Patients rely on pharmacies. Let’s strengthen that bond, not disrupt it

As a pharmacist, pharmacy owner, and lifelong Floridian, I’ve seen the extraordinary value local pharmacies bring to our communities.

Whether in a small town, a rural county or a busy urban neighborhood, pharmacies are where patients turn for trusted guidance. We help families understand their medications, manage chronic conditions, and navigate an increasingly complex health-care system. We do this work because we strongly believe in serving our neighbors and because pharmacies are among Florida’s most accessible, community-based health care resources.

That firsthand understanding of how pharmacies operate is why I have concerns with a provision in HB 697 moving through Florida’s Legislature.

While the bill advances several PBM transparency measures we welcome, it could unintentionally place pressure on pharmacies and create access barriers for patients in ways lawmakers may not intend.

Pharmacies operate within a national supply and reimbursement chain. We do not negotiate drug prices at the state level. Manufacturers sell to wholesalers under national contracts, and PBMs and health plans set acquisition and reimbursement rates that apply nationwide.

When state-level reimbursement is disconnected from the national system that determines acquisition cost, pharmacies are left with numbers that simply don’t match the real world.

The proposed legislation includes a “Most Favored Nation” pricing model that ties Florida’s drug reimbursement to prices set by foreign governments. These systems may look appealing in theory, but they pose challenges that Florida should carefully consider. In many countries that serve as reference points, new medicines face longer approval timelines, reduced availability, and tighter access controls — outcomes we work hard to prevent here at home.

The concern for Florida’s pharmacies is straightforward: reimbursement would be tied to a price we cannot actually pay for the medication. Nothing in the bill requires manufacturers or wholesalers to sell to Florida pharmacies at the government-set rate. If reimbursement falls below acquisition cost, pharmacies cannot sustainably stock medications. Even small gaps can create instability, especially for independent and rural pharmacies that already operate on thin margins.

When reimbursement is out of sync with real-world acquisition costs, pharmacies are placed in a difficult position, either limiting inventory or redirecting patients elsewhere. That means longer drives, fewer care options and higher costs.

Pharmacists wholeheartedly support lowering drug costs for Floridians. Our profession has led the charge on PBM reform, transparency and accountability, and we appreciate that HB 697 includes several provisions that move in that direction.

Florida can take meaningful action right now by requiring insurers and PBMs to share negotiated rebates with patients at the pharmacy counter, ensuring copay assistance counts toward deductibles and out-of-pocket limits, modernizing PBM reimbursement so compensation is tied to actual savings rather than higher list prices, and supporting sustainable reimbursement structures that allow pharmacies, especially those in rural and underserved areas, to keep their doors open and continue serving their communities.

Florida has an opportunity to get this right. We can advance reforms that help patients, strengthen transparency and support the community pharmacies that so many families rely on.

We are ready to work with lawmakers to ensure Florida’s policies reflect both affordability and access, while keeping high-quality, community-based care strong for every patient who walks through our doors.

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Eric J. Larson is a community pharmacist, multi-store pharmacy owner in the Orlando area, and president of the Florida Pharmacy Association.