Senators target ‘Rx gag clauses’

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WASHINGTON — Three senators last month introduced legislation that they say will bring more transparency to prescription drug pricing.

Sens. Susan Collins (R., Maine), Claire McCaskill (D., Mo.) and Debbie Stabenow (D., Mich.) introduced the Patient Right to Know Drug Prices Act (S. 2554) and the Know the Lowest Price Act (S. 2553), which would prohibit the so-called pharmacy gag clauses that cause many consumers to needlessly overpay for their prescriptions.

Pharmacy gag clauses prevent pharmacists from telling consumers if their prescription would cost less if they paid for it out of pocket instead of through their insurance plan. Pharmacists who violate these clauses face significant penalties, the senators noted.

If passed by Congress, the Patient Right to Know Drug Prices Act would bar insurers and pharmacy benefit managers from restricting pharmacies from informing plan enrollees when the costs differ for a drug covered under a benefit plan versus purchasing the same medication without insurance. The bill would apply to plans offered by private employers and through health insurance exchanges.

The Know the Lowest Price Act would provide the same protection for people covered by Medicare Advantage and Medicare Part D plans.

“Insurance is intended to save consumers money,” Collins said. “Gag clauses in contracts that prohibit pharmacists from telling patients about the best prescription drug prices do the opposite.”


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