmacy of Intermountain Heathcare in Midvale, Utah on Sept. 10, 2018. George Frey/Getty Images

Jason Weida, secretary for the state’s Agency for Health Care Administration, called it “the most comprehensive legislation in Florida history to rein in the pharmaceutical industrial complex by holding Big Pharma and PBMs accountable.”

Floridians, he said, now can check drug prices online. MyFloridaRX Prescription Drug Price Locator allows people covered by Medicare, Medicaid, and commercial insurance to check differences in drug costs throughout the state.

Seniors Struggling to Buy Medications

Many of the state’s 6 million seniors desperately need the measure, said Michelle Branham, secretary of the Florida Department of Elder Affairs.

Half of those older than 65 take four or more prescription drugs regularly, she said. Price hikes can hit them hard, especially those on fixed incomes.

“Our seniors shouldn’t have to be making hard decisions like ‘Do I feed my pet this week? Or do I buy my medication?’” said Branham.

And they don’t want to give up the opportunity to discuss drug questions with a pharmacist, she said. Coming from a family with four generations of pharmacists, she understands the importance of that relationship, she said.

“Seniors feel they’re held hostage by PBMs requiring them to use mail-order pharmacies and stripping them of the ability to talk to a pharmacist face-to-face about their prescriptions.”

Seniors often express worry about mail-order drugs, said Nancy Gillan, a home health aide in the Jupiter area.

The prescription “doesn’t always come,” Gillan said. “Sometimes it goes to their neighbors. It sits outside in the hot sun, in South Florida especially. And they just never know when they’re going to get their medication or even if it’s going to come.

And the high cost of medications is a “huge, huge issue,” she said.

“It’s heartbreaking when I hear a senior say, ‘You know, I have my medications. I’m supposed to take my medications, but I can’t afford it.’”

Seniors desperate to stretch their supply of medication often tell her, “Now, I have to take half a pill a day, or I’m taking a pill every other day,” Gillan said. “That is not good for anybody.”

A staff member sorts through drugs while filling a prescription at the Clay-Battelle Community Health Center's pharmacy in Blacksville, W.Va., on March 21, 2017. Brendan Smialowski/AFP via Getty Images

Reining in PBMs also can help locally owned pharmacies, too, said Jesse Brashear, a second-generation pharmacist from Citrus County.

Many “throughout our state have been forced to close” due to aggressive PBM tactics and “take-it-or-leave-it contracts,” Brashear said.

Cheaper Drugs from Canada

Florida continues to fight for federal permission to order cheaper prescription drugs from Canada, DeSantis said.

Florida was the first state to try it, he said.

And while the Trump administration initially approved the measure, the Biden administration and the U.S. Food and Drug Administration (FDA) subsequently held it up, he said.

“They say they’re not sure it’s safe to purchase drugs from Canada,” DeSantis said.

“Meanwhile, they'll approve a jab for a 6-year-old baby with an mRNA COVID shot with almost no data to support that. They don’t care about safety there.”