Troubleshooters: Pharmacist Gag Rule

Nydia Han Image
Monday, May 21, 2018
Troubleshooters: Pharmacist Gag Rule
Troubleshooters: Pharmacist Gag Rule. Nydia Han reports during Action News at 12:30 p.m. on May 20, 2018.

PHILADELPHIA (WPVI) -- Action News Troubleshooter Nydia Han is exposing a disturbing practice in the pharmaceutical world.[br /][br /]It's a rule that gags your pharmacist from providing you money-saving options.[br /][Ads /][br /]It's a hard pill to swallow, the reality that your pharmacist is forbidden from helping you save money on your medication.[br /][br /]When you pay for a prescription, you might be like Michael Dugan.[br /][br /]"Always use my insurance," he said.[br /][br /]But these three words, Pharmacist Gag Rule, might have you paying cash instead.[br /][br /]"I have never heard of this gag rule," Dugan said.[br /][br /]Most consumers haven't, so here's what you need to know: The Gag Rule is a clause written into contracts between pharmacists and PBMs, pharmacy benefit managers.[br /][br /]"These people are outsourced by the insurance companies to handle their prescription programs," said Mel Brodsky.[br /][br /]The rule forbids pharmacists from telling customers they could save money by paying out-of-pocket instead of using their insurance.[br /][br /]"This is really frustrating," Dugan said.[br /][br /]Brodsky leads an association for local pharmacists.[br /][br /]"It's not fair to anybody," he said.[br /][br /]Brodsky says PBMs enacted the Gag Rule out of greed because they pocket the difference between the insurance copay and the cash price.[br /][Ads /][br /]He also says PBMs drive up the cost of medication overall.[br /][br /]"Their CEOs make between 15 and 20 million dollars a year. There's a lot of money that the middlemen are taking," said Brodsky.[br /][br /]The PBM association claims it supports patients paying the lowest price, and opposes the Gag Rule.[br /][br /]But many states are making pharmacist gag rules illegal. In two years, at least 21 states have passed laws prohibiting them.[br /][br /]"It's a really disturbing practice," said Senator Sharif Street. He has co-sponsored legislation to ban pharmacist gag rules in Pennsylvania.[br /][br /]President Trump says his new federal plan would do the same.[br /][br /]Meantime, there are a couple simple things you can do to get around this practice.[br /][br /]"They can go online they can check a drug price and see what it's going to be at a pharmacy in their location, said Shawn Ohri of WellRx.[br /][br /]You can search on free websites like [url HREF="https://www.wellrx.com/" TARGET="blank" REL=""]WellRX[/url] and [url HREF="https://www.goodrx.com/" TARGET="blank" REL=""]GoodRX[/url]. They provide consumers cards or coupons for the prices they show, which include special discounts.[br /][br /]"Using a tool like WellRX, you can come in with a price and information and hand it to the pharmacist, added Ohri.[br /][Ads /][br /]And here's a really simple thing you can do: Just ask. Ask your pharmacist what the cash price is. The pharmacist can't volunteer the information but if you ask, the pharmacist is allowed to answer.[br /][br /]This is part of our continuing effort to create transparency in health care and save you money through [b][url HREF="http://6abc.com/healthcosts/" TARGET="blank" REL=""]Philly Health Costs, our partnership with the Philadelphia Inquirer[/url].[/b][br /][br /][url HREF="http://www.kpparx.com/" TARGET="" REL=""][br /]PARD - an Association of Community Pharmacists[/url][br /][br /][url HREF="https://www.pcmanet.org/" TARGET="" REL=""][br /]Pharmaceutical Care Management Association[/url][br /][br /][url HREF="http://www.legis.state.pa.us/CFDOCS/Legis/PN/Public/btCheck.cfm?txtType=PDF&sessYr=2017&sessInd=0&billBody=S&billTyp=B&billNbr=0637&pn=1388" TARGET="" REL=""]PA Senate Bill 637[/url][br /][br /][url HREF="http://www.ncsl.org/Portals/1/Documents/Health/Pharmacist_Gag_clauses-2018-14523.pdf" TARGET="" REL=""]Prescription Drug Resource Center - Gag Rule[/url][br /][br /][url HREF="http://money.cnn.com/2018/05/10/news/economy/drug-prices-trump-speech/index.html[br /]" TARGET="" REL=""]President Trump's plan for drug prices[/url][br /][br /]-----[br /][br /][b][url HREF="http://6abc.cm/2BucH0r" TARGET="blank" REL=""]Send a News Tip to Action News[/url][/b] [br /] [b][url HREF="http://6abc.cm/2Gcv09s" TARGET="blank" REL=""]Learn More About 6abc Apps[/url][/b]