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Michigan pharmacists back move to ban 'gag clause'

Apr 1, 2018

Credit steve carmody / Michigan Radio

Michigan pharmacists are backing federal legislation to remove “gag clauses” that prevent them from telling customers how they can get their prescription drugs cheaper.

Many employer-sponsored health plans and insurance companies use “gag clauses” to prevent pharmacists from telling a patient they would be charged more for a drug under the patient’s plan than if the patient paid out-of-pocket.

“Usually where this ‘gag clause’ is a problem,” says Larry Wagenknecht, CEO of the Michigan Pharmacists Association, “is when a patient is taking a generic medication. So it’s lower cost. But because the co-pays are so high, it inflates the cost.”

Wagenknecht says these "gag clauses" are costing Michigan consumers millions of dollars a year. He says the money, instead of going to the pharmacist, is actually going back to the insurance company or the pharmacy benefit manager.”

U.S. Sen. Debbie Stabenow (D-Mich.) is part of the group of bipartisan members of Congress pushing a two-bill package. She’s optimistic, even in a divisive election year, the legislation can pass.

“We’re hoping that we can get support to at least say you can’t stop the pharmacist from telling you the best price at the counter,” says Stabenow.

In addition to the federal legislation, more than a dozen states have passed or are considering banning pharmacy “gag clauses."