07/09/2026
Why are some prescription copays INCREASING after July 1st when a new Kansas law was supposed to LOWER prescription costs?
Here's a real example from our pharmacy.
We filled the exact same four prescriptions for one patient in June (before the new law took effect) and again in July (after the law took effect).
✅ The total cost of the prescriptions DECREASED by $71.39
❌ But the patient's total copays INCREASED by 92%!
How is that possible?
Beginning July 1st, Kansas enacted new protections that regulate Pharmacy Benefit Managers (PBMs), the middlemen that process and manage prescription drug claims for insurance companies.
Similar legislation has been proven to lower prescription costs in multiple states by:
-Preventing PBMs from artificially inflating prescription costs after paying pharmacies.
-Requiring PBMs to pass ALL manufacturer rebates through to health plans and employers.
-Prohibiting PBMs from paying their own pharmacies more than other pharmacies for the same prescriptions.
-Moving pharmacy reimbursement to a transparent pricing model that is much harder to manipulate.
While these reforms will reduce overall prescription costs, insurance plans are still able to determine many patient copays. That means some plans can increase what patients pay at the pharmacy counter even when the overall costs of prescriptions are going down.
Even before this law went into effect, we suspected that PBMs might purposely inflate prescription copays in an attempt to claim that this law was increasing costs and to create public opposition to this law. Even more, this new law decreases the hidden profits of PBMs and big insurance companies, and we have already seen attempts to offset this by shifting more costs over to patients.
Keep mind that this new law will result in considerable savings by eliminating hidden fees on prescriptions that are only seen behind the scenes. Several years ago, Butler County moved its employees to a transparent PBM that already operated under many of these same principles. The county has saved enough on prescription benefits to help keep employee health insurance premiums stable despite rising medical costs. That's exactly the kind of long-term savings these reforms are intended to create.
If your prescription copays suddenly increased after July 1st, ask your employer's Human Resources or Benefits Department:
"If this law is reducing the overall cost of prescriptions, why am I paying more?"
If more costs are being shifted to employees while overall prescription spending is decreasing, it may be time for your employer to evaluate other PBM or insurance options.
The prescription insurance system is incredibly complicated, and many employers don't realize how much these middlemen influence what they spend and what their employees pay. If your HR or Benefits Department would like help understanding these changes, we're happy to explain how the new law works and what questions they should be asking.
And lastly (and maybe most importantly), this new law is an important first step in regulating these prescription insurance companies. But this law will only be effective if it’s actually enforced. The Kansas Department of Insurance is now in charge of regulating Pharmacy Benefit Managers, and our state is set to elect a new Insurance Commissioner in November.
One of the candidates for Insurance Commissioner is heavily funded by big insurance companies. Not only did this candidate vote against regulating Pharmacy Benefit Managers, but he also did everything he could to sabotage this bill in every way possible. Kansas pharmacists are truly afraid that he will refuse to enforce this bill if he is elected as Kansas Insurance Commissioner.
The November election is closer than you think, and we need to start spreading the word that Senator Dinah Sykes needs to be elected as our next Kansas Insurance Commissioner. Please share this post and help us spread the word. We need to stop these giant insurance companies from playing games with our health and our bank accounts.
