Here are three things to know.
1. Patients can often pay less for generic medications if they sidestep insurance and pay out of pocket, but contracts with pharmacy benefit managers forbid pharmacists from telling customers this information.
2. Under the bulletin, pharmacy benefit managers must remove “gag orders” that forbid pharmacists from sharing better deals on prescription drugs with patients.
3. The bulletin, effective immediately, also bars insurers and PBMs from charging patients more for their medications than it would cost without insurance coverage.
“Consumers have a right to better understand the cost of their prescription drugs and whether or not they can get those prescriptions filled at a lower cost,” said Ohio Department of Insurance Director Jillian Froment. “We require insurers and pharmacy benefit managers to act in good faith and to follow Ohio law, but these explicit prohibitions will make expectations clear and will protect Ohio consumers.”
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