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Christine Blank is a contributing editor.
There is finally relief from “gag clauses,” which prevented pharmacists from telling patients they can pay a lower out-of-pocket cost for certain prescriptions than the copay with their health insurance.
Pharmacists and patients finally have relief from “gag clauses,” which prevented pharmacists from telling patients they can pay a lower out-of-pocket cost for certain prescriptions than the copay their health insurance charges them.
On October 10, leadership from NCPA, NACDS and other organizations joined President Donald Trump at the White House as he signed legislation prohibiting gag clauses.
The president signed S. 2553, the Know the Lowest Price Act of 2018, and S. 2554, the Patient Right to Know Drug Prices Act, which give community pharmacists more flexibility in informing patients how they can pay less out of pocket for a prescription.
The new law takes effect immediately, and applies to Medicare Part D as well as Affordable Care Act exchange and private insurance plans. The new legislation states that pharmacists cannot be prohibited from discussing the most affordable medication payment options with their patients or be retaliated against for doing so, says NCPA CEO B. Douglas Hoey, RPh, in a statement. “We believe this will help unshackle pharmacists so they can use their expertise in conversations with patients, helping them receive the most appropriate medication at the lowest cost without fear of retribution.”
“The signing of these bills is a victory for patients and for pharmacies worried that a PBM will retaliate against them for disclosing the most affordable healthcare options to patients,” says Hoey. “Everyone agrees – prescription drug prices are too high. By empowering pharmacists to act in patients’ best interest in sharing lower-cost alternatives, we are increasing patients’ ability to afford the medications they need to get healthy and stay that way.”
NACDS also lauded “the focus and the determination that the Trump Administration is bringing to the work of reducing patients’ out-of-pocket drug costs, and we appreciate the diligence of these bills’ Congressional sponsors in leading this legislation all the way to the President’s desk,” says Steven C. Anderson, president and CEO of NACDS, in a statement.
The Pharmaceutical Care Management Association also “strongly supports S. 2553 and S. 2554, legislation that will help ensure America’s patients always pay the lowest cost for their medications at the pharmacy counter, whether it’s the cash price or the patient’s cost-sharing,” the organization says in a statement.
“The President’s drug-pricing blueprint called for ending gag clauses. Within a week of the blueprint’s release, HHS informed Medicare plans that they are unacceptable, and now Congress has responded to the President’s call by formally banning them,” says HHS Secretary Alex Azar in a statement.
“American patients should know: You can always ask your pharmacist whether you’re getting the best deal on the prescription drugs you need. This is just one step in the President’s plans to deliver better healthcare to Americans at lower prices, efforts that have already involved more action to bring down drug prices than any previous President has taken,” Azar says.