Story highlights "Gag rules" may be keeping your pharmacist from telling you about cheaper drug prices

Over 20 states have banned such rules; President Trump plans to tackle them on a federal level

(CNN) Independent pharmacist Ira Katz has been serving the eclectic community of Little Five Points in Atlanta for 37 years. But it wasn't until Georgia passed a law last year banning "gag rules" that Katz could legally tell his patients they might save big bucks on their prescriptions if they paid cash or used a lower-priced generic.

The gag rule was a clause in his contract with one of the pharmaceutical benefit managers, also known as PBMs, that manage most of our nation's prescription drug programs.

"We're not supposed to be in violation of the contract, or they can cut you off," Katz said. "I did it. I don't give a damn what the PBMs say. I did it. It's a travesty."

Invisible to consumers, these benefit managers are the nation's middle men in the drug delivery process, hired by health plans, employers, unions and government programs such as Medicare Part D to administer prescription drug benefits. The managers process and pay your claims, help create the list of medications your plan will cover, set the amount of copays for those drugs and are supposed to save the system money by encouraging the use of lower-cost medications.

Pharmaceutical benefit managers negotiate prices with drug companies on behalf of insurance companies and other payers, and then communicate those prices to retail pharmacies. They also negotiate rebates from manufacturers and discounts from drugstores.

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