SESSION WATCH
THE BILL ITSELF

SB 1158

Drug Prices and Coverage

VERSION S 1158 Filed · BACK TO THE SUMMARY · OFFICIAL RECORD

underlined language is being added; struck language is being deleted. Line numbers are the Legislature's own — the same ones amendments cite.

Florida Senate - 2026 SB 1158 By Senator Grall 29-01540A-26 20261158__
1 A bill to be entitled
2 An act relating to drug prices and coverage; creating
3 s. 381.02036, F.S.; requiring the Agency for Health
4 Care Administration to contract with an entity to
5 designate reference price source countries and analyze
6 certain data; defining the term “real gross domestic
7 product per capita”; providing duties for the
8 contracted entity; requiring the agency to publish
9 annually prescription drug reference prices; amending
10 s. 465.0244, F.S.; prohibiting pharmacies from
11 charging cash-paying customers more than the reference
12 prices for prescribed drugs and biological products;
13 providing applicability; creating s. 499.044, F.S.;
14 providing legislative intent; defining the terms
15 “prescription drug” and “drug”; requiring prescription
16 drug manufacturer permitholders to annually report to
17 the agency international drug price data beginning on
18 a specified date; specifying reporting requirements
19 and penalties; amending s. 626.8825, F.S.; defining
20 terms; requiring that contracts between pharmacy
21 benefit managers and pharmacy benefits plans and
22 programs prohibit pharmacy benefit managers from
23 offering and implementing certain formularies;
24 requiring that contracts between pharmacy benefit
25 managers and participating pharmacies allow a
26 specified option in the administrative appeal
27 procedure; amending s. 626.8827, F.S.; prohibiting
28 pharmacy benefit managers from engaging in certain
29 practices relating to pharmacies and pharmacists;
30 creating s. 627.4231, F.S.; defining terms; requiring
31 certain health insurers to limit covered prescription
32 drug reimbursement to reference prices; requiring that
33 savings from such reimbursement limits be used for
34 certain purposes; providing documentation, assessment,
35 and reporting requirements for such health insurers;
36 providing applicability; requiring the Office of
37 Insurance Regulation and the agency to submit an
38 annual report to the Governor and the Legislature;
39 creating s. 627.42398, F.S.; requiring that certain
40 health insurance policies limit changes to
41 prescription drug formularies under certain
42 circumstances; providing applicability; providing
43 construction; amending s. 627.6699, F.S.; requiring
44 small employer carriers to limit changes to
45 prescription drug formularies; amending s. 641.30,
46 F.S.; requiring health maintenance organizations to
47 comply with requirements on limits on prescription
48 drug reimbursement and on the uses of savings from
49 such limits; amending s. 641.31, F.S.; prohibiting the
50 inclusion of specified provisions in certain health
51 maintenance contracts; providing applicability;
52 providing construction; requiring the Financial
53 Services Commission to adopt certain rules by a
54 specified date; providing a declaration of important
55 state interest; providing an effective date.
57 Be It Enacted by the Legislature of the State of Florida:
59 Section 1. Section 381.02036, Florida Statutes, is created
60 to read:
61 381.02036 International drug reference pricing.—The Agency
62 for Health Care Administration shall contract with an entity to
63 designate reference price source countries and analyze the data
64 submitted under s. 499.044 to establish the reference price for
65 each prescribed drug.
66 (1)(a) The list of reference price source countries must
67 include only countries with a real gross domestic product per
68 capita of at least 60 percent of the United States gross
69 domestic product per capita, using international sales, volume,
70 and pricing data for each country. For the purposes of this
71 paragraph, the term “real gross domestic product per capita”
72 means a country’s most recent estimate based on purchasing power
73 parity for that country available in the most recent edition of
74 the United States Central Intelligence Agency World Factbook.
75 Countries with single-payer health care systems, which include
76 whole-market government price-setting for prescription drugs,
77 must be excluded. The agency contractor shall reevaluate the
78 designated reference price source countries annually and shall
79 revise the list as needed.
80 (b) The agency contractor shall weight the reference price
81 benchmark value of the selected reference price source countries
82 and sort the countries into two or more tiers, using an
83 established index measuring the level of health care system
84 market orientation in each country.
85 (2)(a) The agency contractor shall analyze the data
86 submitted under s. 499.044 to compare prices among source
87 countries using a publicly available, reliable, and consistent
88 exchange rate source. The agency contractor shall establish the
89 reference price for each prescribed drug, which must be the
90 lowest price, after adjusting for volume and difference in
91 national gross domestic product, identified in the source
92 countries. A reference price is not required to be established
93 for a drug that has a domestic price determined by the
94 contractor to be competitive with foreign prices; however, the
95 agency contractor shall identify and report such drugs and their
96 reference prices to the agency.
97 (b) The agency contractor shall prioritize drugs that have
98 little or no competition in the domestic market or that have the
99 greatest difference between the domestic price and the reference
100 price, including, but not limited to, brand name and single
101 source drugs.
102 (3) The agency contractor shall update the reference prices
103 annually and may reevaluate and update a specific reference
104 price at any time based on a significant change documented by
105 supplemental pricing data submitted by a manufacturer under s.
106 499.044(3).
107 (4) The agency contractor shall provide to the agency the
108 reference prices no later than January 1 each year, and the
109 agency shall publish the reference prices online within 10 days
110 after receipt.
111 Section 2. Subsection (3) is added to section 465.0244,
112 Florida Statutes, to read:
113 465.0244 Information disclosure ; reference prices .—
114 (3) A pharmacy may not charge a cash-paying customer an
115 amount greater than the reference price established under s.
116 381.02036 for a prescribed drug or biological product. The limit
117 on a drug or biological product charge applies only to the drug
118 or biological product itself and does not apply to any
119 dispensing fee.
120 Section 3. Section 499.044, Florida Statutes, is created to
121 read:
122 499.044 International drug reference pricing.—
123 (1) It is the intent of the Legislature that patients and
124 third-party payors in this state should not pay more for
125 prescription drugs than those in international markets.
126 (2) As used in this section, the term “prescription drug”
127 or “drug” has the same meaning as the term “prescription drug”
128 in s. 499.003 and includes biological products. The term is
129 limited to those prescription drugs and biological products
130 intended for human use.
131 (3) Beginning October 1, 2026, each prescription drug
132 manufacturer permitholder and nonresident prescription drug
133 manufacturer permitholder shall annually report international
134 prescription drug price data to the Agency for Health Care
135 Administration.
136 (a) Permitholders shall annually report the actual
137 outpatient payment or reimbursement amounts for each prescribed
138 drug in each reference price source country identified pursuant
139 to s. 381.02036, including amounts paid by both third-party
140 payors, such as insurers and public health coverage programs,
141 and by individual consumers not using third-party payors, net of
142 rebates and other forms of discounts. Permitholders may report
143 to the agency the average payment amounts for each drug for a
144 reference price source country, if weighted by utilization
145 volume and fully documented.
146 (b) Permitholders may provide supplemental price data at
147 any time during the year, based on price changes in a reference
148 price source country.
149 (c) Permitholders shall report the data in a format
150 established by the agency in consultation with the contractor
151 established under s. 381.02036.
152 (d) The penalty for failure to timely report required data
153 is a fine of $10,000 a day for the first 30 days, and permit
154 suspension thereafter until compliance is achieved.
155 Section 4. Present paragraphs (b), (c) through (f), (g)
156 through (j), and (k) through (x) of subsection (1) of section
157 626.8825, Florida Statutes, are redesignated as paragraphs (c),
158 (f) through (i), (k) through (n), and (p) through (cc),
159 respectively, paragraph (h) of subsection (2) and paragraph (h)
160 of subsection (3) are amended, and new paragraphs (b), (d), (e),
161 (j), and (o) are added to subsection (1) of that section, to
162 read:
163 626.8825 Pharmacy benefit manager transparency and
164 accountability.—
165 (1) DEFINITIONS.—As used in this section, the term:
166 (b) “Affiliated manufacturer” means a drug or biological
167 product manufacturer that, either directly or indirectly through
168 one or more intermediaries:
169 1. Has an investment or ownership interest in a pharmacy
170 benefit manager holding a certificate of authority issued under
171 this part;
172 2. Shares common ownership with a pharmacy benefit manager
173 holding a certificate of authority issued under this part; or
174 3. Has an investor or a holder of an ownership interest
175 which is a pharmacy benefit manager holding a certificate of
176 authority issued under this part.
177 (d) “Biological product” has the same meaning as in s. 351
178 of the federal Public Health Service Act, 42 U.S.C. s. 262.
179 (e) “Biosimilar” has the same meaning as in s. 351 of the
180 federal Public Health Service Act, 42 U.S.C. s. 262.
181 (j) “Drug” has the same meaning as in s. 499.003.
182 (o) “Interchangeable” has the same meaning as in s. 351 of
183 the federal Public Health Service Act, 42 U.S.C. s. 262.
184 (2) CONTRACTS BETWEEN A PHARMACY BENEFIT MANAGER AND A
185 PHARMACY BENEFITS PLAN OR PROGRAM.—In addition to any other
186 requirements in the Florida Insurance Code, all contractual
187 arrangements executed, amended, adjusted, or renewed on or after
188 July 1, 2023, which are applicable to pharmacy benefits covered
189 on or after January 1, 2024, between a pharmacy benefit manager
190 and a pharmacy benefits plan or program must include, in
191 substantial form, terms that ensure compliance with all of the
192 following requirements and that, except to the extent not
193 allowed by law, shall supersede any contractual terms to the
194 contrary:
195 (h)1. At a minimum, require the pharmacy benefit manager or
196 pharmacy benefits plan or program to, upon revising its
197 formulary of covered prescription drugs during a plan year,
198 provide a 60-day continuity-of-care period in which the covered
199 prescription drug that is being revised from the formulary
200 continues to be provided at the same cost for the patient for a
201 period of 60 days. The 60-day continuity-of-care period
202 commences upon notification to the patient. This requirement
203 does not apply if the covered prescription drug:
204 a. Has been approved and made available over the counter by
205 the United States Food and Drug Administration and has entered
206 the commercial market as such;
207 b. Has been removed or withdrawn from the commercial market
208 by the manufacturer; or
209 c. Is subject to an involuntary recall by state or federal
210 authorities and is no longer available on the commercial market.
211 2. Prohibit the pharmacy benefit manager from offering or
212 implementing a formulary that requires a covered person to
213 receive a drug or biological product manufactured by an
214 affiliated manufacturer when there is an available generically
215 equivalent drug or an available biological product that is
216 biosimilar to and interchangeable for the prescribed biological
217 product.
218 3. 2. Beginning January 1, 2024, and annually thereafter,
219 the pharmacy benefits plan or program shall submit to the
220 office, under the penalty of perjury, a statement attesting to
221 its compliance with the requirements of this subsection.
222 (3) CONTRACTS BETWEEN A PHARMACY BENEFIT MANAGER AND A
223 PARTICIPATING PHARMACY.—In addition to other requirements in the
224 Florida Insurance Code, a participation contract executed,
225 amended, adjusted, or renewed on or after July 1, 2023, that
226 applies to pharmacist services on or after January 1, 2024,
227 between a pharmacy benefit manager and one or more pharmacies or
228 pharmacists, must include, in substantial form, terms that
229 ensure compliance with all of the following requirements, and
230 that, except to the extent not allowed by law, shall supersede
231 any contractual terms in the participation contract to the
232 contrary:
233 (h) The pharmacy benefit manager shall provide a reasonable
234 administrative appeal procedure to allow a pharmacy or
235 pharmacist to challenge the maximum allowable cost pricing
236 information and the reimbursement made under the maximum
237 allowable cost as defined in s. 627.64741 for a specific drug as
238 being below the acquisition cost available to the challenging
239 pharmacy or pharmacist.
240 1. The administrative appeal procedure must include a
241 telephone number and e-mail address, or a website, for the
242 purpose of submitting the administrative appeal. The appeal may
243 be submitted by the pharmacy or an agent of the pharmacy
244 directly to the pharmacy benefit manager or through a pharmacy
245 service administration organization. The administrative appeal
246 procedure must allow a pharmacy or pharmacist the option to
247 submit a consolidated administrative appeal representing
248 multiple substantially similar claims. The pharmacy or
249 pharmacist must be given at least 30 business days after a
250 maximum allowable cost update or after an adjudication for an
251 electronic claim or reimbursement for a nonelectronic claim to
252 file the administrative appeal.
253 2. The pharmacy benefit manager must respond to the
254 administrative appeal within 30 business days after receipt of
255 the appeal.
256 3. If the appeal is upheld, the pharmacy benefit manager
257 must:
258 a. Update the maximum allowable cost pricing information to
259 at least the acquisition cost available to the pharmacy;
260 b. Permit the pharmacy or pharmacist to reverse and rebill
261 the claim in question;
262 c. Provide to the pharmacy or pharmacist the national drug
263 code on which the increase or change is based; and
264 d. Make the increase or change effective for each similarly
265 situated pharmacy or pharmacist who is subject to the applicable
266 maximum allowable cost pricing information.
267 4. If the appeal is denied, the pharmacy benefit manager
268 must provide to the pharmacy or pharmacist the national drug
269 code and the name of the national or regional pharmaceutical
270 wholesalers operating in this state which have the drug
271 currently in stock at a price below the maximum allowable cost
272 pricing information.
273 5. Every 90 days, a pharmacy benefit manager shall report
274 to the office the total number of appeals received and denied in
275 the preceding 90-day period, with an explanation or reason for
276 each denial, for each specific drug for which an appeal was
277 submitted pursuant to this paragraph.
278 Section 5. Subsections (8) and (9) are added to section
279 626.8827, Florida Statutes, to read:
280 626.8827 Pharmacy benefit manager prohibited practices.—In
281 addition to other prohibitions in this part, a pharmacy benefit
282 manager may not do any of the following:
283 (8) Prohibit or restrict a pharmacy or pharmacist from
284 declining to dispense a drug if the reimbursement rate is less
285 than the actual acquisition cost incurred or which would be
286 incurred by the pharmacy or pharmacist.
287 (9) Reimburse a pharmacy or pharmacist less than it
288 reimburses an affiliated pharmacy or pharmacist, as those terms
289 are defined in s. 626.8825.
290 Section 6. Section 627.4231, Florida Statutes, is created
291 to read:
292 627.4231 Insurance reimbursement of prescribed drugs at
293 reference prices.—
294 (1) As used in this section, the term:
295 (a) “Biological product” has the same meaning as in s. 351
296 of the federal Public Health Service Act, 42 U.S.C. s. 262.
297 (b) “Health insurer” means an authorized insurer offering
298 health insurance as defined in s. 624.603, a managed care plan
299 as defined in s. 409.962(10), a health maintenance organization
300 as defined in s. 641.19, or the state group insurance program as
301 established in part I of chapter 110.
302 (c) “Prescription drug” or “drug” has the same meaning as
303 the term “prescription drug” in s. 499.003 and includes
304 biological products. The term is limited to those prescription
305 drugs and biological products intended for human use.
306 (2) A health insurer that provides coverage for outpatient
307 prescription drugs shall provide reimbursement for a covered
308 prescription drug for which there is a reference price under s.
309 381.02036 in an amount no greater than the reference price. This
310 subsection applies to drug reimbursement and does not apply to
311 any covered dispensing or administration fee established under
312 the terms of the provider contract.
313 (3)(a) Savings generated under subsection (2) must be used
314 to reduce policyholder premiums and cost sharing as defined in
315 s. 627.42391(1). Each health insurer shall document anticipated
316 savings and premium reductions in rate filings beginning with
317 the first rate filing following the availability of reference
318 prices under s. 381.02036.
319 (b) Each health insurer shall assess the actuarial effect
320 of the reference pricing under s. 381.02036 for each insurer
321 product for each plan year. Beginning April 1 following the
322 first full plan year in which reference prices under s.
323 381.02036 apply to prescription drug reimbursement, each health
324 insurer shall submit an annual report on the assessed effect to
325 the Office of Insurance Regulation or the Agency for Health Care
326 Administration, as applicable.
327 (4) The requirements of this section apply to prescription
328 drug coverage in the Medicaid program established in chapter 409
329 to the extent a reference price established under s. 381.02036
330 generates greater savings for the program than that provided by
331 the state supplemental rebate program established under s.
332 409.912.
333 (5) Beginning January 1, 2027, and annually thereafter, the
334 Office of Insurance Regulation and the Agency for Health Care
335 Administration shall submit a joint report to the Governor, the
336 President of the Senate, and the Speaker of the House of
337 Representatives detailing the impact of subsections (2), (3),
338 and (4) in the preceding year, including savings realized
339 compared to prescription drug pricing in the United States not
340 using this pricing model, any problems encountered, any barriers
341 to accessing prescription drugs, the domestic and foreign
342 prescription drug market response, the monitoring and evaluation
343 of the impact on prescription drug program or plan beneficiary
344 access, the quality of care, and the program costs.
345 Section 7. Section 627.42398, Florida Statutes, is created
346 to read:
347 627.42398 Insurance policies; limiting changes to
348 prescription drug formularies.—
349 (1) Other than at the time of coverage renewal, an
350 individual or group insurance policy that is delivered, issued
351 for delivery, renewed, amended, or continued in this state and
352 that provides medical, major medical, or similar comprehensive
353 coverage may not, while the insured is taking a prescription
354 drug:
355 (a) Remove the prescription drug from its list of covered
356 drugs during the policy year unless the United States Food and
357 Drug Administration has issued a statement about the drug which
358 calls into question the clinical safety of the drug; the
359 manufacturer of the drug has notified the United States Food and
360 Drug Administration of a manufacturing discontinuance or
361 potential discontinuance of the drug as required by s. 506C of
362 the Federal Food, Drug, and Cosmetic Act, 21 U.S.C. s. 356c; or
363 the drug has been approved and made available over the counter
364 by the United States Food and Drug Administration and has
365 entered the commercial market as such.
366 (b) Reclassify the drug to a more restrictive drug tier or
367 increase the amount that an insured must pay for a copayment,
368 coinsurance, or deductible for prescription drug benefits, or
369 reclassify the drug to a higher cost-sharing tier during the
370 policy year.
372 This subsection applies to drugs for which an insurer negotiates
373 a single acquisition price that will be in effect for the entire
374 plan year.
375 (2) This section does not:
376 (a) Prohibit the addition of prescription drugs to the list
377 of drugs covered under the policy during the policy year.
378 (b) Apply to a grandfathered health plan as defined in s.
379 627.402 or to benefits set forth in s. 627.6513(1)-(14).
380 (c) Alter or amend s. 465.025, which provides conditions
381 under which a pharmacist may substitute a generically equivalent
382 drug product for a brand name drug product.
383 (d) Alter or amend s. 465.0252, which provides conditions
384 under which a pharmacist may dispense a substitute biological
385 product for the prescribed biological product.
386 (e) Apply to a Medicaid managed care plan under part IV of
387 chapter 409.
388 Section 8. Paragraph (e) of subsection (5) of section
389 627.6699, Florida Statutes, is amended to read:
390 627.6699 Employee Health Care Access Act.—
391 (5) AVAILABILITY OF COVERAGE.—
392 (e) All health benefit plans issued under this section must
393 comply with the following conditions:
394 1. For employers who have fewer than two employees, a late
395 enrollee may be excluded from coverage for no longer than 24
396 months if he or she was not covered by creditable coverage
397 continually to a date not more than 63 days before the effective
398 date of his or her new coverage.
399 2. Any requirement used by a small employer carrier in
400 determining whether to provide coverage to a small employer
401 group, including requirements for minimum participation of
402 eligible employees and minimum employer contributions, must be
403 applied uniformly among all small employer groups having the
404 same number of eligible employees applying for coverage or
405 receiving coverage from the small employer carrier, except that
406 a small employer carrier that participates in, administers, or
407 issues health benefits pursuant to s. 381.0406 which do not
408 include a preexisting condition exclusion may require as a
409 condition of offering such benefits that the employer has had no
410 health insurance coverage for its employees for a period of at
411 least 6 months. A small employer carrier may vary application of
412 minimum participation requirements and minimum employer
413 contribution requirements only by the size of the small employer
414 group.
415 3. In applying minimum participation requirements with
416 respect to a small employer, a small employer carrier may shall
417 not consider as an eligible employee employees or dependents who
418 have qualifying existing coverage in an employer-based group
419 insurance plan or an ERISA qualified self-insurance plan in
420 determining whether the applicable percentage of participation
421 is met. However, a small employer carrier may count eligible
422 employees and dependents who have coverage under another health
423 plan that is sponsored by that employer.
424 4. A small employer carrier may shall not increase any
425 requirement for minimum employee participation or any
426 requirement for minimum employer contribution applicable to a
427 small employer at any time after the small employer has been
428 accepted for coverage, unless the employer size has changed, in
429 which case the small employer carrier may apply the requirements
430 that are applicable to the new group size.
431 5. If a small employer carrier offers coverage to a small
432 employer, it must offer coverage to all the small employer’s
433 eligible employees and their dependents. A small employer
434 carrier may not offer coverage limited to certain persons in a
435 group or to part of a group, except with respect to late
436 enrollees.
437 6. A small employer carrier may not modify any health
438 benefit plan issued to a small employer with respect to a small
439 employer or any eligible employee or dependent through riders,
440 endorsements, or otherwise to restrict or exclude coverage for
441 certain diseases or medical conditions otherwise covered by the
442 health benefit plan.
443 7. An initial enrollment period of at least 30 days must be
444 provided. An annual 30-day open enrollment period must be
445 offered to each small employer’s eligible employees and their
446 dependents. A small employer carrier must provide special
447 enrollment periods as required by s. 627.65615.
448 8. A small employer carrier shall limit changes to
449 prescription drug formularies as required by s. 627.42398.
450 Section 9. Subsection (6) is added to section 641.30,
451 Florida Statutes, to read:
452 641.30 Construction and relationship to other laws.—
453 (6) Every health maintenance organization must comply with
454 s. 627.4231.
455 Section 10. Subsection (36) of section 641.31, Florida
456 Statutes, is amended to read:
457 641.31 Health maintenance contracts.—
458 (36) A health maintenance organization may increase the
459 copayment for any benefit, or delete, amend, or limit any of the
460 benefits to which a subscriber is entitled under the group
461 contract only, upon written notice to the contract holder at
462 least 45 days in advance of the time of coverage renewal. The
463 health maintenance organization may amend the contract with the
464 contract holder, with such amendment to be effective immediately
465 at the time of coverage renewal. The written notice to the
466 contract holder must shall specifically identify any deletions,
467 amendments, or limitations to any of the benefits provided in
468 the group contract during the current contract period which will
469 be included in the group contract upon renewal. This subsection
470 does not apply to any increases in benefits. The 45-day notice
471 requirement does shall not apply if benefits are amended,
472 deleted, or limited at the request of the contract holder.
473 (a) Other than at the time of coverage renewal, a health
474 maintenance contract that is delivered, issued for delivery,
475 renewed, amended, or continued in this state and that provides
476 medical, major medical, or similar comprehensive coverage may
477 not, while the subscriber is taking a prescription drug:
478 1. Remove the prescription drug from its list of covered
479 drugs during the policy year or contract year unless the United
480 States Food and Drug Administration has issued a statement about
481 the drug which calls into question the clinical safety of the
482 drug; the manufacturer of the drug has notified the United
483 States Food and Drug Administration of a manufacturing
484 discontinuance or potential discontinuance of the drug as
485 required by s. 506C of the Federal Food, Drug, and Cosmetic Act,
486 21 U.S.C. s. 356c; or the drug has been approved and made
487 available over the counter by the United States Food and Drug
488 Administration and has entered the commercial market as such.
489 2. Reclassify the drug to a more restrictive drug tier or
490 increase the amount that a subscriber must pay for a copayment,
491 coinsurance, or deductible for prescription drug benefits, or
492 reclassify the drug to a higher cost-sharing tier during the
493 policy year or contract year.
495 This paragraph applies to drugs for which a health maintenance
496 organization negotiates a single acquisition price that will be
497 in effect for the entire plan year.
498 (b) This subsection does not:
499 1. Prohibit the addition of prescription drugs to the list
500 of drugs covered during the policy year or contract year.
501 2. Apply to a grandfathered health plan as defined in s.
502 627.402 or to benefits set forth in s. 627.6513(1)-(14).
503 3. Alter or amend s. 465.025, which provides conditions
504 under which a pharmacist may substitute a generically equivalent
505 drug product for a brand name drug product.
506 4. Alter or amend s. 465.0252, which provides conditions
507 under which a pharmacist may dispense a substitute biological
508 product for the prescribed biological product.
509 5. Apply to a Medicaid managed care plan under part IV of
510 chapter 409.
511 Section 11. The Financial Services Commission shall adopt
512 rules to implement sections 4 and 5 of this act by January 1,
513 2027.
514 Section 12. The Legislature finds that this act fulfills an
515 important state interest by:
516 (1) Increasing medication adherence and reducing the
517 likelihood that Floridians would choose to forego, substitute,
518 or ration prescribed medication and therapies due to high cost,
519 by helping cost-burdened Floridians acquire prescribed
520 medication and therapies at competitive, market-based prices.
521 (2) Ensuring that residents of this state do not spend more
522 for the same quantity of a prescription drug than residents of
523 other countries, by regulating even-handedly and prospectively,
524 in a historically regulated industry, both resident and
525 nonresident drug manufacturers with regard to international
526 price transparency and international reference-based upper
527 payment limits.
528 (3) Ensuring that residents of this state are not at a
529 competitive disadvantage compared to residents of other
530 countries, by countering monopolistic and anticompetitive market
531 conditions using international reference-based upper-payment
532 limits regardless of the incidental effect experienced if other
533 states adopt similar legislation.
534 (4) Maximizing the number of residents of this state with
535 commercial health plan coverage who can access competitive,
536 market-based prices without interfering with nationally uniform
537 plan administration.
538 (5) Regulating state-licensed activity and establishing a
539 competitive market without depriving drug manufacturers of
540 reasonable opportunities to profit from their investments, by
541 normalizing both the drug prices paid by residents of this state
542 with those the manufacturers accept in other countries and the
543 profit they benefit from in those countries.
544 Section 13. This act shall take effect July 1, 2026.