Can pharmacists tell patients when it’s cheaper to pay cash for a prescription than to use insurance?
In some cases, prescription drugs are cheaper if paid for directly in cash rather than through insurance coverage, which typically requires a copayment by the insured party and uses prices negotiated by the insurer. In 2018, Congress passed two new laws making sure pharmacists could tell patients about available cost savings, one covering pharmacy practices and another covering prescription drug plans under Medicare or Medicaid. They took effect at the start of 2020.
For years, some pharmacists had been contractually prohibited from telling patients about any cost-saving loopholes. A study published in the American Medical Association journal found that total overpayments due to what has often been referred to as the “gag rule” were $135 million in 2013.
