The "Prescription Reduction Incentives and Competition Enhancement Act" seeks to regulate drug pricing and improve transparency within the pharmaceutical market in Florida. The bill mandates the Agency for Health Care Administration to establish reference prices for prescribed drugs based on international pricing data, ensuring that pharmacies charge cash-paying customers no more than these reference prices. Additionally, prescription drug manufacturers are required to report international drug price data annually, with penalties for non-compliance. The legislation also introduces amendments to existing laws concerning pharmacy benefit managers (PBMs) and health insurers, including prohibiting PBMs from favoring affiliated manufacturers over generically equivalent drugs and requiring a reasonable administrative appeal process for pharmacies.

Moreover, House Bill 697 includes provisions that enhance prescription drug affordability by preventing PBMs from reimbursing pharmacies less than they do for affiliated pharmacies and ensuring that health insurers reimburse covered outpatient prescription drugs at reference prices. The bill limits changes to prescription drug formularies during the policy year, protecting patients from increased cost-sharing for medications they are already taking unless safety concerns arise. Health maintenance organizations must comply with the new reimbursement standards, and annual reporting on the impact of these changes is mandated. The act is set to take effect on July 1, 2026, aiming to ensure that Floridians have access to affordable medications while maintaining competitive pricing in the market.

Statutes affected:
H 697 Filed: 627.6699, 641.31