Pharmacists being prevented from telling customers about cheaper way to purchase prescriptions

Legislation being considered to stop pharmacist 'gag clauses'

DETROIT – Is your pharmacist being prevented from telling you the cheapest way to purchase your prescription?

Legislation is being considered that would stop the practice, called pharmacist "gag clauses," or conditions written into the contracts between insurance companies and pharmacies.

The clauses prevent pharmacists from telling customers if it would be cheaper to pay cash for medicine instead of using insurance and paying the copay.

A study by the University of Southern California found that 23 percent of prescriptions filled in 2013 charged patients copays that were higher than the cash price of their drugs.

By preventing pharmacists from telling customers about this information, insurance companies profit.

One of two bills to stop gag clauses is co-sponsored by Sen. Debbie Stabenow. She talked about the issue with Local 4 during a recent Facebook Live discussion.

"Pharmacists a number of months ago brought this to me," Stabenow said. "I took a look at it and I said, 'Oh my gosh. It's just really horrible.' I started asking people in my own family, in my own staff. They were going in and asking if they could get a better price from the pharmacist and found out that if you ask, the pharmacist can tell you."

Stabenow shared the experience of a Michigan senior citizen with cancer who couldn't afford his $200 copay.

"He left his medicine on the counter, went to walk out and then, of course, he panicked," Stabenow said. "He has cancer. He needs his medication. So he went back and said, 'What could I buy out of pocket?' Then the pharmacist could answer, and he said, 'Sir, you get this whole thing for $8.'"

The bills to ban pharmacist "gag clauses" have bipartisan support, and President Donald Trump has expressed his support as well.

Stabenow's bill received unanimous Senate approval earlier this month. Legislation could be voted on by the full House as early as next week.

In the meantime, customers should always ask pharmacists about the cost of drugs without insurance.


About the Authors

You can watch Kimberly Gill weekdays anchoring Local 4 News at 5 p.m., 6 p.m. and 11 p.m. and streaming live at 10 p.m. on Local 4+. She's an award-winning journalist who finally called Detroit home in 2014. Kim has won Regional Emmy Awards, and was part of the team that won the National Edward R. Murrow Award for Best Newscast in 2022.

Derick is the Lead Digital Editor for ClickOnDetroit and has been with Local 4 News since April 2013. Derick specializes in breaking news, crime and local sports.

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