New law removes the veil over rising prescription drug costs | Orlando Sentinel

PBMs have a significant impact on Florida patients and their ability to obtain the medications they need in a timely and affordable manner, and yet very little is known about their role. Thankfully, Florida’s lawmakers listened to the concerns of constituents who depend on prescription medications and passed a bill this past session that would add transparency and accountability to the pricing process for prescription drugs.

Gov. Rick Scott signed the bill into law in March.

Once effective, the measure will provide an additional level of oversight for PBMs operating in Florida by requiring them to register with the Office of Insurance Regulation, and will go a long way in bringing about a level of transparency to the PBM industry.

Furthermore, by imposing restrictions on PBMs regarding cost, the law will help ensure Florida patients do not pay any more than they must for the medications they need. Although patients often assume that their copayment amount will be less than the retail (“cash”) price of a drug, this is not always the case. Unfortunately, pharmacists are often prohibited by PBMs from telling customers about lower cost options, and are sometimes even obligated to charge a customer the applicable cost-share amount, even if the retail price for the drug is less.

The new law addresses these practices by prohibiting PBMs from charging patients an amount at the point of sale that is greater than the retail price of the drug prescribed. Moreover, it bars PBMs from including in their contracts with pharmacies gag clauses that restrict pharmacists from conveying cost information to customers.

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New law removes the veil over rising prescription drug costs – Orlando Sentinel.