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'Spread Pricing' Plays Key Role in Prescription Drug Price Hikes

The burden of rising prescription drug costs has been disproportionately shouldered by Florida residents. According to the Kaiser Family Foundation, Floridians spent $246,186,700 on prescription drugs in 2018, the 4th highest total of any state. Florida ranked 2nd in the total amount paid with cash ($16,517,829) and 7th in the total amount spent by Medicaid ($24,580,647).

The impact of runaway costs of prescriptions is being felt by individual payors and the state budget through programs like Medicaid. The practice of 'spread pricing' is a large part of the problem.

According to Politico, “Federal and state policymakers tackling prescription drug costs are increasingly taking a look at ‘spread pricing’ — a practice used by drug intermediaries to skim additional profits by exploiting the gap between what pharmacies charge and what insurers will pay.

In May, The Centers for Medicare and Medicaid (CMS) released guidance requiring Medicaid and CHIP plans to include spread pricing in their administrative cost calculations. In response, Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) proposed a bill prohibiting pharmacy benefit managers from engaging in spread pricing.

Have you experienced a prescription drug price hike? Tell us your story or with one-click send the Senate Health, Education, Labor and Pension Committee an email as they consider this and other proposals addressing prescription drugs.

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