On Wednesday, President Trump signed bipartisan legislation that would ban so-called “gag clauses” and allow “pharmacists to tell consumers when they could actually save money by paying the full cash price for prescription drugs rather than using health insurance with large co-payments, deductibles and other out-of-pocket costs.” The New York Times reports. Pharmacists “say they have often been forbidden to share information on drug pricing with customers” because of the gag clauses imposed on them “by companies that manage drug benefits for insurers and employers.” One bill bans gag clauses in commercial insurance and the other applies to outpatient drug coverage in Medicare, either through its fee-for-service program or Medicare Advantage plans. Both were passed by Congress in nearly unanimous votes last month.
According to research published in JAMA in March, people with Medicare Part D drug insurance overpaid for prescriptions by $135 million in 2013. Copayments in those plans were higher than the cash price for nearly 1 in 4 drugs purchased in 2013. For 12 of the 20 most commonly prescribed drugs, patients overpaid by more than 33 percent.
NBC News reports that during the signing, Trump said of drug prices, “It’s way out of whack. It’s way too high.” He continued, “You look at prices in our country and for the exact same drug in other countries, it’s much lower – made in the same plant by the same company – and I said, ‘What’s going on?’”
Critics argue that the bills do not address the causes of high prices and do not require pharmacists to disclose cheaper alternatives. See Kaiser Health News coverage.
At least now, pharmacists can discuss with their patients easy way to save money on prescription drugs without fearing PBM retaliation. The legislation prohibiting gag clauses in commercial insurance contracts will go into effect immediately. However, the bill affecting Medicare beneficiaries wouldn’t take effect until Jan. 1, 2020.