Thanks to a new federal law—the Patient Right to Know Drug Prices Act—your pharmacist is allowed to tell you how you might save money when filling your prescriptions.
As crazy as it sounds, before this law, many pharmacists were prevented from sharing this information with customers because of gag clauses in agreements between their pharmacies and pharmacy benefit managers (PBM). A PBM is the middleman that administers prescription drug programs for insurance companies.
It turns out that in some cases a prescription drug would be cheaper for customers if they paid out of their own pockets instead of using their insurance benefits. However, they had no way of knowing that because a pharmacist couldn’t tell them.
According to an NBC News investigation in 2017, that often resulted in customers being charged a copay that was more expensive than the pharmacy’s cash price for the prescription.
Now, pharmacists can tell you the price difference and it might save you a bundle. For instance, a pharmacist interviewed by NBC News reported a case in which a customer had a $129 insurance copay for an anti-nausea drug while the cash price was $18; another reported a $117 difference between the copay and cash price for an allergy and asthma prevention drug.
Every health insurance plan is different, so your savings might not be so dramatic. Of course, the most important thing to remember is that pharmacists are now allowed—but not required—to share your price options with you. So always ask. Being an informed health care consumer might just keep more money in your pocket.