Pharmacy Gag Clauses

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11 thoughts on “Pharmacy Gag Clauses”

  1. 5

    The Senate will certainly not act before the massive fundraising efforts for the upcoming election have ended.

  2. 4

    Why don’t you ask McConnel why he wants to dump care. Is it because my state pays millions to subsidize his constituents. How much does your state pay. Why there isn’t an infomercial about this is really a question of why?
    Are you on K Street? I sure hope so this ought to be fun!

    2. 3.2

      That’s not actually what this is about. Say you have health insurance with a prescription drug plan that says every prescription has a $20 co-pay. You go to the pharmacy, pull out your card, pay $20 and take your drug home.

      What if your drug is an older standard medication that costs only $8? Tough luck, you still pay $20. The “gag clause” in the pharmacy’s contract with the pharmacy benefit management company prevents your pharmacist from telling you that you could save money by simply paying cash for your prescription instead of using your health insurance.

      What a racket.

      1. 3.2.1

        Just for the sake of completeness: I don’t think these “gag clauses” prevent the pharmacist from responding to a question from a patient/customer about the cost of “paying cash” for the medicine.

    1. 2.1

      Singular,

      Before you cast stones, you may want to step out of your glass house (and realize that merely asking a pharmacist yourself will not give you what you think that you will get because of the gag limitations in play).

      1. 2.1.1

        In addition to MM’s comment about asking about the cash price, it’s also possible to ask if a contractual “gag” agreement prevents the person from answering the question (and following up from there).

        As a practical matter, I don’t see this “dual pricing” applying to community pharmacies, at least when I’m paying $1.45 for month’s worth of bid Rx. The large chains may be different, however.

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