Why Your Pharmacist Can’t Tell You That $20 Prescription Could Cost Only $8br It says that a pharmacy or pharmacist may provide informationbr that “may include the cost and clinical efficacy of a more affordable alternative drug if one is available.”br The North Dakota law also says that a pharmacy benefit manager or insurer may not charge a co-payment that exceeds the actual cost of a medicationbr The White House Council of Economic Advisers said in a report this monthbr that large pharmacy benefit managers “exercise undue market power” and generate “outsized profits for themselves.”br Steven F. Moore, whose family owns Condo Pharmacy in Plattsburgh, N. Y., said the restrictionsbr on pharmacists’ ability to discuss prices with patients were “incredibly frustrating.”br Mr. Moore offered this example of how the pricing works: A consumer filling a prescription forbr a drug to treat diabetes or high blood pressure may owe $20 if he uses insurance coverage.br “This is information that consumers should have,” Mr. Looney said in an interview, “butbr that they were denied under the somewhat arbitrary and capricious contracts that pharmacists were required to abide by.”br Mr. Fasano said that consumers were sometimes paying three or four times as much when they used their insurance as they would have paid without it.br WASHINGTON — As consumers face rapidly rising drug costs, states across the country are moving to block “gag clauses”br that prohibit pharmacists from telling customers that they could save money by paying cash for prescription drugs rather than using their health insurance.