Canton-area lawmaker targets pharmacy clawbacks

Canton-area lawmaker targets pharmacy clawbacks

CLEVELAND, OH (WOIO) - When we get medication from a pharmacist, we trust they're giving us a fair price, but, it turns out, your copay may be biting you in your wallet.

State Reps. Scott Lipps, R-Franklin, and Thomas West, D-Canton, proposed legislation, they hope, keeps pharmaceutical companies honest with customers by getting rid of clawbacks.

"We trust our pharmacies, we trust our healthcare professionals, and it's during the most vulnerable, you know, when we're ill, when we're walking in all we want to do is get better. We hand over our card and we don't think about the amount that's coming, we think about our copay," said West.

West said copays could be costing you because some drugs are actually cheaper than the $10 or $20 dollar copay.

"Every person that goes to the pharmacy takes our their insurance card and hands that over and there's a co-pay, but what they don't realize is that the drug may be cheaper if they didn't use their insurance card from the very beginning. Their co-pay is actually more than what the drug is itself," West said.

Instead of giving customers money back, it gets pocketed by pharmacy benefit management companies, or PBMs.

"They pretty much negotiate the prices and contracts with the pharmacies and the pharmaceutical companies," West said.

West said PBMs issue gag orders to keep pharmacists quiet about cheaper medications for their customers. It's a deceptive move, he wants to get rid of, which is why he introduced a bill Wednesday to stop it.

Cleveland 19 News asked West how people would know if they're overpaying for their medication. He said the information is kept by the PBMs and not made public.

Customers best bet is to ask their pharmacist what the cash price is for their medication without insurance, because it could be cheaper than their copay.

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