Prescription Drugs – Eliminating Pharmacy Benefit Manager (PBM) Gag Clauses
WHEREAS, to protect our lives and well-being, every family in America requires access to affordable prescription drugs. Many people are concerned about the high cost of drugs and are being forced to make tradeoffs between paying for their prescription drugs and buying food or paying rent; and
WHEREAS, according to the Centers for Disease Control and Prevention (CDC), African Americans are more likely to die at earlier ages from all diseases. African Americans ages 18-49 are twiceas likely to die from heart disease as whites. African Americans ages 35-64 years are 50%more likely to have high blood pressure than whites; and
WHEREAS, skyrocketing costs are making some medicines virtually inaccessible to our families and neighbors. Overall drug prices increased almost 9% in 2016, while general inflation increased just over 2% in the same period. Moreover, since 2013 drug prices have risen an average of 10% annually, but inflation has only increased 1.2% on average; and
WHEREAS, prescription drug spending accounted for over 22% of each health insurance premium dollar in 2014, and nearly a quarter of people in their deductible period never picked up their prescriptions from the pharmacy, presumably because of the cost. For many people, out-of-pocket prescription costs are a matter of life and death. Studies on cancer patients show that the higher a patient's out-of-pocket spending, the less likely the patient is to fill her prescription. Patients who do not fill their prescriptions become sicker and require more intense care, which ultimately drives up total health spending; and
WHEREAS, most people pay for health insurance to reduce their out-of-pocket medical expenses. With most health insurance plans, patients are responsible for a co-pay. Typical co-pays run somewhere between $10 and $25 per prescription. With some prescriptions, a co-pay exceeds the actual price of a medication. Many generic drugs can cost just $5 per month; and
WHEREAS, unless patients specifically request information about alternative pricing, "gag rules" compel pharmacists to remain silent. There are Pharmacy Benefit Managers (PBM) who reportedly ban pharmacists from discussing lower-priced drug choices with their patients. If pharmacists violate the rules, they could be fired, cut from drug-distribution networks, or face other penalties; and
WHEREAS, it is up to states legislatures to prohibit gag rules. Connecticut, Georgia, Maine, North Carolina, and most recently Maryland, have already banned these gag clauses; and
WHEREAS, blocking the "gag clauses" that prohibit pharmacists from telling patients that they could save money by paying for their prescription rather than using their health insurance would help make prescription drugs more affordable.
THEREFORE, BE IT RESOLVED that the NAACP supports eliminating the Pharmacy Benefit Manager (PBM) gag clauses; and
BE IT FINALLY RESOLVED that the NAACP will urge all of its Units to work to enact legislation that prohibits a PBM from preventing a pharmacy or pharmacist from providing customers with information to permit them to reduce the out-of-pocket cost for a prescription drug.