By BETHANY BLANKLEY
THE CENTER SQUARE CONTRIBUTOR
(The Center Square) — While Senate Democrats moved to place price controls on some prescription drugs, a step some say will lead to actual cost increases in health care overall, Gov. Ron DeSantis and the Florida legislature took a different approach.
Before the Inflation Reduction Act passed the U.S. Senate last weekend on a strictly party line vote, Gov. DeSantis issued an executive order last month to drive down prescription drug costs and ensure transparency.
Executive Order 22-164 was issued to ensure reforms are put in place to hold pharmacy benefits managers accountable when managing prescription drug benefits for insurance companies.
“Florida continues to lead the nation in ensuring accountability in the healthcare industry and in introducing reforms to combat rising prescriptions costs,” he said when he issued the order July 8. “This executive order requires accountability and transparency for pharmaceutical middlemen when doing business with the state, thereby reducing the upward pressure on prescription drug costs.”
“For far too long leaders have chosen the path of inaction, rather than action, and fallen victim to a pharmaceutical system driven by drug companies rather than consumers,” Agency for Health Care Administration Secretary Simone Marstiller said. She added that the order will provide insight “into the FDA’s review process and all agency health care contracts through the end of the decade.”
The order directs all executive agencies to include provisions in all future contracts and solicitations with PBMs. It prohibits spread pricing and reimbursement clawbacks for all PBMs. It directs agencies to include data transparency and reporting requirements, including a review of all rebates, payments, and relationships between pharmacies, insurers, and manufacturers; and directs all impacted agencies to amend all contracts to the extent feasible with these same provisions.
The governor and state legislature also took action in 2019 and 2020 to lower prescription drug costs for Floridians through its landmark Canadian Prescription Drug Importation program. But it’s been held up by the Biden administration, under review by the FDA for nearly 600 days.
In 2019, Gov. DeSantis and the state legislature created the program to lower prescription drug costs for millions of Floridians. In November 2020, the AHCA submitted its proposal to the U.S. Department of Health and Human Services to allow the state to import pharmaceutical drugs from Canada. Once HHS approves the program, Florida could begin importing a few drug classes from Canada, including maintenance medications for individuals with chronic health conditions like asthma, COPD, diabetes, and HIV/AIDS.
AHCA would contract with a vendor to manage and oversee all aspects of the program and ensure Canadian suppliers and eligible importers comply with all federal and state laws. Eligible importers would be limited to wholesalers and pharmacists that dispense prescription drugs to consumers served by certain state and government programs. Florida’s Program also would comply with Title II of the Federal Drug Supply Chain.
In late July 2020, HHS published its Safe Importation Action plan outlining measures it and the FDA would take to allow for the safe importation of certain prescription drugs. Its final rule on the matter was published last November.
However, Florida still hasn’t heard back on its proposal. As a result, the AHCA filed a FOIA request last month to find out why.
“The FDA must provide transparency on their review process, and Florida will hold them accountable to ensure they are not putting politics over patients,” the state agency said.
Since the federal government won’t act, Gov. DeSantis said he granted AHCA authority to negotiate prices for drugs ineligible for importation, such as insulin and epinephrine. Doing so will “reinforce the demand for Florida’s Canadian Prescription Drug Importation Program and provide another avenue to impact the price Floridians pay for prescription drugs,” he said.
Instead of passing a bill that would give the federal government the authority to cap prescription drug prices, Dean Clancy, senior health policy fellow at Americans for Prosperity, told The Center Square that Congress should be following Gov. DeSantis’ lead.
“Gov. DeSantis‘ EO contains the kind of reforms Congress should be looking at instead of imposing government price controls,” he said. “Ensuring more transparency for the monopolistic middlemen who help drive up pharmaceutical costs will reduce prices and give Americans a personal option for prescription drugs.”
