The prices that Florida families pay at the counter for necessary medications continues to soar – but the reason behind those increases might be more complex than you first think.
That complexity is no accident. It’s the handiwork of greedy businesses that depend on consumers understanding less so they can profit more. In the center of it all is something called Pharmacy Benefit Managers (PBMs), middlemen who are a key reason why Florida patients pay more at the drugstore. Disguised as advocates in the health care system, these PBMs actually drive up the prices we pay for prescriptions.
In his State of the State speech earlier this month, Gov. Ron DeSantis rightly called out these “pharmacy middlemen” that try to manipulate Florida’s health care system and erode patient choice. He’s leading the charge on efforts that will bring real reform to this industry and real relief to consumers.
Fortunately, it looks like an opportunity for real reform is here – but the next six weeks are critical. A pair of pro-patient legislative proposals – SB 1550 by Sen. Jason Brodeur and HB 1509 by Rep. Linda Chaney – would pull back the curtain on the PBMs’ predatory practices and lower drug costs for all Floridians.
Every patient is unique and should have the opportunity to choose the care they receive. Health care works best when it gives patients the freedom to talk with their doctor, ask questions, get second opinions, evaluate alternatives, and then move forward confidently with their decision.
But right now, that’s simply not the case.
Due to a complex web of bureaucracy, PBMs have erected barriers within the health care system that allow them to manipulate the care that patients receive – effectively giving themselves a license to overrule a patient’s decision if they determine it doesn’t align with their financial models.
As a physician practicing in Southwest Florida for 30 years, I’ve seen this firsthand. These subtle but significant practices often involve patients being unable to afford their medications, experiencing avoidable delays in treatments, or being forced to use a pharmacy chosen by the PBM rather than one that they know and trust.
The proposed legislation represents a landmark step toward reversing these predatory practices and putting patients back in the driver’s seat. And with so many struggling to afford their medication, it’s key that the bills are working to provide relief by lowering drug prices.
For many patients, every dollar saved is important. PBMs are pocketing savings intended to lower costs for patients, and the impacts can be extremely significant. In 2021, insurers, PBMs, and their affiliated companies kept upwards of $200 billion in rebates and discounts meant for patients across the nation.
It’s not right, and it’s not fair. That’s why this legislation is so important.
Over the next six weeks, state legislators will discuss and debate these bipartisan proposals. No matter what, it’s essential that action is taken this year to put Florida patients first. My hope is that through this process, legislative leaders will realize that the best approach is a comprehensive solution that strengthens health care accountability and provides maximum relief to patients.
The issue is clear and the solution is here. Now we need legislators to act quickly and pass PBM reform.
Dr. Catherine Kowal lives in Collier County and serves as Treasurer of the Florida Society of Rheumatology.