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S.2553 - Know the Lowest Price Act

Senator Debbie Stabenow speaking at the Senate floor.

A bill to amend title XVIII of the Social Security Act to prohibit Medicare part D plans from restricting pharmacies from informing individuals regarding the prices for certain drugs and biologicals.

You might favor this bill if:
►  You believe that pharmacists should not have to adhere to certain gag clauses which prevent them from telling customers that they could pay less for their prescription if they pay out-of-pocket.

You might oppose this bill if:
►  You believe pharmaceutical companies have the right to ask pharmacists to not disclose to their customers if their prescription would be lower if paid out-of-pocket rather than using a health-care provider.

The Know the Lowest Price Act would crack down on gag clauses that stop pharmacists from telling customers that they could pay less for their prescription if they pay out of pocket. It does so by prohibiting Medicare Part D Plans from restricting a pharmacy’s ability to provide drug price information when there is a difference between the cost of the drug under the plan and the cost of the drug when purchased without insurance.

Many customers have no idea that they could pay less for their prescription if they pay out of pocket rather than using their insurance at the pharmacy counter. That’s because many pharmacists are prohibited from telling their customers that a prescription to treat diabetes or high blood pressure may cost only $8 out of pocket instead of $20 through insurance coverage. A 2018 report found that customers overpaid for prescription drugs at the pharmacy counter 23% of the time.

The bill would apply to plan years beginning on or after January 1, 2020.

"It’s wrong that a person overpays for their medication simply because their pharmacist is not allowed to tell them they could pay a lower price with cash instead of insurance," said sponsor of the bill Senator Stabenow. “My bill bans this outrageous practice and takes an important step toward lowering the skyrocketing prices of prescription drugs.”

"Michigan pharmacists are active members of the community and are committed to providing quality care to our patients and their families," said Larry Wagenknecht, CEO of the Michigan Pharmacists Association. "With passage of Senator Stabenow's Know the Lowest Price Act, pharmacists will be able to help their patients pay less for the prescriptions they need."

“I can’t tell you how frustrated these pharmacists were that they were unable to give that information to their customers, who they knew were struggling to pay a high co-pay,” Senator Susan Collins said.

According to a New York Times article, the lobby for drug benefit companies, the Pharmaceutical Care Management Association, has filed suit in federal court fighting state laws that have already passed "gag order bans," with the excuse that these laws could expose “proprietary trade secrets,” including information about how drug prices are set.

This legislation would ban these gag orders at a federal level.

The legislation passed the Senate on 09/04/18 by unanimous consent and has been received in the House committees on Energy and Commerce, and in addition to the Committee on Ways and Means.


Sponsored by: Sen. Stabenow, Debbie [D-MI].

Cosponsored by: 7 Rep / 6 Dem.

See list of cosponsors.

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