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Florida bill risks higher drug costs, fewer treatment options


Florida lawmakers are right to focus on lowering drug costs. Every Floridian deserves affordable access to the medicines that keep them healthy.

Unfortunately, HB 697, which attempts to cap prescription drug prices through foreign reference pricing, is built on assumptions that don’t reflect how the U.S. drug system actually works.

And it could ultimately raise patient costs while undermining one of Florida’s fastest-growing innovation sectors.

The intention behind HB 697 is understandable. The execution, however, is not workable in the U.S. drug supply chain. The U.S. pharmaceutical system operates on a national, not state-based, scale. The system is national by design. It was built to ensure that medicines can move efficiently across state lines, absorb supply disruptions, and adjust to changing demand.

That flexibility is what keeps pharmacy shelves stocked during crises – and it’s why a single-state pricing mandate cannot simply be layered on top of it.

Every medicine moves through a national network that includes manufacturers, wholesalers, pharmacies, insurers, pharmacy benefit managers, and other players. That network has two interconnected parts: the physical supply chain that delivers the medicine, and the system that determines how it is reimbursed and what patients ultimately pay.

It’s on the reimbursement side of the system where many pricing decisions are made. Many Floridians don’t realize that manufacturers do not control what patients ultimately pay. The prices people see listed publicly are reference benchmarks required by the system. In reality, insurers and their pharmacy benefit managers (PBMs) determine which medications appear on a formulary, how much a patient will pay, and even which pharmacy a patient can use.

PBMs also set the acquisition and reimbursement rates for pharmacies nationwide, and because those rates are uniform across states, there is no such thing as a “Florida price.”  HB 697 assumes pharmacies can dispense medicines at a state-mandated reference price. That means a Florida pharmacy, especially rural or independent pharmacies already operating on thin margins, could be required to dispense a drug at a price below what it paid nationally to acquire it.

The result is predictable: PBMs adjust their formularies, shift utilization, and increase patient cost-sharing to make up the difference. Patients don’t save money, and in many cases, they pay more.

Perhaps most concerning, HB 697 has no requirement that any savings from reference pricing actually reach patients. Without guardrails, insurers and PBMs, not consumers, would retain the benefit.

Beyond the patient affordability problem, HB 697 threatens one of Florida’s most successful and fastest-growing economic engines: our life sciences industry. Florida now ranks among the top states in the nation for clinical trials, biotech manufacturing, and medical technology companies. More than 117,000 Floridians work in life sciences, across biopharma, MedTech, research institutions, digital health, and advanced manufacturing. These are high-skill, high-wage jobs that anchor local economies from Miami to Tampa to Jacksonville.

Since 2012, Florida has outpaced the nation in pharmaceutical and medical device job growth, startup formation, and research expansions. Companies choose Florida because we offer a stable, innovation-friendly environment with fast regulatory pathways and strong partnerships between industry and researchers. That progress is not guaranteed — it depends on policies that support discovery and ensure timely patient access to new therapies.

Foreign reference pricing systems do the opposite. Countries that rely on these models achieve lower prices by restricting or delaying access to new treatments, often for years. Only about half of new medicines reach patients abroad, while nearly 90% reach U.S. patients.

Importing foreign pricing means importing foreign access limits, and that undermines the very foundation of Florida’s competitiveness.

Investors have been clear: foreign-indexed pricing drives capital toward countries prioritizing innovation, including China, which is rapidly expanding its advanced-therapies pipeline.

Adopting a foreign price-control system would signal that Florida is no longer a predictable or supportive environment for biomedical investment. That puts future clinical trials, research partnerships, and high-wage biomanufacturing jobs at risk.

Florida can lead in lowering drug costs, but not by adopting a policy that doesn’t fit the U.S. drug system and offers no guaranteed savings for patients.

There are proven, state-level reforms that would lower costs: applying negotiated rebates directly at the pharmacy counter, increasing PBM transparency, and modernizing PBM compensation so savings flow to patients rather than middlemen.

These solutions improve affordability without jeopardizing access or undermining a thriving innovation ecosystem.

Floridians deserve policies that lower costs and protect access. HB 697 is not the path forward.

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Mark Glickman is the president and CEO of BioFlorida, which represents 9,481 life science companies and research institutions powering Florida’s growing innovation economy.



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