Governor Ron DeSantis announced a new executive order, July 8, aimed at adding transparency to the role of pharmacy benefit managers in administering prescription drug programs, that he says may be contributing to increasing medication costs.
At a press conference in Cape Coral, DeSantis also said the state could wind up in a legal battle with the U.S. Food and Drug Administration over the federal government鈥檚 delay in approving Florida鈥檚 Canadian drug importation program.
DeSantis says will hold pharmacy benefit managers (PBMs) more accountable. PBMs act as a third party between insurance companies and beneficiaries to manage prescription drug benefits.
The order requires state agencies to review their contracts with PBMs to ensure that their costs are justified. DeSantis says the executive order also aims to curb what鈥檚 known as spread pricing and claw backs.
鈥淪pread pricing is a deceptive practice where PBMs collect payment from the individual and keep leftover funds after they鈥檝e already reimbursed the pharmacy for the prescription and the service cost. The practice essentially adds a middle man and that practice drives up the cost for everyday Floridians,鈥� said DeSantis.
鈥淐law backs occur when an individual overpays for their prescription and the PBMs keep the overpayment as a financial bonus.鈥�
An audit commissioned by the (AHCA) shows that PBM prescription drug markup activity, including spread costs and administrative and other fees, cost the state鈥檚 Medicaid system more than $113 million dollars in 2020 alone.
Meanwhile, a bipartisan bill called the was recently introduced in the U.S. Senate that also aims to prohibit spread pricing and claw backs by PBMs.
Governor DeSantis also took aim at the federal government over ongoing delays in approving Florida鈥檚 request to enact a plan to import cheaper prescription medications from Canada. In 2019, DeSantis which would save Floridians an estimated $80 to $150 million dollars in medication costs.
The plan was approved by both President Biden and former President Trump, but the FDA has yet to green-light it. AHCA Secretary Simone Marstiller said the state has made a Freedom of Information Act (FOIA) request to get to the bottom of the delay.
鈥淓ven when we鈥檝e asked for particulars, we鈥檝e been met with resistance and we鈥檝e been promised follow-ups that we鈥檝e never gotten,鈥� said Marstiller.
鈥淪o basically, we鈥檝e gotten zero commitment from the FDA to get this done, notwithstanding their boss President Biden鈥檚 directive to work with the states to get it done. That鈥檚 why we鈥檝e filed the FOIA request so we can find out exactly what鈥檚 going on.鈥�
Marstiller said the FDA has already indicated they may not be able to meet a 20-day deadline for the FOIA request. DeSantis said he鈥檚 determined, as Florida has already set up a warehouse in Polk County to facilitate the drug importation program.
鈥淲e鈥檙e still in this fight. We may even end up in litigation over this potentially, but we were happy to lead the way. Other states like Colorado and others have also wanted to do this as well,鈥� said DeSantis.
DeSantis also took a shot at the Biden administration in suggesting the delay could be politically motivated. 鈥淣ow maybe they just don鈥檛 want to give Florida a win and that wouldn鈥檛 be surprising, knowing what they鈥檙e doing,鈥� said DeSantis.
鈥淚t may be that pharma has told them they don鈥檛 want this, but you know, we鈥檝e got to stop doing policy just on the basis of what pharma wants. I mean, we鈥檝e got to do policy on the basis of what people think is the best.鈥�
The governor has previously said AHCA could begin importing prescription drugs from Canada within 90 days, once the program gets federal approval.
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