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Case Study 1: The Patient Right to Know Drug Prices Act of 2018
Introduction
The Patient Right to Know Drug Prices Act and its partner bill, The Know the Lowest Price Act, were enacted in
2018 to stop health insurance plans and pharmacy benefits managers from restricting pharmacists from telling
patients they could pay less for a prescription if they paid the full price out of pocket instead of using their
insurance and paying a co-pay or other cost-sharing fee. For example, a pharmacist would no longer face
penalties from letting a patient know that the cost of Lipitor would only be $10 out of pocket, as opposed to $60
under insurance, toward deductible.
Instructions
1. Review the original legislation:
Patient Right to Know Drug Prices Act, 42 U.S.C. § 300 (2018).
https://www.congress.gov/115/bills/s2554/BILLS-115s2554enr.pdf
2. Watch the Congressional debate:
United States Senate Session, 115th Congress (2018). https://www.c-span.org/video/?451454-1/ussenate-debates-opioid-legislation
3. Produce a written report examining the factors and stakeholders that led to the policymaking process,
from agenda setting through legislative development.
Required Elements
1. Discuss the history of the legislation, from the agenda setting to development of the legislation.
2. Identify interest groups who were involved in getting this legislation passed and their positions on the
legislation. Also identify the interest groups who were not supportive of this legislation and their
positions on this Act.
3. Present your point of view, identify key legislators supporting this, and discuss why they supported/did
not support this legislation.
4. Identify and incorporate references from opinion pieces, news articles, and/or peer reviewed journal
articles both supporting and not supporting this legislation.
5. Discuss any budgetary implications that may result from this legislation for all relevant stakeholders.
Determine which, if any, health programs will be financially affected (positively or negatively) by this
legislation.
Specifications
Format:
12-point font, double spaced, 1-inch margins use APA format for scholarly papers including
page numbers
Page Limit: 5-7 pages
References: Utilize APA 7th Edition for in-text citation and reference list formatting
Additional Resources
1. Know the Lowest Price Act of 2018, 42 U.S.C. § 1305 (2018).
https://www.congress.gov/115/plaws/publ262/PLAW-115publ262.pdf
EEH536 Health Policy Fall 2023
Case Study 1: The Patient Right to Know Drug Prices Act of 2018
2. Caffrey, M. (11 May 2018). Trump offers blueprint to drive down prescription drug prices; target
rebates, middlemen. American Journal of Managed Care. Online publication.
https://www.ajmc.com/view/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targetsrebates-middlemen
3. National Community Pharmacists Association (NCPA). Homepage. https://ncpa.org/
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