Cooper: Removing pharmacists' 'gags'

From the Chattanooga Times Free Press
By: Clint Cooper

Today, your pharmacist may not be able to inform you that your prescription would cost you less if you paid for it out of pocket than through your insurance plan.

That will change, though, if a bill passed Wednesday by the Senate Health, Education, Labor and Pensions Committee — the Patient Right to Know Drug Prices Act — remains alive.

We hope it will, and we appreciate committee Chairman Lamar Alexander, R-Tenn., for his usual support of common-sense measures that help Americans regardless of their political affiliation.

A recent study published in the Journal of the American Medical Association that reviewed 9.5 million insurance claims, according to The Hill, found that 23 percent of prescriptions filled through insurance coverage cost more for customers than if they had paid out of pocket. Those overpayments totaled $135 million, according to the study.

The bill's lead sponsor, Sen. Susan Collins, R-Maine, said in a news release that such incidents, like one in which a customer used his insurance to pay $129 for a drug that he could have paid $18 for out of pocket, continue to be harmful to consumers.

"By prohibiting gag clauses," she said, "our legislation would take concrete action to lower the cost of prescription drugs, saving consumers money."

Currently, "pharmacy gag clauses" can be instituted by insurers or pharmacy benefit managers that prevent pharmacists from fully informing clients about prices. Pharmacy benefit managers then pocket the difference.

Ahead of the bill, though, 14 states have banned the practice, including Mississippi, South Dakota and Virginia in March alone.

Alexander, in a statement, said the Health, Education, Labor and Pensions Committee has held four bipartisan hearings on the high cost patients pay for prescription drugs. In one of those, he said, Health and Human Services Secretary Alex Azar reported on President Donald Trump's blueprint to reduce what Americans pay for such drugs.

"Many Americans struggle to afford their prescriptions," the Tennessee senator said.

Azar, in a March speech to the Federation of American Hospitals, related a similar personal anecdote regarding differences in costs for health care.

Needing a routine stress test, he inquired about the cost and brushed off an initial report that the information wasn't available. Persisting, he was told an in-hospital test would be $5,500, and eventually that the cash price would be $3,500. Later, he looked up how much the procedure would cost in a doctor's office and learned it was $550.

We hope this bill and more like it will find their way to the Senate floor, so all Americans will be able to pay less for their health care needs.