The House of Representatives approved two “gag clause” bills on September 25, 2018 that would prevent insurers from restricting pharmacies from informing consumers about lower cost, out-of-pocket prices for their prescriptions. The bills were approved by the Senate earlier this month, and are now cleared for the President’s signature.
Specifically, S 2553, the Know the Lowest Price Act of 2018, would prohibit a Medicare Part D or Medicare Advantage prescription drug plan from restricting a pharmacy from informing (or penalize for informing) an enrollee of any differential between the negotiated price of, or copayment or coinsurance for, a drug or biological under the plan and a lower price that would be paid without using health insurance coverage. S 2554, the Patient Right to Know Drug Prices Act, would extend a similar prohibition on sharing drug pricing information to group health plans and health insurance issuers offering group or individual health insurance coverage, along with entities that provide pharmacy benefits management services for such plans/issuers. Furthermore, S 2554 would extend current requirements for generic and brand pharmaceutical companies to submit patent settlement agreements to the Federal Trade Commission and the Justice Department to extend to settlement agreements between manufacturers of biologics and biosimilar biological products.
President Trump has indicated his support for the legislation.