Insurers will no longer be able to prevent pharmacists from telling consumers that paying cash would be cheaper than using insurance to pay for prescriptions.
President Trump signed two bills Wednesday that bar these kinds of "gag rules." Under those rules, says The Associated Press, pharmacists have been prohibited from proactively telling consumers when their prescription would cost less if they paid for it out-of-pocket rather than using their insurance plan. Pharmacists who disobeyed the rules faced penalties.
"I think most people wouldn't be aware that when you go to buy a prescription, it is possible that if you pay cash for that prescription it will be less expensive for you than if you use your insurance company," says Dr. Roger Klein, MD JD.
"The reason for that is the co-payment that you pay the insurance company or the pharmacy benefit manager may be more than the cost of the drug – and what has happened is, in some cases, pharmacy benefit managers or insurance companies have contracted with pharmacies and they haven't let your pharmacists tell you that."
Senators Susan Collins (R-Maine) and Debbie Stabenow (D-Michigan) were the primary drivers for the bills. One bill applies to private health insurance, the other Medicare.
"Senator Collins sponsored both and was a main driver for the private sector bill," Klein explains. "It already is Medicare policy that they have to give you the lowest option, but pharmacies have not been necessarily following that, so this will help in that regard too, but Susan Collins was a driver for this so she deserves credit."
The bills are known as the "Patient Right to Know Drug Policies Act" and the "Know the Lowest Price Act of 2018."
Read an op-ed by Dr. Klein on this issue