Ban “gag” clauses to make prescription drugs more transparent, affordable

One of the biggest challenges facing healthcare consumers today is the skyrocketing costs of prescription drugs. President Trump acknowledged the problem in his Inauguration address, saying, “One of my greatest priorities is to reduce the price of prescription drugs.” Bringing down the price of prescription drugs will help reduce medical costs for families, and Congress is working with President Trump’s administration to make progress and increase access to affordable healthcare.

In May, Congress approved legislation, and President Trump signed “Right to Try” into law, allowing terminally-ill patients, who have exhausted all other options and who are unable to participate in a clinical trial involving certain drug, the ability to access medications that are still in the investigational phase.

Another problem facing healthcare consumers are so-called “gag clauses,” which prevent pharmacies from telling customers – unless customers ask directly – the cash price for prescriptions, even when that price may be lower than their insurance co-pay. Under the current system, pharmacy benefit managers (PBMs) act as third-party middlemen to administer prescription drug portions of health insurance plans. PBMs negotiate how much out-of-pocket costs will be paid by consumers. In some cases, PBM contracts discourage pharmacists from proactively informing consumers that generic versions of their prescriptions drugs may be cheaper than their plan’s co-pay if purchased using cash instead.

I recently supported passage in the House of Representatives of S. 2553, the Know the Lowest Price Act, which is bipartisan legislation to prohibit a health-benefits plan or PBM under Medicare or Medicare Advantage from restricting a pharmacy from informing any enrollee of differences between the price of a drug under the plan and the price of the drug without health insurance coverage. The House also passed S. 2554, the Patient Right to Know Drug Prices Act, which prohibits the use of gag clauses.

I cosponsored H.R. 1316, the Prescription Drug Price Transparency Act, which would require greater transparency regarding bureaucratic PBM practices and fees that increase the price of prescriptions.

The Trump administration has pointed out that the “lack of transparency in drug pricing benefits special interests and prevents patients from being able to make fully informed decisions about their care.” I agree that prescription drug consumers should not be left in the dark. Patients should be informed of the cheapest price for prescriptions, and I will continue working with colleagues in Congress to enact legislation to help consumers.