The rising cost of pharmaceuticals has Americans on edge. So, to find out that there are “gag clauses” prohibiting pharmacists from telling customers about cheaper options is beyond the pale.
These “gag clauses” are enough to make you do just that. They prohibit pharmacists from telling customers that they could save money by paying cash as opposed to using their insurance cards. The New York Times uses the example of a consumer who pays $125 under her insurance plan for an influenza drug that would have cost $100 if purchased with cash. The pharmacist cannot alert the consumer. It’s just wrong.
Most of the difference often goes to the drug benefit managers. This is highway robbery of a different kind, but that all the same.
Federal and state officials have responded, with at least five states adopting laws that allow pharmacists to let the customers know when a better deal is to be had by paying cash, as one savings example. At least a dozen other states are considering legislation to prohibit gag clauses, the Times reported, citing the National Conference of State Legislatures.
Gag clauses are frustrating. Even Alex M. Azar II, the new secretary of health and human services, once a top executive at the drugmaker Eli Lilly for 10 years, expressed concern in the article. “That shouldn’t be happening,” Azar said.
He’s right. It should never happen. Americans are already saddled with increasingly higher drug costs, often times with no rhyme or reason other than pure profit. But it comes at the expense of people who have no choice. The examples have become rife.
Remember the controversy over the skyrocketing price of the EpiPen, once priced as high as $600 for a pack of two? There are plenty other examples.
Who could forget Martin Shkreli, known as “Pharma Bro,” whose Turing Pharmaceuticals bought the U.S. rights to sell Daraprim, a lifesaving medication, and then raised the price from $13.50 to $750 per pill. His answer? It is a capitalist society and his company needed to maximize profits.
Among some other notorious escapades, including getting his bail revoked for putting a $5,000 bounty on a strand of Hillary Clinton’s hair, Shkreli awaits his March 9 sentencing for crimes a judge ruled caused a loss of $10.4 million for investors.
The Times recently wrote about Teva Pharmaceuticals’ announcement that it would sell a copy of Syprine, which treats a rare condition known as Wilson disease. Valeant Pharmaceuticals International had raised the drug price to $21,267 in 2015 from $652 five short years earlier. Teva’s new generic version will hardly made a dent in pricing at $18,375 for a bottle of 100 pills, according to the Times which cited the Elsevier Gold Standard Drug Database.
Someone needs to be looking out for the people who need these drugs. In this case, states that are seeking to abolish the gag rules are on the right track. Clients should at least know when they’re at risk of being gouged.
Pharmacy benefit managers contend that they negotiate for better prices with drug manufacturers and retail drugstores. That may be true, but the end result is not always favorable to the consumer. According to the Times, a White House Council of Economic Advisers report cited large pharmacy benefit managers as exercising undue market power and generating “outsized profits for themselves.”
Consumers attempting to remain healthy should not be responsible for fattening the pockets of an industry that has gone awry when it comes to pricing.