GoodRX and Controlled Substances

[CardinalGirl210]

At my pharmacy, we accept GoodRX coupons but we don't honor it for controlled substances. I'm on a "bad" side of town. My store in general has a lot of theft and heavy security presence. I've been at my store for 9 months now and when I first got there, we had a lot of fake prescriptions and prescriptions from doctor's who write for illegitimate purposes, so it has worked for us. Mostly it is for BZDs, Tylenol #3, Tylenol $4, Tramadol. We fill a lot of Norco as well, but are diligent about checking legitimacy because our cash price is pretty cheap. The closest pharmacy within my chain is 10 minutes away from me and the PIC there also implements the same rule because we see shady folks a lot.

Does your pharmacy honor discount coupons on controls? Is it PIC discretion or your chains discretion? Why or why not do you choose to honor the coupons on controls?

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[ldiot]

Our store doesn't honor them, not even manufacture coupons given by the doctor (eg. Suboxone). For us it's not the chain, it's the manager. It's not the most effective deterrent if you are talking about generic cards like GoodRX; most people will just get pissy over it and pay for it anyways.

 

[CardinalGirl210]

Our store doesn't honor them, not even manufacture coupons given by the doctor (eg. Suboxone). For us it's not the chain, it's the manager. It's not really an effective deterrent if you are talking about generic cards like GoodRX; most people will just get pissy over it and pay for it anyways.

Why deny manufacturer coupons? At least those are trackable because most require a primary insurance be billed. With GoodRX you can fill the same Xanax RX at Walgreens and CVS 5 minutes apart and no one would ever know.

 

[ldiot]

Why deny manufacturer coupons? At least those are trackable because most require a primary insurance be billed. With GoodRX you can fill the same Xanax RX at Walgreens and CVS 5 minutes apart and no one would ever know.

Well my state tracks it no matter what the billing is so that's not the issue. The policy was more of a deterrent for people filling controls; though we just started outright denying a lot of them now.

If they have insurance and requested GoodRX I'd run the insurance anyways to see if it says too early. If they don't have insurance I don't see how it would matter; as it wouldn't be tracked either way. Though people are not stupid and probably only give their insurance info to one pharmacy to avoid too early message at the second one.

 

[WVUPharm2007]

Our store doesn't honor them, not even manufacture coupons given by the doctor (eg. Suboxone). For us it's not the chain, it's the manager.

That's a pretty ****ty thing to do. Someone is trying to get off of opiates and your manager just throws up a roadblock to therapy like that for literally zero reason other than to be a complete ass.

 

[zelman]

That's a pretty ****ty thing to do. Someone is trying to get off of opiates and your manager just throws up a roadblock to therapy like that for literally zero reason other than to be a complete ass.

I agree, but their patient population may have more patients who are trying to get on more suboxone (or sell it all) than get off of heroin.

 

[BenJammin]

Might want to check your third party contracts. Many of these discount card companies contract with them so if you refuse GoodRx for a controlled substances you're in violation of the contract. Why does it matter anyway? You're not going to get fired because you're using a discount card for Norco.

 

[Ackj]

Might want to check your third party contracts. Many of these discount card companies contract with them so if you refuse GoodRx for a controlled substances you're in violation of the contract. Why does it matter anyway? You're not going to get fired because you're using a discount card for Norco.

This is the experience I've had with GoodRx. Somebody presented one with an rx for #180 hydroxychloroquine, and the coupon said it would be something stupid like $8. I told the patient it was way below cost and that price couldn't be right, so they called the 1800 number at the bottom of the coupon that says "if the pharmacy won't accept this coupon, call this." Within about 30 seconds an agent from GoodRx called us and said we were violating a contract by refusing to honor the coupon, and my DM confirmed that we are somehow bound to their outrageous terms.

 

[trailerpark]

I honor every stupid discount card because if Walmart was smart they wouldn't contract with them and the only way they're going to make a change is when they see how much money we lose because of it.

 

[CardinalGirl210]

Might want to check your third party contracts. Many of these discount card companies contract with them so if you refuse GoodRx for a controlled substances you're in violation of the contract. Why does it matter anyway? You're not going to get fired because you're using a discount card for Norco.

My 10-325 #120 cash price costs $149.99 Goodrx price is $24.61

That's a major difference. Is that really not a concern? GoodRx says on their website that some pharmacies may refuse for controlled substances and just to try another pharmacy. I think that #120 Norco at $24.61 is a pharmacy asking to be a pill mill.

 

[CardinalGirl210]

I honor every stupid discount card because it Walmart was smart they wouldn't contract with them and the only way they're going to make a change is when they see how much money we lose because of it.

Lol I don't know. One of my Target friends says she regrets doing the discount cards or offering to apply them for people because she attributes it to them selling to CVS. Haha

 

[wagrxm2000]

A sale is a sale, as long as you aren't losing money then take them. Those customers might buy things up front or bring other non control scripts later.

 

[Wheresmyaricept]

A sale is a sale, as long as you aren't losing money then take them. Those customers might buy things up front or bring other non control scripts later.

Lol do you know how the goodrx cards work? They bring the price down to acquisition cost and then charge you 5 dollars. Pharmacies don't make money on these at all.

 

[wagrxm2000]

Lol do you know how the goodrx cards work? They bring the price down to acquisition cost and then charge you 5 dollars. Pharmacies don't make money on these at all.

Did you read what I put, if it brings them in the store they might buy other things. Oh and they don't lower the cost on all meds to acquisition cost.

 

[steveysmith54]

This is the experience I've had with GoodRx. Somebody presented one with an rx for #180 hydroxychloroquine, and the coupon said it would be something stupid like $8. I told the patient it was way below cost and that price couldn't be right, so they called the 1800 number at the bottom of the coupon that says "if the pharmacy won't accept this coupon, call this." Within about 30 seconds an agent from GoodRx called us and said we were violating a contract by refusing to honor the coupon, and my DM confirmed that we are somehow bound to their outrageous terms.

I ran into the same problem during my retail days. My DM and corporate said that a discount card is no different than an insurance. You can not decline to accept an insurance for a certain medication regardless of the acquisition cost and same goes for a discount card. If your company has a price matching policy and PT says costco price is 2 dollars, then you have the right to decline it for the high acquisition cost reasons, but not when you are asked to bill an insurance/discount card. My corporate said to me to bill the discount card and then open a ticket with the corporate and charge the supplement to the pt at a later time.. Yeah right! like the pt will make a supplement 2 weeks later haha... Point is declining to accept is done in a lot of pharmacies, but proly not ok to do.

 

[Sine Cura]

This is interesting because when I was a CVS pharmacy manager I got feedback from my Rx sup that my store was "red-flagged" for excessive "general" discount card usage (particularly CIIs since they were 10% of sold Rx), mainly HealthTrans/Catamaran, whatever the one is administered by EnvisionRx, and Welldyne, and I was told to stop their use, so I directed my team to phase their use out, so if there was that much of a concern about violating contracts and driving customers away, I never saw it.

 

[ldiot]

That's a pretty ****ty thing to do. Someone is trying to get off of opiates and your manager just throws up a roadblock to therapy like that for literally zero reason other than to be a complete ass.

It depends on the situation. We see about half of the patients being titrated UP on Suboxone to insane doses, and I personally am yet to see a single person come off of it. The local clinics are requiring an appointment every 14 days for the rest of the patient's life. It's a complete scam and at these types of doses it's a huge liability.

 

[Wheresmyaricept]

Did you read what I put, if it brings them in the store they might buy other things. Oh and they don't lower the cost on all meds to acquisition cost.

So you think them buying some toilet paper that we make 80 cents on makes up for the loss encountered at the pharmacy? They would need to buy enough merchandise to make up for the loss. Depending on what they buy, that could be hard if it's all brand name (little profit) or small candy items that are super cheap. Talk to your store manager on what kind of items you actually make a good profit on. You'll be surprised. (Because front end sales totally affect RXM bonus for some reason lolol way to go Walgreens)


Looking at the most recent report from WBA, pharmacy was ~68% of Walgreens sale while front end sales were down compared to same quarter last year, so these people clearly aren't making up with any loss with purchasing items from the front end and if they are, they aren't buying enough.

And I have yet to see any drugs with GoodRX be anything more than acquisition cost so that is news to me, but then again I don't have much time to look it up because I have better things to do at work. The few times I have bothered to look it up, it came out exactly to acquisition cost.


With that being said, I really could not care less if a patient uses it, I'm just playing devil's advocate and being that guy. It's not affecting my pocket and it helps the patient out and typically the people that need to use those cards are the struggling middle class parents. In fact I encourage them to use it if it's too expensive and explain it won't be applied to the deductible, etc. If it is for a controlled substance, it depends on the person. If it's a mom trying to pay for her kid's adderall and PMP comes back clean, or grandma's ambien wasn't covered under part D and can't sleep and PMP comes back clean, I'll use it. If it's someone who has never filled before and their PMP is sketch, I'll refuse to fill the scripts. We have enough narc seekers as is, I don't need them spreading the word that we'll fill it

 

[M0df]

The way I see it is that chains have ability to take out these cards out of their system completely. That might be coming soon. Unless you are doing drop off yourself, who has time to monitor discount card usage. I worked at one cvs where techs would put in cards for any cash script and then some. Never heard a word from rx sup or dm about it being an issue.

 

[wagrxm2000]

So you think them buying some toilet paper that we make 80 cents on makes up for the loss encountered at the pharmacy? They would need to buy enough merchandise to make up for the loss. Depending on what they buy, that could be hard if it's all brand name (little profit) or small candy items that are super cheap. Talk to your store manager on what kind of items you actually make a good profit on. You'll be surprised. (Because front end sales totally affect RXM bonus for some reason lolol way to go Walgreens)


Looking at the most recent report from WBA, pharmacy was ~68% of Walgreens sale while front end sales were down compared to same quarter last year, so these people clearly aren't making up with any loss with purchasing items from the front end and if they are, they aren't buying enough.

And I have yet to see any drugs with GoodRX be anything more than acquisition cost so that is news to me, but then again I don't have much time to look it up because I have better things to do at work. The few times I have bothered to look it up, it came out exactly to acquisition cost.


With that being said, I really could not care less if a patient uses it, I'm just playing devil's advocate and being that guy. It's not affecting my pocket and it helps the patient out and typically the people that need to use those cards are the struggling middle class parents. In fact I encourage them to use it if it's too expensive and explain it won't be applied to the deductible, etc. If it is for a controlled substance, it depends on the person. If it's a mom trying to pay for her kid's adderall and PMP comes back clean, or grandma's ambien wasn't covered under part D and can't sleep and PMP comes back clean, I'll use it. If it's someone who has never filled before and their PMP is sketch, I'll refuse to fill the scripts. We have enough narc seekers as is, I don't need them spreading the word that we'll fill it

This was too long of a response to read it all but to comment about the first paragraph, have you ever looked at the acquisition costs on some of these items we sell up front? Our margins are way better on front end compared to pharmacy. Sales may be higher for pharmacy but margins are so low this is made up by front end. I remember store expensing some batteries that we sell for $5, our cost was under $2.50. So yes that toilet paper is worth every penny. Heck I think I expensed a manila envelope that cost over $1 for like 10 cents.

 

[Wheresmyaricept]

This was too long of a response to read it all but to comment about the first paragraph, have you ever looked at the acquisition costs on some of these items we sell up front? Our margins are way better on front end compared to pharmacy. Sales may be higher for pharmacy but margins are so low this is made up by front end. I remember store expensing some batteries that we sell for $5, our cost was under $2.50. So yes that toilet paper is worth every penny. Heck I think I expensed a manila envelope that cost over $1 for like 10 cents.

Like I said, I don't actually care. Did you even read what I posted? (See this works both ways!)

But you bring up a good point with falling reimbursement. Why do you accept those cards then if reimbursement is so low and you're losing money with these? You're turning pharmacy into a loss leader. If you think them buying store merchandise will keep the store open, maybe you should go open your own convenience store. Didn't even need to go to pharmacy school!

 

[wagrxm2000]

Like I said, I don't actually care. Did you even read what I posted? (See this works both ways!)

But you bring up a good point with falling reimbursement. Why do you accept those cards then if reimbursement is so low and you're losing money with these? You're turning pharmacy into a loss leader. If you think them buying store merchandise will keep the store open, maybe you should go open your own convenience store. Didn't even need to go to pharmacy school!

No I didn't which I stated in the first line, your response was too long.

You are missing the point, these are customers without insurance, if you don't take the card they won't come to your store. I will take a small profit over no profit. These people will come in and buy pop, cigarettes, etc. Yes some won't, but the card doesn't cause a loss everytime either.

 

[samuricool]

Weird, I got a call two days ago bitching about some pharmacy refusing to fill their control prescription because they had a discount card. It was you!!!

 

[Sine Cura]

People actually care about their chain pharmacy's profitability above and beyond merely avoiding a negative annual evaluation? WAT

 

[Sine Cura]

The way I see it is that chains have ability to take out these cards out of their system completely. That might be coming soon. Unless you are doing drop off yourself, who has time to monitor discount card usage. I worked at one cvs where techs would put in cards for any cash script and then some. Never heard a word from rx sup or dm about it being an issue.

This one is easy if you recognize all the typical discount cards on the bag label like "GoodRx," "HealthTrans Access," "Familywize" etc. If you are RXM just tell them to stop it or they will get written up for something totally stupid.

 

[Dr Wario]

I have to say that CVS finally did the smart thing in response to these discount cards. They are very aware that this practice is not going away so why pay the $5 fee toward the processing company when they can implement their own discount card and eliminate that fee all together? This program will roll out soon and they will be eliminating their 90 day/$11.99 service and replacing it with a general discount card that how no membership fee.

 

[owlegrad]

I have to say that CVS finally did the smart thing in response to these discount cards. They are very aware that this practice is not going away so why pay the $5 fee toward the processing company when they can implement their own discount card and eliminate that fee all together? This program will roll out soon and they will be eliminating their 90 day/$11.99 service and replacing it with a general discount card that how no membership fee.

Probably has more to do with the Target acquisition than anything else. I recall somewhere reading about how Target had a similar program and CVS was "committed to providing their patients access and blah blah blah".

 

[Ackj]

I have to say that CVS finally did the smart thing in response to these discount cards. They are very aware that this practice is not going away so why pay the $5 fee toward the processing company when they can implement their own discount card and eliminate that fee all together? This program will roll out soon and they will be eliminating their 90 day/$11.99 service and replacing it with a general discount card that how no membership fee.

Most of the discount card shoppers, in my opinion, won't be satisfied with that. The simvastatin is cheapest with Card A, but pantoprazole is $2 less on Card B, and then clopidogrel you need to use Card C, etc. They will use the CVS discount, and then compare it with the other discounts and use the cheapest one.

 

[wagrxm2000]

I have to say that CVS finally did the smart thing in response to these discount cards. They are very aware that this practice is not going away so why pay the $5 fee toward the processing company when they can implement their own discount card and eliminate that fee all together? This program will roll out soon and they will be eliminating their 90 day/$11.99 service and replacing it with a general discount card that how no membership fee.

Can you explain this again? Unless I'm reading it wrong it won't help if the discount card is still cheaper.

 

[wagrxm2000]

So I put in some common brand and generics, it didn't seem to bring the cost down to the acquisition cost. At least for wag, our savings club is still the better deal

 

[Prepharm1214]

So I put in some common brand and generics, it didn't seem to bring the cost down to the acquisition cost. At least for wag, our savings club is still the better deal

I never understood why people pay for a membership fee for Wags savings club when most drugs are still cheaper at drug mart/walmart as cash items and no upfront cost.

 

[wagrxm2000]

I never understood why people pay for a membership fee for Wags savings club when most drugs are still cheaper at drug mart/walmart as cash items and no upfront cost.

Its one of two things, they hate walmart or they don't want to leave us, at least that's what I'm told. Personally I'd never shop at Walgreens if I didn't have insurance. The discount you get on Walgreens products with the card does help. I do occasionally send people elsewhere like with Wal-Mart's insulin prices.

 

[owlegrad]

Its one of two things, they hate walmart or they don't want to leave us, at least that's what I'm told. Personally I'd never shop at Walgreens if I didn't have insurance.

I feel the same way about CVS. I tell people all the time to go to Publix for the free stuff or Walmart for the cheap stuff. Some do and others don't. I guess our service isn't really that bad if people feel compelled to pay our higher prices for some reason.

 

[Dr Wario]

Can you explain this again? Unless I'm reading it wrong it won't help if the discount card is still cheaper.

I have not seen the pricing as of yet, but I do believe the idea is that it should be the same or better than the discount cards.

 

[maria1oh]

In some inner city locations walgreens/cvs are the only choices. Walmart is more in suburb areas.

It is possible to price match on cvs rxconnect system but most of the cvs pharmacists refuse to do it or they don't know how.

 

[BidingMyTime]

Its one of two things, they hate walmart or they don't want to leave us, at least that's what I'm told. Personally I'd never shop at Walgreens if I didn't have insurance. The discount you get on Walgreens products with the card does help. I do occasionally send people elsewhere like with Wal-Mart's insulin prices.

For the drive-thru....there are people who do all their shopping via drive-thru.

 

[Dr Wario]

For the drive-thru....there are people who do all their shopping via drive-thru.

I have always wondered how other pharmacies handle this, our store is so busy (and subsequently our drive-thru), that is decision is made for us. When a customer asks for something from in front from the drive-thru, we deny the request unless the item is actually located within the pharmacy (excluding pseudoephedrine because our signature machine will not make it out the window). Do other stores actually get customers things from out front? medications only or do you allow milk/soda/toilet paper etc?

 

[maria1oh]

Yes I know of a cvs store slow enough that they do let people shop through the drive through. Also this cvs store offered delivery and would let people order stuff to be delivered with their prescription. Mostly senior citizen living centers that took advantage of the delivery service.

Most cvs stores discontinued their delivery service when the scriptsync program was released since we can now sync their meds and save them multiple trips to the pharmacy.

 

[zelman]

I have always wondered how other pharmacies handle this, our store is so busy (and subsequently our drive-thru), that is decision is made for us. When a customer asks for something from in front from the drive-thru, we deny the request unless the item is actually located within the pharmacy (excluding pseudoephedrine because our signature machine will not make it out the window). Do other stores actually get customers things from out front? medications only or do you allow milk/soda/toilet paper etc?

If someone wants something from the drive thru, I always grab it. And by "it", I mean the most expensive version of whatever they said.

 

[pillpharmer14]

Probably has more to do with the Target acquisition than anything else. I recall somewhere reading about how Target had a similar program and CVS was "committed to providing their patients access and blah blah blah".

Yeah Target price matched, so this is likely an attempt to keep their pampered guests from running to walmart.