FL S1158

Requires the Agency for Health Care Administration to contract with an entity to establish international reference prices for prescription drugs based on prices in countries with at least 60% of U.S. GDP per capita, excluding single-payer systems

Prohibits pharmacies from charging cash-paying customers more than the established reference price for prescription drugs, and requires health insurers to limit reimbursement to reference prices, with savings used to reduce premiums and cost-sharing

Mandates prescription drug manufacturers report international pricing data annually to the agency beginning October 1, 2026, with penalties of $10,000 per day for noncompliance and permit suspension after 30 days

Prohibits pharmacy benefit managers from requiring covered persons to use drugs from affiliated manufacturers when generics or biosimilars are available, and bars PBMs from reimbursing pharmacies less than affiliated pharmacies receive

Restricts health insurers and HMOs from removing drugs from formularies or increasing cost-sharing mid-policy year while an insured is taking the medication, except for FDA safety concerns, market withdrawal, or over-the-counter availability