Lawmakers seek to remove 'gag clauses' that keep pharmacists from revealing lower prescription drug prices

Written by Kelly Gooch | March 16, 2018 | Print  |

A group of bipartisan senators introduced two pieces of prescription drug legislation, including a ban on "gag clauses" that can lead to consumers paying higher prices at the pharmacy. 

The group — led by Susan Collins, R-Maine, Claire McCaskill, D-Mo., and Debbie Stabenow, D-Mich. — revealed the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act March 15, according to a joint news release from senators. Under the two bills, health insurers and pharmacy benefit managers would not be able to use gag clauses that prohibit pharmacists from telling consumers if they would pay less out of pocket for prescription drugs than they would going through insurance.  

"Insurance is intended to save consumers money. Gag clauses in contracts that prohibit pharmacists from telling patients about the best prescription drug prices do the opposite," Ms. Collins said in a statement. She went on to give an example of a customer who paid $129 for a drug using insurance when the cost would have been $18 out of pocket.

"Americans have the right to know which payment method — insurance or cash — would provide the most savings when purchasing prescription drugs.  By prohibiting gag clauses, our legislation would take concrete action to lower the cost of prescription drugs, saving consumers money," Ms. Collins said.

Both recently introduced bills ban insurers and PBMs from mandating that a pharmacy can't provide drug price information to consumers when there is a difference between the cost of the drug under the insurance plan and the cost of the drug when paid for out of pocket, according to the senators. However, the Patient Right to Know Drug Prices Act applies to plans offered through exchanges and private employers, while the Know the Lowest Price Act applies to Medicare Advantage and Medicare Part D beneficiaries.

Other senators in the bipartisan group are John Barrasso, R-Wyo., Bill Cassidy R-La., and Ron Wyden, D-Ore.

 

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