Rheumatoid Arthritis

Lawmakers take aim at PBM practices

One of the things that pharmacy benefit managers (PBMs) do is prohibit pharmacists from telling patients when they could save money by paying cash rather than using their insurance plan. In fact, according to a recent NBC Nightly News segment, pharmacists can be fined thousands of dollars for telling patients they can save money. According to the New York Times (as reported by the Dallas Morning News here) much of the difference between the lower “cash” price and the higher “insurance” price goes directly into the pockets of the PBMs.

Fortunately, state lawmakers are taking aim at these so-called “gag clauses,” helping ensure that patients are informed of the lowest price for a medication. The Alliance for Transparent and Affordable Prescriptions (ATAP) reported that Virginia is the latest state to have passed a bill addressing the PBM practices. Virginia’s HB 1177, currently waiting for the governor’s signature, ensures that…

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