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Pharmacists Deserve Free Speech Too (Editorial)

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Editor Gwen Moritz’ story on pharmacy benefit managers is a must-read for anyone who cares — or should care — about this nation’s astronomical health care costs. Everybody, in other words.

It’s a complex topic but it’s hard not to conclude that the people setting up this byzantine system for reimbursing pharmacists the cost of the drugs they dispense deliberately worked to make it complex. In the U.S., complexity is often the enemy of reform, particularly when the first step in health care reform would be to make health care costs transparent.

Exhibit A in our case that PBMs deliberately seek to conceal the costs of pharmaceuticals is the “gag clause.” This is the language in PBMs’ contracts with pharmacists that prohibits them from notifying customers, for example, that a particular generic drug might be cheaper than the patient’s insurance copayment. A customer can ask, but “pharmacists can’t volunteer that information, which would cut the insurance company and PBM out of the transaction.”

The Arkansas Pharmacy Benefits Manager Licensure Act, to be considered by the state Legislature this week, would authorize the state Insurance Department to license and regulate PBMs. The proposal would also make gag clauses illegal, allowing pharmacists to give important information on costs to consumers.

In addition, the measure would forbid gag clauses that prevent pharmacists from sharing information with the state and federal government, so “they can make complaints to government officials without losing their contracts,” state Rep. Michelle Gray told Moritz.

We ask legislators to approve the Arkansas Pharmacy Benefits Manager Licensure Act to rein in these secretive middlemen who have worked to obscure the price of pharmaceuticals and to return to pharmacists in Arkansas the free speech rights denied them by PBMs.

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