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House of Representatives
Session of 2019 - 2020 Regular Session


Posted: April 4, 2019 03:11 PM
From: Representative Valerie S. Gaydos
To: All House members
Subject: Prohibition of ‘Gag Clauses’ by PBMs
All our citizens deserve the right to know the lowest price available for their prescription drugs at pharmacies. In the near future, I will be introducing legislation permitting pharmacists to disclose to a patient prescription drug information that would allow the patient to get the best available price for medications.

When pharmacy benefit managers (PBMs) contract with pharmacies, the contracts may at times contain what is referred to as a “gag clause”, which prevents pharmacies from telling customers they can save money on a drug if they pay with cash instead of using their health insurance. Language essentially prohibits pharmacists from disclosing any information to their customers that could potentially reduce their out-of-pocket costs for medications. For instance, for many less expensive, generic medicines, co-pays can often be more expensive than if the patient simply pays out-of-pocket and bypasses insurance.

My legislation will ensure pharmacists have the right to provide an insured customer with information regarding the amount of the insured's cost share for a prescription drug and will also give pharmacists the right to share with elected officials data as well as concerns for their patients.

Pharmacists throughout the Commonwealth have been voicing their frustration about not being able to save customers money on their prescription drugs. I believe my legislation will help.

I hope you will join me in cosponsoring this important legislation.

Introduced as HB943