How does GoodRx make money?

[VA Hopeful Dr]

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Why should GoodRx dictate my cash price? Who are you to tell me that my price is too high? This is a 2 way street my friend. If you want to race to the bottom we'll bear hug and take you with us

I don't care if goodrx dictates your cash price or not. But on what planet is a 2 order of magnitude markup OK?

I've done cash only, completely transparent pricing medicine. It was great. I would be happy to go back to that if needed.

 

[BenJammin]

I don't care if goodrx dictates your cash price or not. But on what planet is a 2 order of magnitude markup OK?

I've done cash only, completely transparent pricing medicine. It was great. I would be happy to go back to that if needed.

Because it's the best deal in town? You don't care about GoodRx dictating my cash price well I don't care about honoring your card. I'm not going to sell my products at a loss because you think my margins are too high.

 

[VA Hopeful Dr]

Because it's the best deal in town? You don't care about GoodRx dictating my cash price well I don't care about honoring your card. I'm not going to sell my products at a loss because you think my margins are too high.

Who is saying you need to sell at a loss?

 

[honurasp]

Chiming in a month later here, but here is a pretty thorough article that was posted today in Bloomberg about PBM spreads and how drug pricing works in retail pharmacies billing insurances:

bloomberg()com/graphics/2018-drug-spread-pricing/

A lot of blame is placed on retail pharmacies charging "exorbitant" cash prices for medications and creating "huge markups" on cheap drugs, but barely any of that money goes to the pharmacy for a profit. It's all clawed back by the PBMs and insurance companies. My favorite part of this article are the PBM lobbyists claiming that it's the pharmacist's "that are greedy for more money" for demanding transparency in PBM contracts. Lol

 

[AlPacino]

Even though goodrx says they aren't selling your data, they are definitely getting it and using it for something eventually. When you use discount cards, they get your name, address, phone number, medication used etc. Yeah you save some money but you lose your privacy and gain more spam calls and spam mail.

Bingo. Read the fineprint when you check that user agreement on the GoodRx website/app. When you print or show that coupon you give them full access to your personal data; name, address, dob, phone number, email, etc. There is nothing in place to say that they aren't selling your information to spammers and advertisers. There is a reason alot of retail pharmacies are no longer accepting it.

 

[BidingMyTime]

Who is saying you need to sell at a loss?

Pharmacies--both in hospital and retail have to mark up their prices because they can't have different prices for cash and insurance customers (per the insurance contracts.) The insurance contracts will only pay a fraction of the "cash" cost, so the cash cost has to be marked up in orders of magnitude, in order for the insurance's fraction of the payment to cover their costs. The system sucks, but this is the way it's done, and if you worked for any kind of health system, the medical billing for your charges is being done the same way. Solely because you deal with cash only, you can afford to offer a transparent, lower cost. Hospitals & pharmacies that take insurance don't have that option, because they would go out of business if they did.

 

[VA Hopeful Dr]

Pharmacies--both in hospital and retail have to mark up their prices because they can't have different prices for cash and insurance customers (per the insurance contracts.) The insurance contracts will only pay a fraction of the "cash" cost, so the cash cost has to be marked up in orders of magnitude, in order for the insurance's fraction of the payment to cover their costs. The system sucks, but this is the way it's done, and if you worked for any kind of health system, the medical billing for your charges is being done the same way. Solely because you deal with cash only, you can afford to offer a transparent, lower cost. Hospitals & pharmacies that take insurance don't have that option, because they would go out of business if they did.

Wrong (and I do work for a large health system). You can have cash prices that are 80% of Medicare allowable with no worries that CMS is going to come after you. Otherwise how would places like free standing imaging centers be able to offer major cash discounts?

Besides, even if what you say is true for pharmacy (since insurance does work differently for y'all than it does for my end of the world) why are there pharmacists in this very thread that boast of being able to offer prices better than GoodRx without any coupons or anything?

I didn't know they did claw backs. Shew, that's straight up grimy. If I owned an independent, I'd just just tell them I'd sell it to you for $40, no coupon needed, and keep the difference.

That's what we do.

We run the card, then reverse it and beat the GoodRx price by a decent amount, even if we're losing money, just to damage the brand of GoodRx.
That way, the patient thinks "that card doesn't work and my pharmacy has good prices!"

Exactly what I did when I was working at an independent... what’s worse is sometimes the clawback were so bad that we would end up losing money just to fill it...


Sent from my iPhone using Tapatalk

 

[CetiAlphaFive]

Wrong (and I do work for a large health system). You can have cash prices that are 80% of Medicare allowable with no worries that CMS is going to come after you. Otherwise how would places like free standing imaging centers be able to offer major cash discounts?

Besides, even if what you say is true for pharmacy (since insurance does work differently for y'all than it does for my end of the world) why are there pharmacists in this very thread that boast of being able to offer prices better than GoodRx without any coupons or anything?

I can answer this:

I am absolutely breaking the rules because I think it's the ethically correct thing to do.

They could absolutely penalize us if they found out

 

[VA Hopeful Dr]

I can answer this:

I am absolutely breaking the rules because I think it's the ethically correct thing to do.

They could absolutely penalize us if they found out

I wonder how we get away with it then.

 

[PikminOC]

Chiming in a month later here, but here is a pretty thorough article that was posted today in Bloomberg about PBM spreads and how drug pricing works in retail pharmacies billing insurances:

bloomberg()com/graphics/2018-drug-spread-pricing/

A lot of blame is placed on retail pharmacies charging "exorbitant" cash prices for medications and creating "huge markups" on cheap drugs, but barely any of that money goes to the pharmacy for a profit. It's all clawed back by the PBMs and insurance companies. My favorite part of this article are the PBM lobbyists claiming that it's the pharmacist's "that are greedy for more money" for demanding transparency in PBM contracts. Lol

Just like blame is put on doctors for healthcare costs

 

[PikminOC]

Bingo. Read the fineprint when you check that user agreement on the GoodRx website/app. When you print or show that coupon you give them full access to your personal data; name, address, dob, phone number, email, etc. There is nothing in place to say that they aren't selling your information to spammers and advertisers. There is a reason alot of retail pharmacies are no longer accepting it.

Is that really the reason retail pharmacies dont accept it?

 

[AlPacino]

Is that really the reason retail pharmacies dont accept it?

Cant speak for what other retail locations do but thats one of them. Also retail pharmacies that still accept GoodRx are losing revenue on every single medication dispensed with one of those coupons. Its a money-losing strategy.

 

[PikminOC]

The money is made up in other ways. Grocery purchases, expensive walgreens items, etc

Cant speak for what other retail locations do but thats one of them. Also retail pharmacies that still accept GoodRx are losing revenue on every single medication dispensed with one of those coupons. Its a money-losing strategy.

 

[mgarph]

I’m curious about this: I get rxs often from providers with random GoodRx coupon codes listed on them. Are they getting kickbacks when pharmacies bill these codes?

Some aren't but some are. I think some offices just add it to save cash patients money and some are affiliates getting commission on each claim.

 

[VA Hopeful Dr]

Some aren't but some are. I think some offices just add it to save cash patients money and some are affiliates getting commission on each claim.

I make no money from goodrx. Its mainly either for cash pay patients or patients with terrible insurance.

 

[CetiAlphaFive]

I make no money from goodrx. Its mainly either for cash pay patients or patients with terrible insurance.

What the original reference to was offices that auto-generate it in the "Additional Notes" field

 

[VA Hopeful Dr]

What the original reference to was offices that auto-generate it in the "Additional Notes" field

That's an option?

 

[CetiAlphaFive]

That's an option?

Yeah. Dunno if they actually get paid for it. It's gotta be peanuts

 

[SCRph2014]

I just throw them away when we get them in the mail.

We were specifically instructed by our pharmacy operations to throw them away in front of the rep dropping them off, but to keep the candy and pens

 

[SCRph2014]

The money is made up in other ways. Grocery purchases, expensive walgreens items, etc

Unfortunately, the amount of money spent on goods outside of the pharmacy do not help to balance the pharmacy sales numbers. In my work, it's calculated as a separate department, which includes labor, rent, supplies, etc. Insurance reimbursement is the #1 way to maintaining a profitable pharmacy

 

[BenJammin]

I don't believe for a second that physicians who send discount card codes do not know about it. That is such a crock.

 

[PikminOC]

I don't believe for a second that physicians who send discount card codes do not know about it. That is such a crock.

About what? Discount cards are not covered in med school, residency, cme, or jobs.

 

[VA Hopeful Dr]

I don't believe for a second that physicians who send discount card codes do not know about it. That is such a crock.

Seriously? Are you one of those people who think we also get paid for every prescription we write?

 

[BenJammin]

Seriously? Are you one of those people who think we also get paid for every prescription we write?

What I'm saying is very clear. Two facts and you can only be one. You're either getting paid by a discount card company to put those codes into your electronic prescriptions or you're ignorant to what your eprescribe software is including in the prescriptions you transmit to pharmacies. Which is it?

 

[Modest_anteater]

How is this true? Pharmacies, drug companies all make buying meds complicated in order to continue to skim as much as they can from the consumer. GoodRx is better than nothing and allows consumers to price compare.

I have filled Drug A for years, had good insurance, and paid $150/mo until my deductible was met
I went in to fill Drug A and cash paid, and have paid sometimes more and sometimes less than the $150/mo depending on the pharmacy.
I used GoodRx and paid $30 for a 3 month supply of Drug A and knew which pharmacy was the cheapest. Even with Good RX, the prices could vary from $30-100

So tell me how GoodRX and the like are not beneficial to consumers. This is the only way to be educated unless you call every pharmacy, ask for the cash price of every drug you have.
Its crazy to me how two Walgreen and CVS using Insurance, cash pay, and good RX can be 100-200% different in prices.

Atleast with good Rx, I can put in the drug and get a list of the prices.

Pharmacies can be transparent but choose not to in order to keep skimming of the ignorant.

Every Pharmacy has a cash Price. They could publish all Cash price online but choose not too because they know market forces would drive prices down and they won't be able to take in $100+ profit from some drugs.

Good RX essentially publishes the "Cash Price" of the pharmacy.

"Good RX essentially publishes the "Cash Price" of the pharmacy." Except often times it's inaccurate because different pharmacies paid much different prices for the drugs depending on when and where the drugs were bought whole sale.

 

[Modest_anteater]

Walgreens has fired a few people for this in my area.

seems like a good way to make money. say you get 1,000 patients on it that fill twice a month. that's 2,000 USD a month

 

[CetiAlphaFive]

I accidentally read some of Tikitorche's posts again and got a migraine

 

[PikminOC]

I do not get any money from any prescriptions I write. I have blocked all my prescription info so it doesnt go to the drug reps. I give the goodrx card so meds are affordable. Some of my patients dont have insurance so a med like Abilify is relatively inexpensive on goodrx. You are making alot of untrue assumptions.
I write my prescriptions by hand and give it to the patient. I dont know of any docs that get kickbacks from meds other than oncology docs.

 

[VA Hopeful Dr]

What I'm saying is very clear. Two facts and you can only be one. You're either getting paid by a discount card company to put those codes into your electronic prescriptions or you're ignorant to what your eprescribe software is including in the prescriptions you transmit to pharmacies. Which is it?

If I knew how to automatically include the discount card codes in my prescriptions I would, and I'm not being paid anything by any discount card company.

I could put them in manually but I'm too lazy for that.

 

[CetiAlphaFive]

I do not get any money from any prescriptions I write. I have blocked all my prescription info so it doesnt go to the drug reps. I give the goodrx card so

You what?

 

[SCRph2014]

I write my prescriptions by hand and give it to the patient. I dont know of any docs that get kickbacks from meds other than oncology docs.

There shouldn't be any doctors receiving any kickbacks from medications, per the law.

 

[PikminOC]

Oncology doctors do. They circumvent the law by being paid for administration of the med. A percentage, not flat fee
Cancer drug choices tied to drugmaker payouts to doctors | Reuters

 

[PikminOC]

You what?

They get the prescription data from an AMA list. I opted out of this. So reps dont come, and thats fine

 

[CetiAlphaFive]

Just like blame is put on doctors for healthcare costs

I'm confused by this post.
Are there any other employees in a hospital making a half million dollars per year?

They get the prescription data from an AMA list. I opted out of this. So reps dont come, and thats fine

Google "PBM" and "DUR"

 

[VA Hopeful Dr]

I'm confused by this post.
Are there any other employees in a hospital making a half million dollars per year?

Strawman. Our actual income is a fairly small percentage of healthcare spending (7-ish% last time I looked). So even if you cut our pay in half, you're only saving a little over 3%...

 

[CetiAlphaFive]

Strawman. Our actual income is a fairly small percentage of healthcare spending (7-ish% last time I looked). So even if you cut our pay in half, you're only saving a little over 3%...

Next you're gonna tell me I can't blame the president for the economy

 

[JamesL1585]

The first idea I ever had for a startup, Iodine (who beat us to market), got purchased by GoodRx. I was sad.

 

[mgarph]

Why not just distribute the discount cards and earn $1 per claim when they are used? Check it out here: http://www.YourRxHelp.biz/help1023 you might as well since all the chains accept them anyway and the techs are putting cash patients on discount cards to save them money

Dude in my district (3 letter) got fired for this, luckily it was a tech...probably made as much from the commissions as he did from his salary

 

[greenswall]

I know this is old news, but crazy that this is a public company now...

 

[PikminOC]

I know this is old news, but crazy that this is a public company now...

What's that mean for us? Is that good or bad?