House OKs bill to let pharmacists offer lowest price

(Update: Adding Walden statement)

Rep. Greg Walden, R-Ore., led the House passage Tuesday of two bipartisan bills that aim to lower drug costs and give patients more control over their health care.

With Walden’s support, the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act passed the House unanimously after being passed in the Senate last week.

These bills will ban the use of so-called “gag clauses,” which restrict a pharmacist’s ability to inform a patient that their drug would be cheaper if they paid out of pocket than if they paid through their insurance. While there is already a regulation on this practice in Medicare Part D, this legislation if signed into law will end the practice across Medicare Advantage Prescription Drug Plans, Medicare Part D, and group and individual health insurance.

Walden said Tuesday the legislation marks an important step forward to end this troubling practice of limiting information disclosed to patients, which he first heard about from an Oregon pharmacist.

“I rise in support of two bills that will bring some much-needed transparency into the drug supply chain, and help patients afford the medicines they need,” Walden said in a speech on the House floor.

“I first heard about the gag clause issue from Michele, an independent pharmacist from Grants Pass, Oregon, in my district. She told me that as a pharmacist she was precluded — under certain insurance contracts — from telling a patient that their cash price would be cheaper than going through their insurance. Michele told me that she once even received a cease and desist letter for trying to help a child with a terminal disease access his medication. That is simply unacceptable.”

Michele Belcher, owner and pharmacist at Grants Pass Pharmacy, said earlier this month that gag clauses prevent pharmacists from fully disclosing pricing options to patients and need to be banned.

“Gag clauses are an unnecessary restriction on our ability as pharmacists to communicate with our patients,” said Belcher. “That should never happen. I applaud Representative Walden for taking this issue on.”

On Sept. 13, the House Energy and Commerce Committee — where Walden serves as Chairman — unanimously advanced a combined version of these two bills to the full House of Representatives for consideration.

Both pieces of legislation that passed in the House today now head to the President’s desk to be signed into law. To read more about the Patient Right to Know Drug Prices Act, please click here. To read more about the Know the Lowest Price Act, please click here.

Senator Ron Wyden, D-Ore., on Tuesday applauded congressional passage of a bill that cracks down on pharmacy benefit manager practices restricting consumers’ ability to get the lowest possible price on their prescriptions.

The bill, called the “Know the Lowest Price Act,” cleared the House of Representatives and now goes to the president’s desk for signature.

“I’m glad Oregonians will be able to find out if they can get a better deal on their prescriptions,”Wyden said. “Before this bill, drug middlemen placed artificial barriers on pharmacists so they couldn’t tell their customers if it was cheaper to pay out of pocket than with their insurance. Stopping this outrageous practice is an important step, but there’s more work to be done to lower prices and fix America’s broken drug system.”

Many customers have no idea that they could pay less for their prescription if they pay out of pocket rather than using their insurance at the pharmacy counter. 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. And many pharmacists are frustrated that they can’t help their customers save money.

The “Know the Lowest Price Act” cracks down on this practice by prohibiting Medicare Part D plans from restricting a pharmacy’s ability to provide drug price information to seniors when there is a difference between the cost of the drug under the plan and the cost of the drug when purchased without insurance.

Congress also cleared a similar bill Tuesday that would extend this ban on pharmacy gag clauses to individual and employer-sponsored insurance as well.