Why do we accept discount cards?

[pharm B]

Does anyone have a primer on how and why these things came into existence?

Why do we even accept them? Sure, it gets the patient in the door, but some of these cards charge US for the privilege of using them, or they "allow" us to make a whopping single digit profit on an item.

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[trailerpark]

Walmart contracts with them and denies others. I think Walmart wants patients in the door so they will get all their rx there and then buy all the China junk in the store then buy all their groceries there and on and on and on...


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[VeeSee]

As long as my pay isn't effected I could care less

That's the company's problem

 

[wagrxm2000]

You answered your own question. It gets people in the doors.


You could ask the same about test strips. Why sell them when often we get reimbursed under our cost. It gets customers in the store.

 

[PikminOC]

Walmart contracts with them and denies others. I think Walmart wants patients in the door so they will get all their rx there and then buy all the China junk in the store then buy all their groceries there and on and on and on...


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As opposed to the way overpriced China junk in CVS and Walgreens?

 

[MountainPharmD]

Chains accept them because the pharmacists working for them don't care. I assure you at my independent pharmacy we do not accept discount cards or BS from sites like Blink Health or GoodRx.

 

[mgarph]

I agree it's because it keeps the patient happy and doesn't really affect the pharmacist's pay/bonus at the end of the day at a chain. I would definitely not accept at an independent but at a chain it doesn't matter although I generally don't discount narcotics as it just encourages them to come to you. While a grey area (conflict of interest profit wise), if you feel like distributing them / making a commission each time they are used you can sign up here:

http://www.yourrxhelp.biz/help1023/en/index.html

 

[SmallCapPharma]

Just curious. What is the commission on these?


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[Gombrich12]

I agree it's because it keeps the patient happy and doesn't really affect the pharmacist's pay/bonus at the end of the day at a chain. I would definitely not accept at an independent but at a chain it doesn't matter although I generally don't discount narcotics as it just encourages them to come to you. While a grey area (conflict of interest profit wise), if you feel like distributing them / making a commission each time they are used you can sign up here:

http://www.yourrxhelp.biz/help1023/en/index.html

Sounds like a good way to get fired.

 

[trailerpark]

Most *******es who forget to renew their welfare and have to pay cash aren't even smart enough to look up a discount card. We have other people on straight Medicaid try to use a discount card on their dollar copay.


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[pharm B]

You answered your own question. It gets people in the doors.


You could ask the same about test strips. Why sell them when often we get reimbursed under our cost. It gets customers in the store.

I don't need some of these people coming in. If they pick up one maintenance med a month, and we're making less than $2 profit each time, I'm okay with them going elsewhere. I care how my corporation does because it's smaller than CVS or Wags.

Does anyone price match the card?

Example: one of the cards I've seen reduced the patient's cost by 50 cents, but charged us $21. So we made a whopping $3 if we left the card on, versus just dropping the price 50 cents.

 

[pharm B]

Chains accept them because the pharmacists working for them don't care. I assure you at my independent pharmacy we do not accept discount cards or BS from sites like Blink Health or GoodRx.

If and when I take a PIC position, I'm making it my practice to eliminate them. Corporate says we allow them, but this chain still sees a LOT of variation in work flow and practices from store to store.

 

[wagrxm2000]

I don't need some of these people coming in. If they pick up one maintenance med a month, and we're making less than $2 profit each time, I'm okay with them going elsewhere. I care how my corporation does because it's smaller than CVS or Wags.

Does anyone price match the card?

Example: one of the cards I've seen reduced the patient's cost by 50 cents, but charged us $21. So we made a whopping $3 if we left the card on, versus just dropping the price 50 cents.

Maybe its just my store but these customers do buy other things other then meds from us. Plus the margins are way better up front.

 

[pharm B]

Maybe its just my store but these customers do buy other things other then meds from us. Plus the margins are way better up front.

Maybe I'll make it a policy that discount cards can't be used if the patient isn't willing to come inside the store (vice using the window).

 

[wagrxm2000]

Maybe I'll make it a policy that discount cards can't be used if the patient isn't willing to come inside the store (vice using the window).

What percent would you say don't buy anything else? Even if only 10% that's still money lost if you banned all of them.

 

[pharm B]

What percent would you say don't buy anything else? Even if only 10% that's still money lost if you banned all of them.

It's time that could be spent implementing other things, like doing phone CMRs/TIPs.

 

[txpharmguy]

It's time that could be spent implementing other things, like doing phone CMRs/TIPs.

Right! Lol. What kind of buy in do you get from patients wanting this service?
To me, I'd rather save my patients money than have them go without. I'm a big advocate for GoodRx. Before anyone says that the reimbursement is low, have you looked at reimbursement on MPD plans? {OK, there's no reimbursement other than what the patient pays). However, if you're making $15 gross profit over your acquisition cost, to me, that's a win. Why would a patient pay over a $100 for atorvastatin when they can get it for about $20? (Acquisition cost for 30 atorvastatin 20 mg is well below $10}

 

[pharm B]

Right! Lol. What kind of buy in do you get from patients wanting this service?

I've actually had a lot of our patients ask about the service (and made a decent number of interventions as well). The only downside to MTM these days is that a lot of plans in our area don't allow you to initiate billing for something not already addressed as a TIP. I have a roster of about 100 patients who are eligible for MTM services with my store, and two other stores in my area aren't addressing theirs, so I could feasibly do their 80+ (each) patients if I had some extra time.

Why would a patient pay over a $100 for atorvastatin when they can get it for about $20? (Acquisition cost for 30 atorvastatin 20 mg is well below $10}

Why not just adjust your pricing? Why market a drug for a price no one will pay anyway?

 

[txpharmguy]

I've actually had a lot of our patients ask about the service (and made a decent number of interventions as well). The only downside to MTM these days is that a lot of plans in our area don't allow you to initiate billing for something not already addressed as a TIP. I have a roster of about 100 patients who are eligible for MTM services with my store, and two other stores in my area aren't addressing theirs, so I could feasibly do their 80+ (each) patients if I had some extra time.


Why not just adjust your pricing? Why market a drug for a price no one will pay anyway?

Because I work for a national chain. If you're at an independent and have sufficient staffing to perform these services, that's great. That's not likely with the big chains Most retail pharmacists get a dirty look if they step out of the pharmacy for a minute or two to answer nature's call

 

[pharm B]

Most retail pharmacists get a dirty look if they step out of the pharmacy for a minute or two to answer nature's call

If only there were an organization that fought to protect decent working conditions for pharmacists...

 

[imcallingcorp]

If only there were an organization that fought to protect decent working conditions for pharmacists...

these cards are actually great for people who use chains as they rip you off on many meds or you can go to your local independant and get a great price without these cards. one company faxed me a contract for their savings card showing how many millions of peolle you can have access to thats how they represent these as "access to lives". not as bad now as more and more people are insured but damn when i was at a big retail chain and i compare to drug costs that i now see on a day to day basis at my own store its amazing how much certain drugs were overcharged.

 

[PharFromNormal]

these cards are actually great for people who use chains AND ARE CASH PAY as they rip you off on many meds or you can go to your local independant and get a great price without these cards.

FTFY
Chains can also often provide much cheaper copays for some patients as they are willing to lose or make nearly nothing on third party paid scripts more often than indys are. Depends on the specific situation. I'm all for empowered patients - shop are around using all the benefits available to you for the lowest price (if you are merely looking at cost).

 

[SouthernRetailRPH]

If and when I take a PIC position, I'm making it my practice to eliminate them. Corporate says we allow them, but this chain still sees a LOT of variation in work flow and practices from store to store.

That will piss a lot of people off when they have been using them month after month and their prices go way up

 

[greenswall]

What do y'all think about Blink Health? It looks like its a discount card where the patients prepays them and their copay is 0 at the pharmacy, they says its really cheap

 

[Prepharm1214]

I just tried a variety of medications on the blink health website and was shocked how low the copays were as well. We've had a few customers use it but it hasnt caught on quite yet like Goodrx.

 

[KennethCool]

So what happens when a patient types in and prepays for the wrong med?

 

[Prepharm1214]

So what happens when a patient types in and prepays for the wrong med?

When you process the claim it will reject, as far as the patient goes I'm sure they have some sort of customer support to refund errors

 

[Rxgirl87]

CVS told us we don't accept blink anymore. I've had techs mistakenly tell customers that we don't take goodrx and sup always came down on us for not giving disc card to customer

 

[lord999]

For Walmart, it's a little bit more complicated than just driving customers. That's what you see in retail. Wal-Mart also is a wholesaler in the pharmacy sense. One of the matters that drive acquisition costs from PhRMA are the pricing bands from the insurances you take as part of the contract with PhRMA.

Easier to give an explained example:

Lisinopril 10 mg for 1 tab:
AWP or WAS (whatever fictitious number is used): 0.50

Blue Cross MAC: $0.10
Caremark MAC: $0.08
Lord999s Krazy Kard MAC: $0.30

Realistically, the MAC should be around the mean of the legitimate plans (0.09 although in actual practice, the harmonic mean with patient count as the denominator is used), but with the Krazy Kard, it's at an inflated $0.16.

Here's how everyone but the patient wins:
Krazy Kard gets some sweet love from IMGHealth and marketers to the poor and stupid because I have the suckers' demographic data who used my cards and their probable health condition. A simple HIPAA business associate agreement later, and Mr. Anderson's Lisinopril, his physician, and the demographic data I got from him signing up is now in the hands of insurance companies and marketers.

Wal-Mart makes three postives: people in the door as mentioned, the opportunity to fleece customers by charging above reimbursement rates paid in cash who would be greatful, and the opportunity to inflate their MAC to insurance companies to demand better reimbursement terms. "Blue Cross, I have this company that pays three times your MAC so either raise your rates or we're walking. No liability either for the fleecing, after all, it's a discount card.

Same thing for PhRMA and aggregators. Easier to buy data from small fry than Blue Cross, so divide and concur (intentional spelling) is their gain.

The easiest analogy to relate is try to go into Kohls and buy anything at full price. There's a coupon for anything at 15% off, so what's really going on? It's that number games and creative accounting intentionally obfuscate third parties from knowing your business, a time honored tradition in pharmacy.

Industry will happily give indigent patients free Meds from their supply in exchange for positive outcomes data to argue with regulators and insurance, loss of privacy, and a tax writeoff. That's more valuable in small quantities than selling the drug. God bless America for figuring out a way to turn anything into an opportunity.

 

[PharFromNormal]

For Walmart, it's a little bit more complicated than just driving customers. That's what you see in retail. Wal-Mart also is a wholesaler in the pharmacy sense. One of the matters that drive acquisition costs from PhRMA are the pricing bands from the insurances you take as part of the contract with PhRMA.

Easier to give an explained example:

Lisinopril 10 mg for 1 tab:
AWP or WAS (whatever fictitious number is used): 0.50

Blue Cross MAC: $0.10
Caremark MAC: $0.08
Lord999s Krazy Kard MAC: $0.30

Realistically, the MAC should be around the mean of the legitimate plans (0.09 although in actual practice, the harmonic mean with patient count as the denominator is used), but with the Krazy Kard, it's at an inflated $0.16.

Here's how everyone but the patient wins:
Krazy Kard gets some sweet love from IMGHealth and marketers to the poor and stupid because I have the suckers' demographic data who used my cards and their probable health condition. A simple HIPAA business associate agreement later, and Mr. Anderson's Lisinopril, his physician, and the demographic data I got from him signing up is now in the hands of insurance companies and marketers.

Wal-Mart makes three postives: people in the door as mentioned, the opportunity to fleece customers by charging above reimbursement rates paid in cash who would be greatful, and the opportunity to inflate their MAC to insurance companies to demand better reimbursement terms. "Blue Cross, I have this company that pays three times your MAC so either raise your rates or we're walking. No liability either for the fleecing, after all, it's a discount card.

Same thing for PhRMA and aggregators. Easier to buy data from small fry than Blue Cross, so divide and concur (intentional spelling) is their gain.

The easiest analogy to relate is try to go into Kohls and buy anything at full price. There's a coupon for anything at 15% off, so what's really going on? It's that number games and creative accounting intentionally obfuscate third parties from knowing your business, a time honored tradition in pharmacy.

Industry will happily give indigent patients free Meds from their supply in exchange for positive outcomes data to argue with regulators and insurance, loss of privacy, and a tax writeoff. That's more valuable in small quantities than selling the drug. God bless America for figuring out a way to turn anything into an opportunity.

Well said. Capitalists gonna capitalize.

 

[CetiAlphaFive]

For Walmart, it's a little bit more complicated than just driving customers. That's what you see in retail. Wal-Mart also is a wholesaler in the pharmacy sense. One of the matters that drive acquisition costs from PhRMA are the pricing bands from the insurances you take as part of the contract with PhRMA.

Easier to give an explained example:

Lisinopril 10 mg for 1 tab:
AWP or WAS (whatever fictitious number is used): 0.50

Blue Cross MAC: $0.10
Caremark MAC: $0.08
Lord999s Krazy Kard MAC: $0.30

Realistically, the MAC should be around the mean of the legitimate plans (0.09 although in actual practice, the harmonic mean with patient count as the denominator is used), but with the Krazy Kard, it's at an inflated $0.16.

Here's how everyone but the patient wins:
Krazy Kard gets some sweet love from IMGHealth and marketers to the poor and stupid because I have the suckers' demographic data who used my cards and their probable health condition. A simple HIPAA business associate agreement later, and Mr. Anderson's Lisinopril, his physician, and the demographic data I got from him signing up is now in the hands of insurance companies and marketers.

Wal-Mart makes three postives: people in the door as mentioned, the opportunity to fleece customers by charging above reimbursement rates paid in cash who would be greatful, and the opportunity to inflate their MAC to insurance companies to demand better reimbursement terms. "Blue Cross, I have this company that pays three times your MAC so either raise your rates or we're walking. No liability either for the fleecing, after all, it's a discount card.

Same thing for PhRMA and aggregators. Easier to buy data from small fry than Blue Cross, so divide and concur (intentional spelling) is their gain.

The easiest analogy to relate is try to go into Kohls and buy anything at full price. There's a coupon for anything at 15% off, so what's really going on? It's that number games and creative accounting intentionally obfuscate third parties from knowing your business, a time honored tradition in pharmacy.

Industry will happily give indigent patients free Meds from their supply in exchange for positive outcomes data to argue with regulators and insurance, loss of privacy, and a tax writeoff. That's more valuable in small quantities than selling the drug. God bless America for figuring out a way to turn anything into an opportunity.

Target and Walmart also track average shopping cart size for Rx vs non Rx customers.

 

[Wickett]

I work for a regional chain; I don't know if the big chains let you, but our system allows us to modify prices for cash fills. If someone has no insurance and brings in a discount card, I tell them I can simply look at our acquisition cost and give them a discount on my own without the middle man.

As long as they get a fair price and I can make a profit, everyone is happy. It makes things much simpler than processing 8 different cards to see what saves the most.

 

[RxPreceptor]

I work for a regional chain; I don't know if the big chains let you, but our system allows us to modify prices for cash fills. If someone has no insurance and brings in a discount card, I tell them I can simply look at our acquisition cost and give them a discount on my own without the middle man.

As long as they get a fair price and I can make a profit, everyone is happy. It makes things much simpler than processing 8 different cards to see what saves the most.

Must be really nice...but isn't this just going to blow up in your face eventually once the general mass catches on?

 

[Sparda29]

I don't accept them. Anyone walks in with one of those, I just tell them our computer system is not compatible with those cards.

 

[BenJammin]

The chains can accept discount cards because they don't transmit their real acquisition costs to GoodRx. Those rebates are what keep them afloat. That and treating independents like garbage.