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About the author: Toneth Sang recently completed her first year at the UNC Eshelman School of Pharmacy.

Drug prices in the United States (US) far exceed that of other industrialized nations. For instance, the price of the top 20 highest-revenue grossing drugs is three time more expensive in the US compared to the United Kingdom (UK). So, reducing drug prices has become a major priority for many legislators, prompting new efforts to pass bills that would make prescription medications more affordable at the counter.

Quite surprisingly, some prescription drugs have a lower patient copay when paid out of pocket than when billed through insurance. For example, a drug that costs $100 through health insurance could only cost $75 if a customer paid in cash. However, some customers wouldn’t know this because of “gag clauses” that contractually prohibit pharmacists from disclosing cheaper cash drug prices to customer and from discussing cheaper alternative therapies with customers. Pharmacists have historically played an important role in helping patients to understand the costs of their available treatment options; however, some pharmacists have been denied this opportunity due to these policies.

The new excitement around gag clauses has spurred even state legislators to pass bills prohibiting the clauses. North Carolina, in particular, passed two bills (H 466 and S 384) that allow pharmacists to discuss cheaper alternatives with customers without being fined. The Patient Right to Know Drug Prices Act and the Know the Lowest Price Act are two bipartisan bills that were passed to illegalize the gag clause, with hopes of reducing out-of-pocket costs for some patients. Under this law, however, pharmacists are not mandated to disclose drug prices so it is up to the customer to ask about alternatives. This may still be problematic because many customers are unaware of this clause and would not think to ask about cheaper options.

Although banning the gag clause is a much-needed step toward reducing drug prices, it is not sufficient to fully address the issue of high patient drug spend. America remains the top spender per capita on pharmaceutical products compared to nine other high-income countries. In acknowledgement of this, President Trump put forth a blueprint for reducing drug cost. The blueprint discusses numerous ways the government plans on tackling the issue.

Since the publication of the blueprint, the FDA has approved more generics and biosimilars and some big pharmaceutical companies have halted steep price increases for some drugs. Although promising, the journey to reducing drug costs still has a long way to go and more obstacles to overcome. As long as the topic remains in the headlines, the pressure to improve drug prices will cause more positive outcomes for patients and society as a whole.

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