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GoodRx is coming for subscription prescription (techcrunch.com)
57 points by prostoalex 18 days ago | hide | past | web | favorite | 38 comments



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.


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?


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.


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


Thank you for doing this!

I was subscribed an otic cream that cost over $200 when the pharmacist told me there were similar, slightly less effective drops for $50. I spent 2 hours at the pharmacy calling back to my physician and waiting to try to get the prescription changed. Most don't have that time flexibility to do that.

I think the pharmacist regretted telling me, as it was such a pain to get the prescription changed with my Dr.


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.


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.


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.


> 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.


But generics are not all they are cracked up to be. Bottle of Lies, for example, details problems with generics. And I've had personal experience with the FDA (finally) pulling a generic off the market b/c there was a potential for the drug to cause cancer.

I'm all for generics, but I'd like the government to do its part to protect the health and safety of the citizenry. (And no, I don't believe big pharma is being honest.)


My insurer has an app and web site to look up drug prices. It doesn’t require a login.

My doc could certainly use the same site I do to check. Her EMR could certainly check.

My doc will sit there with me as I look up prices and compare cheaper meds. I just wish it was faster to save both our time.


GoodRx is partnered with PBMs which is why the pharmacies accept discount programs like that, because it's contractually required if they want to work with that PBM on other plans. https://www.drugchannels.net/2017/05/five-fun-facts-about-ne...


This was before Cigna (health insurance company) bought Express Scripts. I don’t see what the insurance company, who is paying for the medicine, gets out of having GoodRx in the middle.


It's an alternative to insurance, if you use GoodRx the pharmacy doesn't bill your insurance.


Am I the only one bothered by the fact that we're already paying for insurance, which is supposed to not only negotiate lower prices for drugs for us, but also pay for a percentage of the cost at the pharmacy? The last few times I have been prescribed something, it was better to use GoodRx than make a prescription claim with my insurance company. So, we're being weaned away from that, paying in a more direct manner for drugs, but still paying the same for insurance. We're overwhelmingly accepting the stealth downsizing of our insurance plans, and praising the people doing it.


It's not the insurers driving it though, as far as I can tell anyway.

It'd be interesting to see a couple worked examples of why their prices end up lower.


Which means you're not eating into your insurance's deductible or out-of-pocket max for the year.

In many cases, that's not going to make financial sense.


I can tell you why you are getting a discount on pricing. The drug companies want to charge high as possible. So the insurers charge a copay to make the patient price sensitive. Now the drug company gives copay assistance to the patient to shield them for the copay. That way they can charge the highest amount to the insurer without the patient feeling he pinch. Now patients without insurance get screwed in this mess so some drug companies provide free medicine for some of these cases.

The real answer is the forbid these rebates and force drug companies to sell at a reasonable price. That is why Medicare prevents this kind of scheme. Also California recently restricts rebates on generic medicines. I have an essential drug due to my dialysis that became generic. I used to get a $85/month copay subsidy from the drug manufacturer. When it became generic, the copay became $10. You should have seen how hard they drug company employees were trying to push me to complain to state legislators about this.


There are quite a few prescriptions that I know I need but currently require a doctors visit. That takes time and is expensive. Being able to connect with a doctor or nurse through telemedicine or an app for a set of basic scenarios, I would use it. It would likely be much cheaper as well (insurance prefers this because it’s $40 instead of $100 for a visit or whatever).

Getting an antiviral for early flu symptoms is much better when it takes 5 minutes for a prescription rather than a day or two for an appointment plus a few hours.

Similarly for UTI prescriptions or doing a strep throat test and course of antibiotics.

If we can avoid all the “no brainer” visits then that frees up healthcare for more important stuff.


Based on my experience (written about here: https://news.ycombinator.com/item?id=17183682) I suspect they're one of the many companies pushing flyers to doctor's offices just to gather data. They do appear to offer some lower prices on prescriptions, not exactly sure how that works though. Maybe they have some type of Costco-like "members only" model, except anyone and everyone is a member.

In any case, I'll never use their service(s).


Advertising? “We have a big group of users, and being featured with us will cost you X and bring Y more sales”.

Price comparison sites is not a new thing?


Price segmentation for pharmacies I believe.


GoodRx has well-connected Silicon Valley founders and a good PR team. We now see lots of this sort of submarine PR from tech companies.

http://www.paulgraham.com/submarine.html


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


Do you know how to find out what a given drug will cost with insurance, other than going to the pharmacy and ask them to ring it up (which takes several minutes at my local Walgreens)?

I've brought a GoodRX coupon to the pharmacy a couple of times, and every single time it's been cheaper with my insurance (which isn't anything special).

The last time I did this, I was also puzzled to hear the pharmacist say that they "already had my GoodRX coupon in the system". I thought the coupon would be unique for each medication.


> Do you know how to find out what a given drug will cost with insurance?

Theoretically your insurer should provide that via some sort of online portal, but in my experience the usability of such tools has always been terrible.


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.


GoodRx is just a smartphone app that doesn't even require login. You just pick your drug, dose, prescription duration, and let the pharmacist scan it. It's so accessible that the pharmacist told me about it and then scanned her own app on her smartphone for me.

I don't know anything about the competitors, but do they have as frictionless of a UX?


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


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.)


>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.


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.


I have a $7900 deductible.


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.


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

That's pretty normal, even with traditional insurance, and has been for at least 20 years.

For a medicine I take, it's $28 for a 30-day supply, and $25 for a 90-day supply. The catch is that the non-SV insurance companies usually require that you get the 90-day supply by mail. Perhaps this is where GoodRx has an advantage.


Probably better marketing.


And the manufacturer coupon of medication often only applies to 30-day prescriptions. GoodRx offers coupons for 90-day supplies.


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.




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