“Gag clauses” that forbid pharmacists from telling consumers when they could save money by paying cash instead of their insurance copay have been part of some contracts between pharmacies and the companies that manage prescription drug programs for insurance plans. The largest of these pharmacy benefit managers, or PBMs, insist that their contracts do not have gag clauses, and that their members are offered the lowest available price.
But contracts are considered proprietary legal documents, not to be made public. Even a contract template of Express Scripts, among the largest PBMs, with a plan sponsor was removed from the website of media organization Axios after the company complained of copyright infringement.
A typical pharmacist may deal with several different PBMs, each with different rules, and the uncertainty about gag clauses can contribute to fear of running afoul of a powerful corporation.
“Part of it is, we don’t know” what’s in the contracts, said Patricia Epple, CEO of the Pennsylvania Pharmacists Association. “All of it is done under the guise of, ‘This is proprietary information.’”
Eliminating gag rules is a small step toward price transparency that dozens of states are pursuing.
Drug price 'gag clauses' make your medicine more expensive. Now, they're under fire nationally
Time to shine some light in ......
But contracts are considered proprietary legal documents, not to be made public. Even a contract template of Express Scripts, among the largest PBMs, with a plan sponsor was removed from the website of media organization Axios after the company complained of copyright infringement.
A typical pharmacist may deal with several different PBMs, each with different rules, and the uncertainty about gag clauses can contribute to fear of running afoul of a powerful corporation.
“Part of it is, we don’t know” what’s in the contracts, said Patricia Epple, CEO of the Pennsylvania Pharmacists Association. “All of it is done under the guise of, ‘This is proprietary information.’”
Eliminating gag rules is a small step toward price transparency that dozens of states are pursuing.
Drug price 'gag clauses' make your medicine more expensive. Now, they're under fire nationally
Time to shine some light in ......