President’s signature frees pharmacists to help patients identify ways to decrease their medication costs

Bipartisan 'gag clause' bills seen as tools to address patients’ high drug costs

President Trump has signed into law two popular bills striking down so-called “gag clauses” in PBM contracts. Gag clauses barred pharmacists from telling patients the cash price of their medications, even when the out-of-pocket cost was lower than their copay. With the new laws, PBMs can no longer penalize pharmacists who share cost information with patients.

APhA was one of the groups invited to the White House for the bills’ signing.

“We applaud Congress for its efforts to increase transparency and target PBM practices that negatively affect patients,” said APhA CEO Tom Menighan, BSPharm, MBA, ScD. “It is not only good for patients, it is good for the health care system and promotes transparency.”

Menighan added, “For years pharmacists have been providing great care but have been prohibited due to contractual restrictions from sharing information on how patients might better navigate their prescription drug costs. This new law allows pharmacists to have those needed conversations with patients.”

Gag clauses went from unknown to infamous because of national scrutiny over rising drug prices for patients.

“It’s wrong that a person overpays for their medication simply because their pharmacist is not allowed to tell them they could pay a lower price with cash instead of insurance,” said Sen. Debbie Stabenow (D-MI).

The Know the Lowest Price Act (S. 2553), introduced by Sens. Stabenow and Susan Collins (R-ME), prohibits gag clauses in Medicare Advantage and Part D plans. The bill passed the U.S. Senate unanimously on September 7, 2018, and cleared the U.S. House of Representatives 2 weeks later.

"Who would think that using your debit card to buy your prescription drugs would be less expensive than using your insurance card? It's counterintuitive," Collins said in a press release. "Americans have the right to know which payment method provides the most savings when purchasing their prescription drugs."

The president also signed the Patient Right to Know Drug Prices Act (S. 2554), introduced by Sens. Collins and Claire McCaskill (D-MO), to end the potential use of gag clauses by employer-sponsored and health insurance exchange plans. The bill passed the Senate 98–2 on September 17. The House passed the bill on September 25.

“The signing of the gag clause bills is timely, since October is American Pharmacists Month,” Menighan said. “The theme is that pharmacists are ‘easy to reach and ready to help.’ With gag clauses prohibited, pharmacists can do even more to ensure patients are receiving the most appropriate medications as affordably as possible and do their utmost to provide patients with the best possible care.”