Federal Law Changes Will Require Pharmacists To Share Cost Savings

Oct 23, 2018

A former Utah lawmaker and retired emergency room doctor, Brian Shiozawa, says federal legislation banning pharmacy gag clauses will lower the cost of prescriptions for American patients.

In December 2017 Shiozawa began work as U.S. Department of Health and Human Services Region 8 director overseeing intergovernmental and external affairs for Utah, Colorado, Wyoming, Montana, North Dakota and South Dakota.

On October 10, 2018, President Trump signed two bills, the Know the Lowest Price Act of 2018 and the Patient Right to Know Drug Prices Act. Shiozawa says the new laws allow the pharmacist to tell customers when they can save money on their medicine.

“But what this does, is it simplifies and makes it much more transparent, and just an effort to bring the cost down for the patient,” Shiozawa says.

The action, listed in the president’s drug pricing blueprint, ends pharmacy gag clauses that allowed health insurance companies and pharmacy benefit managers to keep information about the best deals on prescriptions drugs from patients. As of October 10, those gag order provisions are prohibited.

“Let the pharmacist sit down with the patients and say, you know, we have some generics or good alternatives that cost less. Or, just saying, look maybe you ought to just pay five bucks out of pocket, and they can talk to them about that,” he said.

Television and other advertisements about prescription products will include the price of the medicine to help consumers find the best deal.

“It will give us the right to understand how much we are paying. And before, they would just say this is what it costs.”

The new laws don’t require pharmacists to tell patients about lower cost options. If pharmacy workers don’t share the information voluntarily, it is up to the customer to ask for pricing information.  

And the law does not address how patients who pay the cash price outside their insurance plan can apply that expense toward meeting their policy’s deductible.