A bipartisan pro-transparency bill for pharmaceutical drug prices offered by U.S. Sens. Susan Collins (R-ME) and Bill Cassidy (R-LA) received unanimous consent Sept. 4 from the U.S. Senate, which sent the legislation to the U.S. House for consideration.
“Passing this bill and eliminating gag clauses gives patients more power to lower their health care costs,” said Sen. Cassidy, a medical doctor. “It makes prices transparent so patients can save money with less expensive prescriptions.”
The Know the Lowest Price Act of 2018, S. 2553, would prohibit a health-benefits plan or pharmacy-benefits manager under Medicare or Medicare Advantage from restricting a pharmacy from informing an enrollee of any difference between the price of a drug under the plan and the price of the drug without health-insurance coverage, according to the congressional record summary.
S. 2553 includes provisions from Sen. Cassidy’s May 29 white paper, Ideas to Make Health Care Affordable Again, that address gag clauses and decreasing patient drug costs.
“Families and patients have seen their health insurance premiums and the cost of care go up year after year. It’s unaffordable and unsustainable, and things aren’t going to get better until we change our broken system,” the senator said when releasing the nine-page paper in May.
“I’m focused on lowering health care costs because we have to make health care affordable again,” he said. “That’s what these ideas I’m outlining are intended to do.”
Sens. Cassidy and Collins are original cosponsors of S. 2553, introduced on March 14 by U.S. Sen. Debbie Stabenow (D-MI). U.S. Sen. Deb Fischer (R-NE) is among the other 11 cosponsors of S. 2553.
“Americans spend an estimated $340 billion on prescription drugs each year, including a staggering $45 billion out-of-pocket,” Sen. Collins wrote in an Aug. 3 column posted on her website. “Because of this enormous expense, one out of five Americans do not fill a prescription because they are unable to afford it.”
Upon learning about gag clauses earlier this year, Sen. Collins wrote that they have resulted in some patients paying double, triple or higher for prescription drugs.
“In fact, in 2013 alone, consumers overpaid an estimated $135 million due to gag clauses,” wrote Sen. Collins. “Many pharmacists express frustration that they are unable to disclose this information unless their customers ask.
“How can it be that an insurance company’s prescription benefit manager, whose very job is to negotiate prices, is negotiating a price that may actually be higher than the consumer would pay out of pocket?” she asked.