There’s an easy way to lower the cost of many prescription drugs — sometimes by a lot. And it doesn’t involve buying them online or traveling to Canada!
So, who knows just how to get that exact same med at a lower cost? It’s none other than the pharmacist standing on the other side of the counter.
Only… he can’t breathe a word about it!
It’s bad enough that so many of the drugs we’re prescribed are unnecessary or come along with some horrific risks. But now, it turns out that we could well be paying much more for them than we should be — whatever your copay is.
That’s because of a deep, dark secret – a plan devised to allow pharmacy benefit managers (that is, third-party administrators) to get a little extra from every Rx at our expense.
But by asking your pharmacist one simple question next time you need a prescription drug, you can put those “benefits” back in your pocket.
Don’t ask and they won’t tell
Talk about a gag order!
Pharmacists all over the U.S. are forced to remain silent even when they know an easy way you can save money when filling that Rx. And this big secret is simply by paying cash!
That’s right — your copay is often higher than what you would plunk down for a drug using your own money instead of your insurance plan. And most pharmacists would love to tell you about it, only… they can’t.
Very often, as part of their contracts, they’re prohibited from spilling the beans on that little detail. And guess who gets to pocket that extra money as payback?
It’s those pharmacy benefit managers, or PBMs. These are the middlemen who manage drug distribution and other aspects of health care plans between insurance companies and pharmacies.
So, why are we just now hearing about this kickback if it’s been going on for ages?
Complaints are now pouring in from all directions, including the White House Council of Economic Advisers, which used a recent scathing report to call out PBMs for exercising “undue market power” and generating “outsized profits for themselves.”
Wow! And it’s not like drugs aren’t expensive enough to begin with!
Not only that, but lawmakers in five states — Connecticut, Maine, Georgia, North Carolina, and North Dakota – have already passed statutes that either ban those provisions in a pharmacist’s contract or allow them to be ignored.
But the industry apparently knows no shame in its pursuit of profits.
The Pharmaceutical Care Management Association, the lobby for the companies that employ those PBMs, has actually filed a lawsuit in federal court to keep North Dakota from enforcing that ban.
While the CEO of that group claims that these gag clauses are rare, his counterpart at the association for pharmacists says that the practice is relatively common — that this “deception by omission” goes on all the time.
But now that you know about it, there’s no reason to put up with it any longer. If you must fill a prescription (especially if you don’t live in one of those states I mentioned), be sure and ask the pharmacist for two prices – one if you pay out of pocket and the other if you use your insurance.
And there’s one other thing you should always be asking. And that’s a question for your doctor about whether you really need that Rx med… or not. You might be very surprised by his answer.
Because you’ll definitely be saving the most money by not filling prescriptions that aren’t really necessary!
“Why your pharmacist can’t tell you that $20 prescription could cost only $8” Robert Pear, February 24, 2018, The New York Times, nytimes.com