Which Pharmacy Do I Send it To? Commonsense Reforms to Lower Prices

Price transparency is foundational to lower health care costs for all Americans. When patients can compare the price of a service at multiple facilities, they can choose the provider that offers the best value at lowest cost. Drug costs are no different.

Unfortunately, Americans are left in the dark when it comes to the price of prescription drugs. When a patient is prescribed a medication, they typically have no idea how much their prescription will cost until they fill it at the pharmacy. Patients are often unaware that different pharmacies will charge different prices to fill their prescription. At the same time, providers do not have real-time access to prescription prices, limiting their ability to evaluate cost in their treatment plans. One 2022 survey found that 20.2% of seniors didn’t fill prescriptions, delayed filling prescriptions, and skipped doses due to the high cost of their medications.

President Trump’s law to end surprise bills required real-time benefit information, including the requirement to give patients health care prices ahead of time.

• On August 5, 2025, the Department of Health and Human Services (HHS) announced a new reform that delivers much-needed price transparency to patients. In recent years, some health care facilities have added features to their Electronic Health Record (EHR) systems, known as Real-Time Prescription Benefits (RTPBs), that provide patients with much-needed price transparency.
  • RTPBs allow patients to determine how much their prescription will cost before it is sent
    to their pharmacy. They also help patients compare the price of alternative drugs for their condition. However, many facilities do not provide patients with an EHR that includes
    these cost comparison tools.
• The new rule requires all facilities that use HHS-certified EHR systems to include an RTPB feature that discloses how much a patient will pay for a prescription based on their specific health plan. These price transparency tools must also provide a cost estimate of alternative brand and generic medications that can treat the same condition. This reform will ensure that families who visit 96% of hospitals and 78% of physician offices that use HHS-certified EHRs can finally have drug price transparency.
  
• When consumers compare the prices of different drugs before they fill their prescription, patients can reduce their prescription drug expenses by 40%, saving them up to $106 every month. Individuals who use RTPBs to determine their prescription price are also 11% more likely to fill it.