According to a 2013 study published in JAMA in March, people with Medicare Part D drug insurance unknowingly overpaid for prescriptions by $135 million. Copays in those plans were higher than the cash price for nearly 25% of drugs purchased. Patients overpaid by more than 33% for 12 of the 20 most commonly prescribed drugs.
President Trump recently signed two bills passed by Congress with broad bipartisan support, “Know the Lowest Price Act of 2018” (for Medicare and Medicare Advantage beneficiaries) and “Patient Right to Know Drug Prices Act” (for commercial employer-based and individual policies).
When the cash price for a prescription is less than what you would pay using your insurance plan, pharmacists may no longer be required to keep that a secret. In the past, pharmacists could have been fined for violating their contracts with pharmacy benefit managers and even dropped from insurance networks for disclosing cheaper drug options to consumers. There is a catch, though: pharmacists will be permitted, but not required, to tell patients about lower-cost options. It’s up to the customer to ask.
