PBM ‘gag clauses’ under fire in newly introduced Senate bills – Drug for nerve pain boosts high for opioid abusers.

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PBM ‘gag clauses’ under fire in newly introduced Senate bills – Drug for nerve pain boosts high for opioid abusers. (866) 348-2889

A bipartisan group of U.S. senators introduced legislation on Wednesday, March 14, that would prohibit PBMs from imposing “gag clauses” in pharmacy contracts that bar pharmacists from telling patients when the out-of-pocket cost of drugs is less than the copay through their insurance. If pharmacists violate the gag clauses, PBMs may end the contracts or otherwise impose penalties—a practice widely criticized for inhibiting price transparency and contributing to rising health care costs for patients. APhA supports the bills.

“APhA believes this legislation will empower pharmacists to increase patients’ access to information and affordable and cost-effective medications,” said APhA CEO Tom Menighan, BSPharm, MBA, ScD. “We greatly appreciate the sponsors’ taking action to help our patients.”

Sens. Debbie Stabenow (D-MI), Susan Collins (R-ME), Ron Wyden (D-OR), and Bill Cassidy (R-LA) introduced the Know the Lowest Price Act (S. 2553), which would prohibit Part D plan sponsors’ and contracted PBMs’ restrictions barring pharmacies from informing individuals on drug prices. The bill was written after discussions with pharmacists, who expressed frustration with their inability to help patients struggling with high copayments.

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