The proposed bill seeks to regulate drug prices and improve transparency in prescription drug coverage in Florida by establishing a new section, 381.02036. This section mandates the Agency for Health Care Administration to contract with an entity to identify reference price source countries and analyze data to set reference prices for prescribed drugs. The bill defines "real gross domestic product per capita" and requires the agency to publish annual reference prices, prohibiting pharmacies from charging cash-paying customers more than these prices. Additionally, it outlines reporting requirements for prescription drug manufacturers regarding international price data.

The bill also amends existing laws related to pharmacy benefit managers (PBMs) and health insurers, requiring PBMs to ensure contracts with pharmacy benefits plans prohibit certain formularies and provide an administrative appeal process. Health insurers must limit prescription drug reimbursements to reference prices and use any savings to reduce policyholder premiums and cost-sharing. The legislation restricts changes to drug formularies during the policy year, ensuring that drugs already covered cannot be removed or have increased cost-sharing, except under specific circumstances. Overall, the bill aims to align Florida's drug prices with international standards, enhance medication adherence, and improve the affordability and accessibility of prescription medications for consumers, with an effective date of July 1, 2026.

Statutes affected:
S 1158 Filed: 627.6699, 641.31