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Today the House Energy and Commerce Committee approved a bill cosponsored by Congresswoman Debbie Dingell (MI-12) that bans the practice of prohibiting pharmacists from telling patients when less-expensive options to pay for prescription drugs may be available.

Currently, Pharmacy Benefit Managers (PBMs) are able to include requirements in contracts that prevent pharmacists from providing advice to their patients on the best and cheapest out-of-pocket alternatives to medications covered under insurance. This is commonly known as a "gag clause." As a result, patients may be paying more for their prescriptions than is warranted.

The Know the Cost Act, sponsored by Congressman Buddy Carter (R-GA) and cosponsored by Dingell, prohibits group health plans offered by employers and individual health insurance plans, as well as Medicare Advantage and Medicare Part D Plans, from restricting a pharmacy’s ability to inform a patient about the lower cost, out-of-pocket price options for their prescription. Additionally, the measure will require notifications to Medicare beneficiaries of the potential outcomes of paying out-of-pocket rather than with insurance.

“Prescription drugs cost too much for too many and unfortunately, many customers are paying more than they should when less expensive options are available,” said Dingell. “On a recent trip the pharmacy, I was informed the prescription would cost $1300. After calling the doctor, the pharmacist and others, we found an alternative that cost $30. People stop me every day with similar stories. Patients deserve to have all the information when picking up their prescriptions. Banning gag clauses is a good first step to making our healthcare system fairer and more affordable.”

The House is expected to consider the Know the Cost Act before the October recess. 

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