The House of Representatives by a unanimous vote July 7 approved a measure that would stop pharmacy benefit managers from imposing "gag clauses" on pharmacists, which may prevent them from recommending less expensive alternative prescription drugs.

House Bill 943 now goes to the governor's desk for signature.

"Gag clauses" stem from language contained in some pharmacy contracts that disallows pharmacists from disclosing any information to their customers that could potentially reduce their out-of-pocket costs for medications.

State Rep. Valerie Gaydos, R-Allegheny, said HB 943 "would empower pharmacists to tell their customers everything they need to know in order to make an informed purchasing decision," Auditor General Eugene DePasquale in a statement applauded the legislation, whose main sponsor was Gaydos.

"As I've warned for years, gag clauses ultimately prevent pharmacists from giving customers practical advice on how to save money on their prescriptions," DePasquale said. "In some cases, consumers might save money by paying cash instead of using their insurance—but gag clauses stop pharmacists from volunteering that helpful advice unless a customer specifically asks."

DePasquale has produced two special reports on PBMs, which act as middlemen between drug manufacturers and pharmacists. PBMs hold considerable power over the marketplace: they set reimbursement rates for pharmacists, collect rebates from drug manufacturers and often decide which medications are covered by insurance.

Independent pharmacists have long complained that rules imposed by PBMs, some of which have business relationships with large chain pharmacies, have made it hard for them to compete. Pennsylvania Pharmacists Association data show that dozens of independent pharmacies in Pennsylvania closed or were sold in the past 18 months.

"When small pharmacies close, consumers pay the price," DePasquale said.