Two bills now on President Donald Trump’s desk would make it easier to buy a prescription drug at the best price available.
If signed into law as expected, the legislation — referred to as the “Know the Lowest Price Act” and “Patient Right to Know Drug Prices Act” — will bar so-called gag clauses. The change from both bills will effectively allow pharmacists to inform more customers when a prescription will cost them less money if they pay out of pocket.
The U.S. House and Senate passed the bills with bipartisan support in September, and they were presented to Trump on Thursday.
Trump has already publicly indicated that he supports the bills. “I support legislation that will remove gag clauses and urge the Senate to act,” he tweeted after the House passed the two bills.
About gag clauses
As we detail in “The 50 Percent Cost-Cutting Tip Your Pharmacist Can’t Share,” gag clauses appear in contracts between pharmacies and drug benefits managers — companies that manage drug benefits on behalf of health insurers and employers.
Gag clauses prevent pharmacists from informing customers when it would be cheaper to pay for a drug out of pocket instead of pay their insurance copay for the drug.
A September announcement from the office of Democratic Sen. Debbie Stabenow of Michigan, who sponsored the Know the Lowest Price Act, notes that many customers are unaware that they could save money by paying out of pocket.
The statement continues:
“That’s because many pharmacists are prohibited from telling their customers that a prescription to treat diabetes or high blood pressure may cost only $8 out of pocket instead of $20 through insurance coverage. One 2018 report found that customers overpaid for prescription drugs at the pharmacy counter 23% of the time.”
About the bills
The Know the Lowest Price Act will apply to Medicare Part D plans and will thus impact folks with that type of plan. Now, for the bad news: This bill applies to plan years that start on or after Jan. 1, 2020. So, it will not affect current Medicare plans or 2019 Medicare plans.
The Patient Right to Know Drug Prices Act, sponsored by GOP Sen. Susan Collins of Maine, will apply to individual health insurance plans and group health insurance plans, aka employer-sponsored plans. So, it will affect folks who have those types of plans. This bill does not specify when the law takes effect.
For more ways to lower your medication costs, check out “10 Expert Tips for Slashing Prescription Drug Costs.”
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