drug pricing

FL Pharmacy Groups Fight PBMs with HB 1043

Florida pharmacy advocacy group Small Business Pharmacies Aligned for Reform (SPAR) and national advocacy group Pharmacists United for Truth and Transparency (PUTT) counseled with Republican and Democrat state representatives to advocate for HB 1043’s passage. HB 1043, titled, “Medicaid Pharmacy Benefit Savings” would require: “AHCA to select single pharmacy benefit administrator through competitive procurement process by specified date; provides contract requirements; requires agency to calculate amount equal to specified percentage of managed care organization’s net underwriting gain for certain contract year & reduce organization’s contract term payment by such amount.” The sponsor of the bill, Rep. Randy Fine (D-53) claims that with this bill, “there will be losers”, however, “the taxpayer, the recipient, and the local pharmacy will benefit.  The people we are here to fight for will benefit.” Dawn Butterfield, the founding member of SPAR, claims that, “We as independent pharmacy owners have been ringing in our state’s Medicaid program for more than three …

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Republicans look to curb prescription middlemen’s fees and practices

Florida Politics A recent report shows that Pharmacy Benefit Managers could be costing the state hundreds of millions. A band of Republican lawmakers hope to reel in pharmacy benefit managers and save Florida’s Medicaid program millions of dollars. They say their legislation (SB 1306/HB 1043) would level the playing field to contest unfair practices by pharmacy benefit managers, known as PBMs. In doing so, one sponsor, Doral Sen. Ana Maria Rodriguez, said the state could save at least $143 million in the bill’s first year. “Our pharmacies are being gouged for providing services to communities that would otherwise be left no choice and they’d suffer dire health consequences from lack of access to care,” said Rep. Jackie Toledo, a Tampa Representative who has routinely tackled issues tied to PBMs. Stuart Sen. Gayle Harrell, who has also championed health care reform, fears neighborhoods are losing their community pharmacies to PBMs, which …

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Marco Rubio Backs Jeanne Shaheen’s Proposal to Reduce Prescription Drug Prices

Florida Daily Last week, U.S. Sen. Marco Rubio, R-Fla., backed U.S. Sen. Jeanne Shaheen’s, D-NH, “Ensuring Timely Access to Generics Act.” The bill “would tackle exorbitant prescription costs by increasing competition for generic drugs through better oversight of the Food and Drug Administration’s (FDA) citizen petition process.” “This legislation ensures the FDA’s ability to reject citizen petitions if they believe that the primary purpose of the petition is to delay the approval of an application, thereby increasing competition in the marketplace and lowering costs for patients. The bill would also set a time limit to ensure that citizen petitions are submitted in a timely manner after the petitioning party becomes aware of the information upon which their petition is based. This time limit helps avoid instances where brand-name drug manufacturers slow down the FDA review process by filing citizen petitions shortly before a generic drug is set to be reviewed by FDA,” …

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State Rep. Randy Fine Files House Bill To Lower Cost, Increase Access to Prescription Drugs

Space Coast Daily Florida State Rep. Randy Fine filed HB 1043 his week which would save the State of Florida more than $100 million in prescription drug costs while increasing access to critical prescription drugs to Medicaid recipients. “State studies conducted over the past year prove definitively that the only people in Florida benefiting from Prescription Benefits Managers are the Managers themselves,” said Fine. “By allowing PBMs to both serve as the middleman and the retailer we have destroyed the fiduciary duty to be efficient, and as a result, these companies are making hundreds of millions of dollars in government-mandated excess profits.” HB will shift to a fee-for-service model that more than a half dozen states have implemented, saving hundreds of millions of dollars. Fine said the number of pharmacies eligible to distribute these less-expensive drugs will increase dramatically, making it easier for these Floridians to obtain prescriptions from the …

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Florida lawmakers to consider heatedly-opposed PBM reform again in 2021

The Center Square There is bipartisan support in the Florida Legislature to impose transparency requirements and restrict pharmacy benefit managers’ (PBMs) role in prescription drug costs. Nevertheless, bills seeking to do so have failed the last few years, including in 2020. A December audit commissioned by Florida’s Agency for Health Care Administration (AHCA) may spur that effort in 2021 after documenting “prescription markups” by PBMs cost Florida’s Medicaid system $113.3 million in 2020. According to the analysis by Millman, PBMs charged $89.6 million in “spread costs,” $17.9 million in administrative fees, $5.8 million in transaction fees and $47,000 in other fees during the 12-month examination of 22 million claims. Millman’s audit confirms PBMs have been “gaming the system,” Florida Pharmacy Association (FPA) CEO Michael Jackson said. “These middlemen siphon off cash to line their own pockets and control prescription drug decision-making in Florida.” FPA is a member of EMPOWER Patients, …

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What Every Challenger Brand Can Learn From The Nation’s Smallest Pharmacies

Forbes A campaign against drug rebate kickbacks isn’t something you’d typically think would have much relevance to small businesses in other industries.  However, a recent effort by a Florida-based small business pharmacy advocacy group, SPAR (Small Business Pharmacies Aligned for Reform), is offering a glimpse of how small, challenger businesses can fight back against much larger and more powerful organizations—and win. The founding of SPAR dates to a Trump administration Executive Order to prevent the drug rebate kickbacks passed between prescription drug manufacturers and pharmacy benefit managers (PBMs). Essentially, PBMs, which work with health insurance companies, negotiate with pharmaceutical companies to receive a portion of a drug’s list price every time that drug is dispensed. These “rebates,” which the PBMs receive, are factored into the cost of a drug’s final cost to the patient, which leads to steep price increases for consumers and patients. When PBMs and pharmaceutical companies launched heavily-funded lobbying …

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Bay Area Lawmaker Takes On Pharmacy Benefit Managers

Bay News 9 December 17, 2019 State Rep. Jackie Toledo officially announced a new bill Tuesday that she said is designed to lower prescription drug costs while increasing pharmacy access to all patients. State Rep. Toledo outlines Prescription Drug Cost Reduction Act HB 961 is gaining bipartisan support Toledo says pharmacy benefit managers are price gouging Surrounded by pharmacy owners, patients, other state representatives, and even doctors, she outlined the Prescription Drug Cost Reduction Act. “The PBMs would have to disclose how they are making their money, and it would prohibit the practice of spread pricing, which is charging someone more than what the drug actually costs, or reimbursing the pharmacies less than what the drug costs,” said Toledo, a Republican. “Plus, it bans the practice of of steering. So instead of you going to the PBM owned pharmacy, you have a choice.” PBM stands for Pharmacy Benefit Managers. Toledo calls them …

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Tampa lawmaker Jackie Toledo leads push to lower drug costs in Florida

Tampa Bay Times December 17, 2019 Jackie Toledo recently had an issue with the cost of medication. It’s a problem the Republican state representative from South Tampa said she’s heard too many times before. Toledo said this kind of scenario is happening way too often. That’s why she’s filing a bill today to regulate pharmacy benefit managers, or PBMs. The measure, she said, would keep drug costs down for consumers and independent pharmacies in Florida. Called the Prescription Drug Cost Reduction Act, the bill aims to prohibit health care monopolies that reduce patient choice, and to eliminate the practice of “steering” patients to PBM-owned pharmacies. It also would prohibit predatory practices that threaten to squeeze independent pharmacies. “Florida should have been the leader in this,” said Kevin Sneed, dean of the University of South Florida’s College of Pharmacy. “Until it happens in Florida and Texas, it hasn’t happened nationally when …

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Rep. Toledo files bill to address sky-high prescription drug prices

The Floridian December 18, 2019 Cutting the astronomical costs of prescription drugs is a bipartisan effort that is being pushed both at the federal and state levels of government, and considering that Florida has a huge and growing retirement community, the need to cut drug costs for those on a fixed retirement income is that much more important. Sen. Rick Scott (R) and Rep. Debbie Mucarsel-Powell (D) have both vowed to address the costly drug problem, penning their own federal legislation to help curb the issue. Accessibility to less –expensive drugs is also part of the mix, so it’s not a surprise that state legislators like Rep. Jackie Toledo (R) and others are banning together with healthcare providers to announce legislation (HB 961) that would address the prescription drug cost and accessibility problem in Florida. Rep. Toledo, alongside Reps. Randy Fine (R), Kamia Brown (D) and Sen. Javier Jose Rodriguez (D) took aim at Pharmacy Benefit Managers (PBMs), that according …

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Florida’s Rx drug supply chain needs fixing, more transparency

The Floridian November 6, 2019 Yesterday, the Florida Senate met in two separate committees to discuss the issue of Pharmacy Benefit Managers (PBMs) in the prescription drug supply chain. Both meetings had diverse panels representing the various interests in the matter as they attempted to move toward reform. The Senate Committee on Health Policy met in the morning with four panelists from the Small Business Pharmacies Aligned for Reform (SPAR), Coalition of State Rheumatology Organizations, Pharmaceutical Care Management Association, and Florida Association of Health Plans Inc. They discussed issues including transparency, contracting, payments, steering, and clawbacks. Independent pharmacist, Kevin Duane, stated that the inefficiencies of the PBM process have an eventual effect on the health of the patient. Over the past four years, 15% of the independent pharmacies in Florida have shut down, and there’s been an alarming drop in medication adherence. He cited that “the patients, when an independent pharmacy …

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