A 44-year-old member of Generation X, Florida Governor Ron DeSantis could be an unlikely candidate to squeeze his party’s older voters away from Donald J. Trump, a 76-year-old baby boomer.
But he tries anyway.
As Mr. DeSantis nears the official rollout of a 2024 presidential campaign, he is quickly trying to gain a foothold with this large, politically influential group of voters, and does so by appealing to their pockets.
He has mainly focused on his efforts to reduce the cost of prescription drugs in Florida, including pushing the federal government for permission to import cheaper drugs from Canada. This month, he signed a bill that he says will cut costs by regulating middlemen in the pharmaceutical industry.
“We think health care is too expensive,” Mr. DeSantis said as he signed the bill into law in Palm Beach County. “Prescription drugs are too expensive.”
“In our healthcare system,” he continued, “you see a lot of bureaucracy, bureaucracy. And people make money off this system that doesn’t really add value to the system.”
While touring the country performing at Republican fundraisers, the governor added a line about the new law to his stupid speech.
The efforts to highlight the cost of drugs come as Mr. Trump, who would be Mr. DeSantis’ main Republican rival, has attacked him for supporting plans to restructure Social Security and Medicare – programs that are sacred to many older Americans. (Mr. Trump himself has expressed similar sentiments in the past.)
According to the Pew Research Center, more than 60 percent of Republican and Republican voters are over the age of 50. Older voters also contributed to DeSantis’ landslide re-election victory last year. According to exit polls, he won 6 out of 10 votes from the over-65s.
The issue of prescription drugs, the prices of which have risen in recent years, reflects one of Mr. DeSantis’ advantages in a primary: the ability to promote a long list of laws he signed into law this year.
But talking about drug costs also illustrates the potential messaging challenges Mr. DeSantis could face as a candidate. The governor, who considers himself a policy expert, has at times struggled to make the topic tangible to voters. The cost of drugs is much drier and more complicated than the red meat he’s been feeding his base for conservative reasons, such as shutting down diversity programs in public schools, banning gender reassignment care for minors, and limiting the ability of undocumented immigrants to find work and access social services.
And because he’s signing so many new bills — including 37 in one day — even some observant Floridians aren’t aware of his latest effort to drive down drug costs with legislation regulating industry intermediaries, so-called pharmacy benefit managers.
Al Salvi, 61, is the kind of voter who seems likely to be aware of the new law. Mr. Salvi, a cancer survivor who volunteers with AARP in Florida, traveled to Tallahassee from South Florida to testify on three bills during this year’s legislative session. In 2019, he appeared with Mr. DeSantis at an event promoting the initiative to import prescription drugs from Canada and other countries. But he had never heard of the law targeting pharmacy fee administrators.
“Is that damn?” Mr. Salvi said in an interview. “Every time I go to the pharmacy, I see a pharmacist. I have never seen a pharmacy benefit manager.”
“The problem with the messages,” he added, “is that people won’t understand because they need to know how the supply chain works.”
Pharmacy benefit managers work with drug manufacturers, insurance plans and pharmacies to provide discounted medications to patients. But patient advocates question whether benefit managers are succeeding enough savings for the consumer. All 50 states have sought increased oversight of them, according to the National Academy for State Health Policy.
Industry lobbyists dispute that benefits managers are not helping consumers. And they say Florida’s new law, which passed with broad bipartisan support, will not reduce the cost of drugs.
When Mr. DeSantis discusses the matter publicly, he can sometimes seem opaque. He tends to talk briefly about how he believes benefit managers are harming both consumers and community pharmacies before going into detailed explanations of practices he denigrates, using technical terms like “arbitration opportunity” and “vertically integrated entities.” He often refers to pharmacy administrators by the acronym “PPEs”.
The governor’s office says that if voters are not aware of the policy changes, the news media is to blame.
“Could it be that people are missing out on the great things Governor DeSantis is doing because media outlets like DailyExpertNews choose to only amplify those angles and stories that promote their leftist agenda?” Mr. DeSantis’ press secretary, Bryan Griffin, wrote in an email. (Mr. Griffin joined the governor’s political operation on Monday.) “We’ve held a press conference almost every day for the past two weeks to promote the governor’s record legislative achievements during this session. The problem is not with us.”
Those studying the issue say they believe Mr. DeSantis’ plan could have a real impact on drug prices and transparency, especially when compared to Mr. Trump’s efforts. When Mr. Trump was in the White House, he tried to end rebates for pharmacy benefit administrators, arguing that they drove up drug prices. But in the end, he dropped the issue for most of his term.
“Trump’s plan was substantial. But in the end, it was more bark than bite,” said Antonio Ciaccia, the CEO of 46brooklyn, an Ohio-based nonprofit focused on drug pricing education and research. “DeSantis’s plan is more bite than bark.”
Under Florida’s new law, a state attorney will handle consumer and pharmacy complaints against the drug brokers. And state regulators will have broad enforcement powers, including the ability to issue hefty fines and even revoke a pharmacy administrator’s right to work in Florida.
The state also has access to contracts of benefit managers, who are involved in almost everything every step of drug pricing. The three largest intermediaries, CVS Caremark, Express Scripts and OptumRx, own a majority of the market. They are jointly owned with insurance plans and sometimes pharmacies. For example, CVS Health owns CVS Caremark, as well as the CVS retail pharmacy chain and the health insurance company Aetna.
“The oversight should help shed light on the drug pricing black box,” said Senator Jason Brodeur, an Orlando Republican who sponsored the bill.
President Biden, for his part, is popular with older voters and has pushed through his own plans to lower drug prices. But his government has stopped Florida and other states from bringing in Canadian drugs, leading Mr. DeSantis sued the Food and Drug Administration last year. Florida passed four years ago the law that allows the importation of Canadian drugs.
“It’s being held back by the Biden administration and the FDA because they say it’s not safe to buy drugs from Canada,” Mr. DeSantis said recently. “They’re just interfering with the pharmaceutical companies.”
Carly Kempler, a spokeswoman for the FDA, said the agency had a duty “to ensure that the proposed imports would not pose an additional risk to public health and safety while significantly reducing the cost of covered products to U.S. consumers.” .”
For now, Mr. DeSantis still appears to be editing his prescription drug posts.
At a stop in rural Wisconsin, he briefly mentioned the Pharmacy Benefit Administrators Act.
“We’ve moved to hold Big Pharma accountable by shining a light and reining in things like pharmacy benefit managers that make you pay more for expensive drugs,” he said.
The audience responded with mild applause, having erupted in cheers moments earlier when Mr. DeSantis described a bill he signed that would allow the death penalty for sexual assault against children.
