
GoodRx is coming for subscription prescription - prostoalex
https://techcrunch.com/2019/09/26/goodrx-is-coming-for-subscription-prescription-services-with-the-launch-of-goodrx-care/
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dhruvp
For those wondering, here’s how GoodRx works and makes money:

1\. GoodRx obtains prices of drugs at all pharmacies through contracts it has
with PBMs (middleman that determines insurance payouts to pharmacies).

2\. Pharmacies have wildly different prices from one another - going to one
pharmacy over another can save you and your insurance a lot of money.

3\. When you use a GoodRx coupon, the insurance company pays GoodRx a small
amount as they had to spend less on their patient thanks to the coupon (i.e
they didn’t use a super expensive pharmacy).

4\. The pharmacy pays GoodRx a referral fee (kind of like a restaurant pays
yelp a referral fee when you use a yelp coupon).

Over the last 5 years, insurance companies are increasingly pushing high
deductible plans on to employers. As a result, patients are way more price
sensitive than they used to be. If you had no deductible, you probably
wouldn’t care too much about drug price differences because the copays
wouldn’t be that different. However, due to these new plans you care a lot
more and hence services like GoodRx and Blink become a lot more important.

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appleflaxen
but it works even if you have no insurance. plus it doesn't know what
insurance you have. isn't that incompatible with what you are describing?

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lotsofpulp
I’m confused as to what value GoodRx adds in the payer - provider - patient
chain?

Is this another data harvesting play? Why would insurance companies give
GoodRx a piece of their revenue? They all have their own PBMs.

Why would a pharmacy give them a piece of their revenue? They can just charge
$0.01 less to the patient and not have to pay a commission to GoodRx.

~~~
davycro
I don’t know how goodRx makes money, but it’s a great tool for doctors. I use
it every shift to pick affordable antibiotics, blood thinners, eye drops, etc
for my patients. Yesterday I accidentally prescribed an ear drop that cost
$320 for the bottle, when there was a $15 option that was just as effective.
Only way for me to know that was GoodRx

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njovin
It seems crazy to me that as a professional who’s diagnoses basically has to
be followed there’s no other means to know how your treatment plan will
financially affect a patient.

Imagine if your car mechanic recommended a fix but had no idea what the parts
would cost. And the difference between two perfectly suitable parts could be
the equivalent of half of someone’s paycheck.

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dreamcompiler
Doctors know generics are cheaper (or at least they used to be) but that's
about it for their price awareness. This is not their fault. Doctors are
inundated by drug salespeople "educating" them to prescribe the most expensive
drugs. And drug salespeople never--ever--push aspirin.

~~~
davycro
Every script I write is for a generic. I have never met a drug rep.

For many ailments there are five or six different drugs suited for the job.
Goodrx helps me pick the most affordable.

~~~
dreamcompiler
> I have never met a drug rep.

Interesting. I wonder if this is because you're an ER doc and work in a
hospital? Every doctor I know who sees patients in an office has to deal with
sales reps.

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woofyman
A 90 day supply of my 3 generic drugs using GoodRx is cheaper than 30 day
supply using insurance.

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Edmond
90 day supply of prescription drugs has always been cheaper than 30 supply. It
is also cheaper if you it get mail-delivered.

Prescription benefit managers like Medco/ExpressScript have offered such
options for years...Not sure what the GoodRX angle is.

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woofyman
Using GoodRx, $120 for 90 day supply of 3 generics. Using insurance, $180 for
3 generics 30 day supply.

~~~
ceejayoz
Using GoodRx is still “using insurance”, isn’t it? My insurer offers 90 day
supplies with a cheaper copay via Express Scripts already.

(Their customer service blows, though.)

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woofyman
>cheaper copay

I’m not talking about copays. My insurance doesn’t have a coppay until I hit
the deductible. I’m paying cash for the drugs.

~~~
ceejayoz
Copay, coinsurance, deductible, whatever.

If you're paying cash _outside_ of insurance coverage, it's not counting
towards the deductible or annual out-of-pocket max, which screws you if you
have significant other healthcare costs.

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woofyman
I have a $7900 deductible.

~~~
ceejayoz
Yeah, so imagine spending $3k on GoodRx prescriptions, then winding up in the
hospital and finding out you've still got all $7900 of it left to cover before
insurance kicks in.

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ilaksh
I have used GoodRx when I did not have insurance. I believe that is a very
significant part of its business model.

Adding "prescription services" now, essentially GoodRx is becoming a health
insurance company that doesn't actually do the insurance part. I mean, it's
really offering virtual doctor visits.

So the next step would be "emergency coverage" for an "additional monthly
service fee" with an optional "self-pay threshold" for lower monthly fees and
higher "emergency assurance".

I think it would be a good thing if they could take it all the way. The thing
that is not clear is whether any company could actually make that profitable
without excluding people who had certain expensive conditions.

