CINCINNATI -- Pharmacists in Ohio have been under a "gag order" that prevented them from offering customers the lowest prices on prescription medication, according to the state Department of Insurance. That changed Wednesday, and the new policy could make a difference worth thousands of dollars each year for customers such as Amy Barron.
"I think it's awesome," Barron, who pays $1,400 each month for just one of her rheumatoid arthritis medications. "It's not right that patients are being charged an exorbitant amount of money for medications."
According to a release from the Department of Insurance, some insurers and pharmacy benefit managers have used tightly binding contracts to prevent pharmacists from telling patients about ways they could obtain their prescriptions at a lower cost.
"For example, if a consumer has a $20 co-pay for a prescription that only costs $10 if purchased without insurance, the consumer must be charged a lesser amount," department director Jillian Froment said in the release.
Although CVS Health Vice President David Palombi insisted to the Columbus Dispatch that CVS pharmacies did not engage in such practices, employees and a provider manual said otherwise. According to the manual, sharing "business practices and trade secrets," including about pricing, can be punished with a lawsuit.
Sarah Priestle, who works at Hart Pharmacy, can vouch for the existence and impact of the restrictions herself.
"I wish I could say I only saw it once or twice in the year it's been happening, but I would say I see it at least a couple times a month," she said.
Priestle added she often had to bite her tongue and overcharge customers because of insurer policies.
"It was frustrating for us as pharmacists," she said. "To go ahead and charge that person maybe three or four times the cost of what we know we wouldn't charge them if they paid cash. … It seems like (the change) should always have been the rule, but was not."