Hank Investigates: Prescription Copays

(WHDH) — You might be paying more than you have to for your prescription drugs and have no idea. Hank Phillippi Ryan reveals how asking one simple question could save you money at the pharmacy. 7 Investigates.

When you pick up your prescription at the drug store you may never worry about the price.

Hank: “How much is your copay?”
Man: “$25.”

Woman: “I believe it’s $15.”

You just figure your insurance copay’s gotta be the best deal.

Hank: “Do you think that copay is the lowest price could possibly pay?”
Woman: “Yes.”

But our investigation found that’s not always true! Because sometimes the actual price of the drug may be less than your copay.

Hank: “As a pharmacist, have you ever been in a position where someone pays too much?”
Brown: “Yes.”

For instance, say you’re buying Levothyroxine, a common thyroid medication, and your insurance copay is twenty dollars.
But without using your insurance, we found you can get a month’s supply for just $11.
That’s $9 cheaper!

And for the prescription steroid Prednisone, we found a month’s supply for $5.20.
That’s almost 15 dollars cheaper if you bypass insurance!

How often does it happen? In a recent Journal of the American Medical Association, researchers who studied millions of prescription payments estimated one in four times, customers who used insurance paid more than if they hadn’t.

Hank: “What do you think about that?”
Brown: “I think its a travesty.”

The head of the Massachusetts Independent Pharmacists Association, brave enough to talk about it, says it happens at some pharmacies across the state and the country. And he says in some cases the pharmacist is prohibited from telling you about it.

Hank: “So this is a secret your pharmacist is not allowed to tell you?”
Todd Brown, Executive Director, Massachusetts Independent Pharmacists Association: “Correct.”
Hank: “They can’t tell me?”
Brown: “Correct.”
Hank: “That I could be saving money? They’re not allowed to?”
Brown: “Correct.”

Why can’t some pharmacists tell you? The system is very complicated–but experts say its set up in such a way that some pharmacists could be penalized if they volunteer the information.

Brown: “They could be terminated from their network.”
Hank: “And what would happen then?
Brown: “Most likely a pharmacy would close.”

But there is something you can do! Although some pharmacists can’t volunteer the information, they can provide it.

Hank: “So If a customer asks you, then you can tell them?”
Brown: “Yes the pharmacist can tell them.”

In 14 other states there are rules against that pricing secrecy but not in Massachusetts. Some pharmacists who are angry about the practice are hoping Beacon Hill lawmakers will take action.

There is also a bill on Capitol Hill to outlaw prescription pricing secrets:

https://www.congress.gov/bill/115th-congress/senate-bill/2554/text

https://www.govtrack.us/congress/bills/115/s2554/summary

(Copyright (c) 2018 Sunbeam Television. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)