Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8
Steven
F. Moore, whose family owns Condo Pharmacy in Plattsburgh, N.Y., said
the restrictions on pharmacists’ ability to discuss prices with patients
were “incredibly frustrating.”Mr.
Moore offered this example of how the pricing works: A consumer filling
a prescription for a drug to treat diabetes or high blood pressure may
owe $20 if he uses insurance coverage. By contrast, a consumer paying
cash might have to pay $8 to $15.Mark
Merritt, the president and chief executive of the Pharmaceutical Care
Management Association, which represents benefit managers, said he
agreed that consumers should pay the lower amount.As
for the use of gag clauses, he said: “It’s not condoned by the
industry. We don’t defend it. It has occurred on rare occasions, but
it’s an outlier practice that we oppose.”However,
Thomas E. Menighan, the chief executive of the American Pharmacists
Association, said that such clauses were “not an outlier,” but instead a
relatively common practice. Under many contracts, he said, “the
pharmacist cannot volunteer the fact that a medicine is less expensive
if you pay the cash price and we don’t run it through your health plan.”