Florida must balance drug costs with patients’ needs

As a doctor in the Sunshine State, I’ve witnessed firsthand the struggles many Floridians face in affording life-saving medications.

The high cost of prescription drugs is a concern that resonates from the bustling streets of Miami to the quieter avenues of Sarasota. If consumer prices had increased at the same rate as drug prices over the last 15 years, gas would now cost $12.20 a gallon, and milk would be priced at $13 a gallon.

However, if the major drug companies get their way, this dire affordability crisis is poised to get worse.

The drug companies that continue to raise their prices to record highs are trying to convince Florida politicians to regulate pharmacy benefit managers — one of the only allies that Floridians have in drug pricing discussions. Listening to the drug companies by taking this action will only make things worse for many of my patients.

PBMs, intermediaries that insurers hire to negotiate with drug manufacturers, negotiate drug prices and manage drug benefit plans. The drug companies have fooled Gov. Ron DeSantis and others into believing that they pocket too much of the cost savings they secure from them, but this is not true. Of every dollar spent on prescriptions, 65% goes to the drug companies and only 6% goes to PBMs.

One cannot blame the drug companies for trying to point the blame elsewhere, but from my experience in health care,

I’ve seen how PBMs can also be a lifeline for patients struggling with high medication costs.

PBMs have especially helped Florida’s seniors, with the Office of Management and Budget finding they saved Medicare Part D a full 20%, offsetting nearly $30 billion in costs.

Florida’s policymakers, including senators Marco Rubio and Rick Scott, have been vocal about addressing high drug prices. While their efforts are commendable, targeting PBMs with stringent regulations, as some proposed bills in Congress suggest, is not a solution to anything. Such moves could disrupt the delicate balance of drug pricing negotiations and potentially lead to even higher costs for patients.

One of the proposed bills, the PBM Transparency Act, would cause drug prices to soar. As a doctor, I’ve seen how PBMs use their bargaining power to keep medication costs down, especially for generic drugs, which are a lifeline for many.

In Pensacola, a local pharmacist shared with me how PBMs have helped small pharmacies like his negotiate better deals with drug manufacturers. This is crucial in a state where small businesses are the backbone of our communities. Disrupting this dynamic could have far-reaching consequences, not just for patients but for the entire health care ecosystem in Florida.

As Floridians, we need a solution that addresses the root cause of high drug prices — the pricing strategies of Big Pharma. Legislators should focus on measures that prevent drug manufacturers from artificially inflating prices or delaying the entry of cheaper generic drugs into the market.

While the intentions behind regulating PBMs might be to lower drug costs, we must tread carefully. The governor and members of Congress should focus on reforms that directly target the practices of pharmaceutical companies. Only then can we ensure that all Floridians have access to affordable health care without compromising the quality of care.

Nicole Natale