The cost of prescription drugs can be a financial burden for Floridians already facing mounting health care costs. Pharmacy benefit managers (PBMs) are doing their part on behalf of patients.
The core mission for each PBM is to reduce prescription drug costs and improve health care quality for patients. PBMs reduce drug costs through negotiations with drug manufacturers and pharmacies. They help health plan sponsors improve the quality of care by helping patients stay on their medications and by preventing harmful drug interactions.
In Florida, PBMs will save consumers and health care programs more than $43 billion over 10 years, and PBMs helped the state Medicaid program save $2.3 billion.
State Rep. Jackie Toledo has introduced a bill, HB 961, that would cause health care costs to skyrocket for many Floridians, their employers, and the state while lining the pockets of independent pharmacists and padding the bottom line of Big Pharma.
The legislation would strip away incentives that health plan sponsors and PBMs use to help patients choose lower-cost, clinically equivalent options to fill their prescriptions while mandating that pharmacists get a guaranteed profit on every drug they dispense, no matter the cost to employers and health plans.
Rather than offer solutions to lower prescription drug costs, the pharmacist’s lobby prefers to vilify PBMs — the only entity in the prescription drug supply chain that is fighting to reduce drug costs for Floridians and patients nationwide. Instead of urging lawmakers to find ways to lower Floridians’ drug costs, these pharmacists are demanding lawmakers to adopt an agenda that would almost certainly increase them.
Indeed, despite independents pharmacists’ claims that PBMs aren’t transparent, PBMs support transparency for patients and their providers, policymakers, employers, unions, and other health plan sponsors so they can make informed decisions that lead to optimal health outcomes and lower costs.
Independent pharmacies are doing just fine in Florida. As one representative from their own national association recently stated, the number of independently-owned pharmacies is “holding pretty steady.” In 2019, the number of independent pharmacies operating in Florida is around 1,541, which is up from 1,164 in 2010.
That’s right: there are over 32% more independent pharmacies open today in Florida than 10 years ago. So why are they calling for lawmakers to impose additional mandates on PBMs? Actually, it’s a pretty easy answer: pharmacy owners want state legislators to guarantee that patients pay more so they can make higher profits.
PBMs understand that pharmacists play an important role in our health care system, but we believe the primary focus for everyone in the prescription drug supply chain, including PBMs and pharmacists, should be on making prescription drugs more affordable and more accessible for patients.
That’s why HB 961 is a bad prescription for Florida’s consumers. If independent pharmacy interests have their way, prescription drug costs will rise significantly. That’s bad for consumers, bad for employers, and bad for Florida’s own state budget.
Scott Woods is Assistant Vice President, State Affairs for the Pharmaceutical Care Management Association.