Calls intensified this week for the General Assembly to force more transparency from pharmacy middlemen accused of billing Ohio’s Medicaid managed-care plans for much more than they reimburse pharmacists (Source: “Ohio legislators hear support for bill seeking transparency in prescription pricing,” Columbus Dispatch, April 10, 2018).
Ten witnesses — cancer patients, representatives of national consumer groups and others — appeared before the House Government Accountability and Oversight Committee to testify in favor of House Bill 479, which would require that pharmacy customers be told about and receive the cash price for medicine whenever it’s cheaper than an insurance co-payment.
Ohio pharmacists have said that their contracts with pharmacy-benefit managers in some cases include clauses that prohibit them from telling customers that the cash price for drugs is cheaper than their co-payments.
The Ohio Department of Insurance ordered the PBMs last week to stop enforcing any gag rules. But Heather Free, pharmacy director for the nonprofit Equitas Health, told the committee on Tuesday that the legislation it’s considering remains essential “to ensure that PBMs do not engage in the harmful clawback practice.”
Pharmacy-benefit managers say they negotiate better prices from drugmakers and pharmacies than customers would otherwise receive.