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Gov. DeSantis proposes pharmaceutical transparency to fight rising drug costs

State seeks to reign in PBMs, DeSantis says

THE VILLAGES, Fla. – Florida Gov. Ron DeSantis on Thursday held a news conference at a recreation center in The Villages, proposing legislation for the 2023 regular session that would bolster state residents’ ability to choose a pharmacy and add transparency to how prescription drugs are procured and sold.

“What we find when we we look at this is just there’s so much bureaucracy, there’s middlemen, there’s a whole host of things that have been built up over the years so there’s a lot of people that make a lot of money and the people that end up paying are the consumers, some of our small businesses — you have these community pharmacies, they’re getting hit — and so we wanted to do something about it,” DeSantis said.

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DeSantis’ proposal was comprised of three pillars: prohibiting spread pricing, prohibiting reimbursement clawbacks and “tackling issues” with steering, described by the governor as when consumers are not given the option to shop around for a preferred pharmacy to pick up their prescriptions.

“I think this package of reforms is a great step in the right direction, I think we’re gonna get broad support in the Florida Legislature for that and so I’m pleased to be here to say that this will be something that we’ll be pursuing and I think you’ve seen over the last four years that when we say we’re going to do something we usually do get it done,” DeSantis said.

In 2019, between DeSantis and then-state House Speaker Jose Oliva, Florida began efforts to import cheaper prescription medications from Canada. The plan faced opposition in a legal challenge launched by Pharmaceutical Research & Manufacturers of America which remained unresolved as of April 2022.

At the news conference Thursday, DeSantis blamed the Food and Drug Administration for the plan’s current stasis, accusing the federal government of stonewalling and conspiring against Florida in drug manufacturers’ interests.

“This has been ready to go, literally all they have to do is sign on the dotted line and basically what they’re saying is ‘Well, you know, if you buy the same drug in Canada we’re really concerned about safety and all this other stuff.’ You know, the FDA wasn’t as concerned and isn’t as concerned about safety when they’re authorizing MRA shots for six-month-old babies,” DeSantis said. “...We got to get to the point where our consumers in America are treated equitably because we pay so much more than all these other countries, and so that’s something we’re fighting. We’re in court against the FDA on that, they’re stonewalling us as best as they can to try to do it because look, at the end of the day, what the FDA is doing is they’re running interference for the pharmaceutical companies and that’s what they’ve done.”

Discussion surrounding the imported Canadian drugs opened the conference but didn’t go much further, as despite the placard on DeSantis’ lectern reading “LOWER DRUG PRICES,” the event was gathered to propose such changes as forcing drug manufacturers to issue an annual report outlining and explaining price increases instead.

The news conference Thursday echoed an event DeSantis held in July about the same issues, that time to a crowd in Cape Coral, before he signed executive order 22-164 to prohibit spread pricing and clawbacks in pharmacy benefit manager (PBM) contracts, hasten work toward implementing the plan to import drugs from Canada and audit PBMs to justify drug costs to the state.

In EO 22-164, price spreading was defined as “when the PBM retains a portion of the amount, or spread, between what the employer or health plan pays the PBM and the amount that the PBM reimburses the pharmacy for a beneficiary’s prescription,” and financial clawbacks described as “when PBMs include contractual provisions that allow for the recoupment of overpayments to network pharmacies and the PBM retains such recoupments.”

In general, though Thursday’s conference was a follow-up to the July event, it focused on “reining in” PBMs and preventing them from skimming money from consumers and smaller pharmacies, DeSantis said.

“Last year, I did an executive order to bring more accountability with pharmaceuticals for state contracts, and that was really ordering our agencies to get in line when they negotiate these things and take on issues like pharmacy benefit managers, PBMs is what they’re called, and these are the middlemen that operate in between the system, and so that’s good but what we want to do is do that across the state and of course I can’t do that through executive order, we have to work with the legislature to be able to do that, and so that’s what we’re here to announce today,” DeSantis said.

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The event Thursday at Eisenhower Regional Recreation Center also featured the state’s Surgeon General Joseph Ladapo and Katie Scanlon, senior director of pharmacy administration at Publix Super Markets, both to discuss the state of the prescription drug industry.

Ladapo said he wanted to “dispel a myth” concerning the research and development process of pharmaceutical drugs in America.

“The myth is that pharmaceutical companies are spending a lot of money on research,” Ladapo said, citing “different groups” of researchers. “...Most of the innovation in terms of drugs that has been happening in this country comes not from the pharmaceutical industry. It starts in universities. That’s where the research is actually being done. That is driving most of the innovation in pharmaceutical space.”

Scanlon, representing Publix, said the corporation feels DeSantis’ proposal is a “critical first step” to make it so state residents can have access to medications at the lowest possible prices, focusing her statements on steering.

“We have customers come in that say, ‘You know, this is the pharmacy that’s closest to my house, the pharmacist knows me and my family., but I no longer can come here because I have to send my prescriptions to the pharmacy, where you know, even getting in touch with someone is often a bit of a challenge,’” Scanlon said. “...We really believe that it’s important for consumers who wish to have that face-to-face relationship with their local pharmacist (to), you know, have that option.”

[WATCH THE NEWS CONFERENCE AGAIN IN THE VIDEO PLAYER BELOW]

The governor’s previous news conference took place in Bonita Springs, where DeSantis signed an executive order, EO 23-06, meant to follow up on a previous order signed exactly four years prior. It directs the Florida Department of Environmental Protection to secure $3.5 billion over the next four years for Everglades restoration, prioritize projects related to Indian River Lagoon restoration, protect Florida communities from “flooding, sea level rise, and future storm events” and quicken land conservation efforts by focusing on acquisitions in the Florida Wildlife Corridor.


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