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How do free drug discount cards work?

Discussion in 'Pharmacy' started by RhinoRX, Aug 3, 2009.

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  1. RhinoRX

    RhinoRX

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    SDN Members don't see this ad. (About Ads)
    I'm a tech at a pharmacy, and we recently got a packet of "Free Drug Discount Cards" that we can put in for the uninsured, or for those whose prescriptions aren't covered by insurance... I've put some in and seen the people's copays drop by anywhere between $10 and $250... HOW DOES IT WORK??

    I have no problem getting people their prescriptions for lower out of pocket costs, but who picks up that remainder of payment that the card took off? Nothing's ever "free"... How can a company out there afford this?
  2. Praziquantel86

    Praziquantel86 Moderator Emeritus

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    Many of them are paid for by th drug manufacturers. It gets the patient established on a maintenance medication and comfortable with that regimen. Eventually the coupons stop coming and they're unwilling to switch.

    You'll very rarely see coupouns for one-and-done medications, unless there's a high rate of reuse. ZPak for viral bronchitis comes to mind.
  3. RhinoRX

    RhinoRX

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    I know some coupons are paid by the drug companies, but I'm talking about a whole other type of coupon... These cards are ones that don't only cover 1 medication, they offer a discount on ALL medications for those people who have no coverage or whose primary insurance doesn't cover a certain med...
  4. chuckle beast

    chuckle beast

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    banned in Massachusetts
  5. Praziquantel86

    Praziquantel86 Moderator Emeritus

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    Still paid for by drug companies...through PhRMA (the industry trade group). They get tax breaks and good publicity for helping out.
  6. metrarx

    metrarx

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    .....
    Last edited: Jan 26, 2010
  7. Asrai

    Asrai

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    I've seen cards through RXCUT (I think) that have taken copays from $90 down to about $8. I have no idea how it works or why, but it does and our patients are beyond grateful for it.
  8. RhinoRX

    RhinoRX

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    It's NOT a chain card and it's not a "generic list" program or anything... We have 2 cards that offer these discounts: One is "Free Drug Card USA" which is red, and then the other one is "Family Agelity" and it's orange... And on each one it says that they can be used as many times as you need, for as many people as you want :confused:
    Last edited: Aug 4, 2009
  9. Prepharm1214

    Prepharm1214

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    I've seen Rite Aid's discount card take a 30 day supply of Ambien from $45 to 8.99, so there are big saving in some drugs. Most though are a few dollars such on vicodin, ibuprofen, etc.
  10. fieldkj

    fieldkj

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    most of the discount cards that is being talked about are distributed by the PBM's and the cost of the medication is usually a zero balance and then the cost of adjudications is taken from the pharmacies overall insurance check from those patients that are actually insured
  11. Sparda29

    Sparda29 En Taro Adun Gold Donor

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    You guys aren't talking about the slips that the patient's bring in with the prescription from the doctor right?
  12. RhinoRX

    RhinoRX

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    No, not those... I took one of the cards so I can post the info on here:

    I'm looking at a red and white card, at the top it says "USA DRUG PLAN", there's a logo of a company, "HealthTrans," and then all the ID numbers, RxGroups, etc.. It also says "Brand Name and Generics, 10-85% Savings on most drugs - use over and over again"

    At the bottom it says "This card is accepted at over 80% of pharmacies nationwide. This is a free discount card, this is NOT insurance."

    This thing not only saves uninsured people a LOT, but sometimes the discount through this card is better than what some people pay for insurance... :confused: I'm not complaining, since it's helping people out, but I just can't accept the fact that some unknown company is just handing out free money...
  13. Vitamin K

    Vitamin K

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    I know what you're talking about. It's just like the program promoted by Montel. It's like praziquantel86 said...the drug companies go in on them. It saves people money and gives them a huge tax break. It's not just one company doing it, it's a collaboration.
  14. BugsNDrugs

    BugsNDrugs

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    While I can't answer your question about how this is paid for, I know exactly what you're talking about. While it helps the people who have the cards, they are all a pretty bad thing for the pharmacy that processes them. At the pharmacy I work at, we run the card, and the medication is discounted. The only problem is that it costs so much to run claims to these cards. If I remember correctly, some of these cards charge anywhere from $3-$6 per claim! And there is no reimbursement from these cards. So basically, we usually end up losing A LOT of money with these cards, since the discount they give usually knocks the price down lower than what we would usually charge as cash price. We take the cards just to help out the customer and hopefully keep them coming back, but I kind of wish we didn't.
  15. Pharma101

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    @BugsNDrugs, @RhinoRX, @metrarx, @Asrai, @Prepharm1214, @fieldkj thank you all for your comments on discount drug cards. I was glad to find your posts through Google.

    We are doing some serious research on this topic and boy it's confusing. Are any of you available to contribute some of your info you know on discount drug cards in private? You don't need to disclose your name or anything.

    I'm not sure If I can private message you or you can private message me but we could really use your help on research basis. We are working on building a medicine search engine and this data can be of so much help to us. Contact me if you like and I'll give you more details, I promise we will try and make it worth your time. Thanks to all again.
  16. charfdorn

    charfdorn

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    Wait wait - you're doing serious research by visiting a student forum? Shouldn't you be contacting the distributors of these cards, and the drug companies that participate? Seems to me like a better place to start... but I'm not a serious researcher...
    GroverPsychMD likes this.
  17. farmist

    farmist

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    The county here provides a discount card. It's seems the main beneficiaries are the frequent fliers from the ER.
  18. c_daye

    c_daye New Member

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    So, I'm a physician in residency training - and I called the pharmacy at Wal-Mart to check on some prices of meds, I have a patient who is uninsured, and I just wanted to double-check prices to make sure they could fill the prescription I wrote! The person I talked to in the pharmacy told me about this "USA Drug Plan", and how they have the cards available there. She gave me a website to look it up myself, and I have to admit - the website looks pretty shady, with no explanation of "how" this works. It seems from her experience (and the experience of RhinoRX) that this thing really works, but I am hesitant to suggest this to patients, because frankly I have no idea what I'm getting them into!

    Just try googling USA Drug Plan. I can find no credible source that talks about it. I tried looking it up at Better Business Bureau, and didn't find anything either.

    What is this?
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  19. RhinoRX

    RhinoRX

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    LOL Exactly. It's a shady looking card, but it works... Just no one knows how. If it was county-sponsored, I'm pretty sure they'd want people to know the god they do... The only clue is the logo on the front of a company called HealthTrans.
  20. rex_b

    rex_b Member

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    Maybe I can help shed some light. I know this topic is a bit older but I just came across it in Google Search.

    The cards are created for cash paying customers (paying retail) and the majority of these customers are uninsured. PBMs negotiate rates with the pharmacies via their own MAC lists and a simple AWP- percentage to get the discounted prices. Within the price the customer pays is the negotiate price + dispensing fee which pays the admistration costs of managing the plan / marketing / etc. etc and can vary from $2-$6+ depending on the medication and pharmacy.

    I believe these are a win-win b/c the pharmacy gets a new customer which may buy other items and becomes loyal and also gets the information from the patient for marketing. The patient wins because they pay a lower price than retail.

    I am the owner of Group Net LLC (www.group-net.org) that provides such cards and other resources for patients to save money.

    Let me know if you have any questions I be more than happy to answer.
  21. litetigre

    litetigre

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    Can I ask who pay for the administrative cost? How is it factored in the price? If pt is going to get discount, should they join the pharmacy drug discount program and avoid the middle man?
  22. Doctor M

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    These discount drugs do exactly that...discount. The pharmacy does not get paid from any drug manufacturer or any PBM. The pharmacy gets paid what ever the patient pays. For example, take the drug OXYCODONE 30 mg #100 tabs. The cash price may be $139.00 but running the discount card takes the price to $65.00. The pharmacy only collects the $65.00 and the AWP balance is not collected from anyone. Now realize that you are still making money but it drops your reimbursement dramatically. There are a ton of discount cards out there...I havent really seen any "shady" discount cards out there. They are great for customers but suck for the pharmacy. You independent owners now what I mean when it comes to reimbursement from the PBM's vs cash upfront paying patients.

    Let me just be clear that as a rule, our pharmacy does not price gouge. We never charge AWP. We always discount the drugs but these discount drugs can take your profits down to nothing!

    Dr. M
  23. rex_b

    rex_b Member

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    The pharmacy pays. But the pharmacy also takes a part of the dispensing fee as well. Even on an in-house plan the pharmacy uses either their own or outside PBM to make the transaction.
  24. rex_b

    rex_b Member

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    This is correct. The negotiated price is what the customer pays. I have heard conversations about submitting the claims for rebates from the MFGs for certain eligible drugs but for the most part this doesn't happen to my knowledge.

    Dr. M I do agree that it can be a bit harder for the independent owners and I have even seen some push back from them. But I really think the IO should take a different approach and embrace. While some medications can be discounted hugely you could look at these as a loss leader and convert your customers into buying other high profit items. Not to mention gaining a loyal customer and word of mouth advertising you can foster with this customer. Use it as a marketing tool. Go to places of distribution of any local discount cards and ask they send those takers to your pharmacy.

    You could even create your own discount program within your community.

    I see it all the time when IOs get upset and create negative press around themselves when they could easily create positive press.

    But again these are my personal opinions.
  25. SmKN808

    SmKN808 ♥...6102 o/ɔ doɔlʇs Lifetime Donor

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    can i get a card :xf: what...? DAMMIT i'm insured :p:laugh:

    naaah, but seriously... thanks! guys/gals, for clarifying this matter as i was curious to know how it works also :thumbup: at first i immediately assumed "scam" after like the first 6 post. but, obviously! i was wrong considering eh? :rolleyes: oh well, i'm over it :D
  26. rex_b

    rex_b Member

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    Even if you are insured doesn't mean you may not be able to benefit. I talk to insured people everyday that have high deductible plans, are paying for medication out of their HSA, the medication isn't covered in their formularies, or the medication is on tier 4 copay etc etc. Even Medicare gaps are people paying those retail rates. And don't get me started on workers compensation claims.

    At the end of the day insurance pricing and our pricing are back and forth better depending on the medication. Many times we beat them out. But if you have a $10 copay it wouldn't matter.
  27. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    Pharmacists take it up the a**, especially independents. This is the biggest scam in the universe....
  28. confettiflyer

    confettiflyer Unicorn w/ dirty wings

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    We had little signs at our in window for one of these plans a long time ago...then 3-4 weeks later, we got word that we should stop making it the default plan for pt's. We were signing pt's up at our terminals and using their phone #'s as the ID #.

    I'd get an occasional cash person with a $120 fee see it dropped down to $60 and become elated...I think we were then told to stop suggesting it to people at the in-window.

    Didn't think much of it...not many people used it.
  29. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    You are so full of you know what I can predict your eyes are brown. Your pie in the sky model works if new customers come in because you accept the card, except it's ALMOST NEVER the way it works. What happens is your cash paying customer who was paying $150.00 per month for drug X now pays $125.00 per month and you just lost $300.00 per year. Multiply that by 100 patients that take three medications each and it's $90,000.00 per year. There is no upside for the independent to take these and the person who thought this moronic idea up needs to be villianized as one of the destroyers of community pharmacy.
  30. Doctor M

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    These cards are crap cause the drug dealers are the ones who use it...The discounts cards arent shady, its the people coming in with 270 oxys and 120 oxycontin ane methadone...WTF!!!That UNARx card is the one they all use...Whatever...Almost all my legitimate customers have insurance...So im not embracing a damn thing about these discount cards...I already discount the drugs enough to people with no ins...
  31. rex_b

    rex_b Member

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    Nice to see you are in a good mood.

    There were questions asked and I answered them to the best my ability. And I would like to know exactly what you think I may have answered incorrectly if you would please.

    At the end of the day the pharmacy doesn't have to be in any network they don't want to be. But if you accept the network and the pricing then there isn't much I can say about your choice.

    And I'm intrigued why you call these plans moronic or scams? Tell that to our customers that saved just over $4.6M last month alone off retail rates.
  32. rex_b

    rex_b Member

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    While there may be people obtaining prescriptions illegally I have no idea and do not embrace that at all.

    We aim to help those on hard times.
  33. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    You aim to enrich yourselves by stealing from independent pharmacies. Chains too, but they can afford it. The implication in your assumption is the pharmacist means sh**. All that matters is the drug. There is NO value in the service provided. Do they have delivey, do they have charge accounts, do they do DME, do they provide MTM (formally or informally). All these things cost money and factor into the cost. You factor none of them into the cost. You act as if the cost of the drug is the only thing that matters. Your cards are destroying independent pharmacy and in the long run are one of the many reasons 30 years from now pharmacists will be making 60K per year.
  34. rex_b

    rex_b Member

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    Thank you again for your civility and professionalism.

    As I stated before if a pharmacy doesn't want to accept certain pricing they are not obligated to be in any network.

    With that said how do you rationalize insurance pricing? They to negotiate a discounted rate.
  35. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    I don't like that either. But please don't equate what your provide with what insurance provides in an effort to debase the profession of pharmacy for your personal profit.
  36. rex_b

    rex_b Member

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    Insurance that provides prescription benefits is essentially the same except they take a co-insurance or co-pay from the patient and them reimburse the pharmacy after a set time period. And at a discounted rate. Not to mention they charge their customer an administration fee to do this.

    A lot of pharmacies don't like waiting on that payment and would rather cash up front and some at times are willing to discount even further for not having to wait on receivables.

    I'm not sure why you think I am debasing the profession for my personal gain. I'm simply stating facts about the industry and would hope you can return the same. As I stated above I don't see a difference in the programs and even pointed out another benefit to pharmacy owners.
  37. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    Because you are a ___________ fill in the word of your choice. PBM's perform DUR, formulary maintainence and a host of other services that you DO NOT provide. To think that all PBM's do is process claims is to say that all pharmacists do is count pills. You are a _________.
  38. rex_b

    rex_b Member

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    Great to see you showing your true character yet again.

    This is the first time you have brought up anything about PBMs. I clearly stated in my post the similarities/difference between insurance prescription benefit plans and discount arrangements. Which of course you didn't address.

    By redirecting my questions and statements with name-calling and subject changing I will have to assume you agree with me.
  39. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    No ____, I obviously don't agree with you. When Blues Cross sells you a drug plan, they hire a PBM to do the things I mentioned. It's not just reimbursing for claims. In addition, it's the PBM that negotiates the prices and formularies on behalf of the insurance company. The Insurance company provides more than just a discount and claims processing. To think otherwise, proves your knowledge of the field would be lost in a thimble.
  40. rex_b

    rex_b Member

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    To think that discount plan providers don't have to hire a PBM proves your knowledge as well.

    You also didn't state any difference between a person having a prescription drug plan vs. a discount arrangement. Obviously I think the drug plan provided by the insurance company isn't in the best interest of the consumer.
  41. Old Timer

    Old Timer SDN Advisor SDN Advisor

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    I know you hire a PBM. But a drug plan through an insurance company manages their therapy. I did point that out several times, but the thimble must be full or you just choose to ignore it. A concept with you seem to hold in little regard which is of course invaluable. There is no point in continuing this moronic discussion.

    You are foolish enough to come here and tout a service that is detrimental to pharmacies and pharmacists and are surprised nobody here agrees with you. It's like going to an atheist discussion board to tout the advantages of Jesus Christ or going to an Orthodox Jewish board to hawk a BLT sandwich.

    Please everyone, DONT FEED THIS TROLL..... I was foolish to try to reason with him/her/it......
  42. rex_b

    rex_b Member

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    Obviously you have your opinion which is heavily biased as I have mine. I answer only to our members (most of which are uninsured) that saved well over $100M in 2009 off retail rates.

    I answered every question truthfully and gave examples of how to embrace such plans as they aren't going anywhere. You can continue to buck the trend but your fate is in your hands.

    I only hope that your customers don't see the characteristics that you show on this forum and that guests viewing this thread don't start stereotyping pharmacists/owners based on your actions.
  43. Doctor M

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    usually we dont even need to use those discount cards...We price our drugs at a fair price where the patient gets a huge discount and we are able to pay our bills...we also push generic drugs, so we worry very little about these cards...We also know what we pay for the drug, so that helps our patients too...
  44. rex_b

    rex_b Member

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    Great to hear! Good pricing always brings customers back.

    About 80% of our use is generic drugs also b/c the profit margins are so huge that it allows for nice discounts vs. brand name drugs.
  45. Doctor M

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    PBM's sure do take a lot of the profits for doing formularies, DUR's and negotiate prices...this is all $$$$ driven and very little overhead...PBM's rake it in big time...I do not like PBM's for my own selfish reasons...that is they take way too much away...just today, i filled a 3 month supply of evista...I made 3 dollars...screw you PBM...

    Im sorry, i forgot the transmission fees too...yeah it costs them money too but they sure do make money of those small fees!
    Last edited: Jan 19, 2010
  46. Doctor M

    Doctor M

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    Its interesting to know that PBMs will pay pharmacys MAC (maximum allowable cost) for a generic but charge the ins company AWP - % pricing...this is absurd...take for example generic soma...say AWP for 60 tabs is $40 dollars. MAC is $7.45 and the AWP -45% is $22. That means that the PBM keeps $14.55, the pharmacy gets $7.45. What a rip off...MAC pricing is a gimick as you can see...If anyone can argue for the PBM please do so...
  47. DrugGuru

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    I will answer any questions you may have, FULLY!
  48. charfdorn

    charfdorn

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    Except, apparently, for the question about which this thread is written.
  49. DrugGuru

    DrugGuru

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    Your info is totally incorrect!
  50. DrugGuru

    DrugGuru

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    The pharmacies sign contracts and AGREE to a price they will sell the drugs for. The price is lower in the hopes that a new cash customer that is uninsured or under-insured with a discount card will pick up other items in the store. There is no gun to the pharmacists head. If they don't agree, then they should ignore the program. If you do a pharmacy lookup at one of the discount card sites you will see it is pretty much the bigger chains. You can also price the drugs on those same sites. CVS & Walgreens are ALWAYS far more than Kroger or Kmart.

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