Many Pharmacists Can’t Tell You About Lower Cost Options

Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8 New York Times

• “The clauses force the pharmacists to remain silent as, for example, a consumer pays $125 under her insurance plan for an influenza drug that would have cost $100 if purchased with cash.”
  • “Much of the difference often goes to the drug benefit managers.”

• Gag laws in most states

• “At least five states have adopted laws to make sure pharmacists can inform patients about less costly ways to obtain their medicines, and at least a dozen others are considering legislation to prohibit gag clauses… “

• “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.”

• North Dakota and a good law for consumers, but it being sued by Pharmaceutical Care Management Association,

  • “In North Dakota, a new law explicitly bans gag orders. It says that a pharmacy or pharmacist may provide information that “may include the cost and clinical efficacy of a more affordable alternative drug if one is available.”

  • “The North Dakota law also says that a pharmacy benefit manager or insurer may not charge a co-payment that exceeds the actual cost of a medication.”

  📄 Download the NYT PDF from VitaminDWiki

See also VitaminDWiki

• US Healthcare is 2X more expensive than in other countries - what can be done

See also web

• Pharmacy ‘Clawbacks’ Targeted in Latest State Law Aimed at PBMs July 2017, law passed in Connecticut
  • "Most patients never realize there’s a cheaper cash price because of clauses in contracts between pharmacies and PBMs that bar the drugstore from telling people there’s a cheaper way to pay."

• What Do Clawback Fees Mean for Pharmacies and Patients? iMedicare.com

• Search Google for clawbacks pharmacy 36,000 hits Feb 2018

Drug profit motives - personal note by Henry Lahore, Founder of VitaminDWiki

A few years ago I picked up 4 prescriptions for my father-in law.

One "prescription" was for a bottle of 12 aspirin,which cost $12 (325 mg = standard dose)

On the shelf at the drugstore was a bottle of aspirin costing $0.01 per pill

I suspect the pharmacist got about $4 for selling the "prescription"

I also suspect that the doctor was able to bill Medicare for making the prescription.