Recent congressional action advanced two related bipartisan, bicameral bills from U.S. Sen. Susan Collins (R-ME) and U.S. Rep. Cathy McMorris Rodgers (R-WA) that would ban gag clauses, which prohibit pharmacists from informing customers when the cash price for a prescription costs less than it would under their health insurance cost-sharing plans.
The U.S. Senate on Sept. 17 voted 98-2 to pass the Patient Right to Know Drug Prices Act, S. 2554, introduced by Sen. Collins on March 14. In the U.S. House, Rep. McMorris Rodgers’ bill, the Know the Cost Act of 2018, H.R. 6733, received voice vote approval on Sept. 13 from the U.S. House Energy and Commerce Committee.
“Insurance is intended to save consumers money,” Sen. Collins said this week. “Gag clauses that prevent pharmacists from telling patients how to pay the lowest possible price for their prescription drugs do the opposite.”
Citing a recent study of 9.5 million insurance claims, the senator said 23 percent of customers overpaid for prescriptions when using their insurance. “Our bipartisan legislation to stop this egregious practice will help lower the cost of prescription drugs, saving consumers money and improving health care,” she said.
S. 2554 would prohibit health insurers and pharmacy benefit managers from using gag clauses in their contracts. Lead original cosponsor U.S. Sen. Claire McCaskill (D-MO) joined Sen. Collins in authoring and sponsoring S. 2554, which has more than two dozen other cosponsors. S. 2554 now heads to the House for consideration.
A separate and related bill, the Know the Lowest Price Act of 2018, S. 2553, from Sen. Collins and U.S. Sens. John Barrasso (R-WY), Bill Cassidy (R-LA), Ron Wyden (D-OR), and Debbie Stabenow (D-MI), would provide the same gag clause protection for patients covered by Medicare Advantage and Medicare Part D plans. S. 2553 received unanimous Senate approval earlier this month.
Rep. McMorris Rodgers, one of several original cosponsors of H.R. 6733, which was introduced on Sept. 7 by U.S. Rep. Earl “Buddy” Carter (R-GA), said approval of the bill by the House Energy and Commerce Committee allows for “an important step by banning rules that hide valuable information and decrease patient choice.”
“As prescription drugs costs continue to skyrocket, I am leading on solutions to bring transparency to drug pricing,” Rep. McMorris Rodgers said. “Patients should have access to this information so they can make informed decisions and help save money.”
H.R. 6733, which is also under consideration in the U.S. House Ways and Means Committee, has garnered support from several groups, including the American Medical Association.
Congresswoman McMorris Rodgers is also an original cosponsor of the Prescription Drug Price Transparency Act, H.R. 1316, which would require greater transparency from pharmacy benefit managers (PBMs) – the middlemen used by employers and federal programs to set consumer health plan prescription drug prices.
PBMs claim to provide cost savings via rebates to federal programs, however the lack of transparency around their operations makes it difficult to track such savings, according to a Sept. 17 statement from the lawmaker’s office, which said H.R. 1316 would change that by requiring greater transparency from PBMs.
H.R. 1316 has 56 cosponsors and is under consideration in four House committees.