New York Estate Planning & Elder Law Blog
Having prescription drug coverage is extremely important to ensuring we get necessary, life-saving medications while also making sure we do not go bankrupt on impoverished it the process. However, using prescription drug insurance to buy medications does not always yield the best price for consumers and pharmacists know this but cannot always inform patients about the cost savings because they are contractually bound in one way or another to remain silent.
Congress recently passed a pair of bipartisan bills aimed at helping consumers get the best price on prescription drugs by prohibiting contractual obligations that require pharmacists to stay silent about how consumers may be able to save money. If signed into law, the the Patient Right to Know Drug Prices Act (S.2554) and the Know the Lowest Price Act (S. 2553) would remove barriers placed on pharmacists and allow them to volunteer information to help patients save money on vital prescriptions.
The Patient Right to Know Drug Prices Act (S.2554) would bar insurers and Pharmacy Benefit Managers (PBMs) from placing limits on a pharmacy’s ability to tell consumers when there is a difference between how much a patient would pay for a prescription with insurance compared to without it. The bill would apply to insurance plans offered through exchanges on the Affordable Care Act (ACA) and by those offered by private companies.
On the other hand, the Know the Lowest Price Act (S. 2553) would provide all of the same protections listed above but for Americans who are on plans like Medicare Advantage and Medicare Part D plans. Currently, pharmacists can respond directly to questions by consumers about their drug prices but cannot preempt such questions by proactively telling patients with Medicare about any benefits of purchasing drugs without Medicare coverage.
While consumers are legally allowed to ask their pharmacists about price comparisons, most of them do not know what questions to ask or to even inquire in the first place in order to save money. Many experts and advocates studying the issue on how to lower prescription drug prices champion the legislation as one of the tools the government can use to achieve these goals. Hopefully these two pieces of legislation will help remove the barriers that unfortunately exist because large drug companies with to legally prevent pharmacists from helping patients save their hard earned money.