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, a coalition of neighborhood and independent pharmacies demanding lawmakers resist lobbying by the insurance and pharmaceutical industries to pass PBM reforms that aren’t just “checking a superficial box.”
Through Wednesday, at least two 2021 bills proposing increased transparency in PBM operating procedures have been filed in the Senate. Continue Reading