N.O. lawmaker seeks to end gag order on pharmacists about "claw-backs"

(WVUE) - Many people cannot do without prescription drugs whey they're sick. And now a state lawmaker wants to free pharmacists to tell customers about ways to avoid that.

In his "Medical Waste" investigations, FOX 8's Lee Zurik exposed how some patients pay more than they need to at pharmacies due to a practice called "claw-backs."

"There are some groups that contract with pharmacies who regulate medications on behalf of insurance companies, and it's been found nationally that woven into these contracts are essentially these gag orders that prevent a pharmacist that if he knows that a patient is going to purchase some medication and that it would be cheaper just to pay cash than to pay the co-pay, they are prohibited from telling the patient which is the cheaper option," said Sen. J.P. Morrell, D-New Orleans.

Claw-backs involve companies netting, or "clawing back," money from insured consumers when they pay co-pays that exceed the actual costs of a particular drug to their insurance company, or pharmacy benefit manager.

"What this bill seeks to do is say you can't do that. A pharmacist is going to be in front of a patient, he will see the pricing on the item and can tell that patient what is most affordable for them to do. That's what the bill does," said Morrell, talking about of SB 241 before the Senate Health and Welfare Committee.

The head of a pharmacy group agrees that more should be done at the state level.

"This issue of claw-backs and co-pays being more than a pharmacist is getting paid for a drug is something that Arkansas and Louisiana addressed two years ago in a bill that Sen. Johns and Sen. Mills authored that would have prohibited the claw-backs. ...While  that prohibited the claw-backs and it gave the pharmacist the ability to not have that claw-back, it didn't give them the opportunity to in some of these contracts share that information with the patient," said Randal Johnson, President and CEO of the Louisiana Independent Pharmacies Association.

Morrell said patients deserve to save money on prescriptions when possible.

"On average, this interaction or lack of interaction with pharmacists on average costs patients actually about 23% increased cost on drugs. The average savings with a bill like this in existence is probably about $7 or $8 on a typical prescription," he said.

"Do you see any fallout from that, other than people are getting more for their money?" asked Sen. Dan Claitor, R-Baton Rouge.

Morrell said in response, "It might hurt the profit margin of prescription, you know, benefit managers, but otherwise it should be okay."

Copyright 2018 WVUE. All rights reserved.