This article has been updated with a statement from Surescripts.
When GoodRx announced a planned integration with Surescripts, both companies touted the deal as a win for price transparency. Pharmacists, however, aren’t so sure.
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A group of pharmacists are pushing back against the deal, which they say doesn’t reflect the true cost of drugs, and could steer patients away from independent pharmacies. They asked Surescripts’ board to rescind it in an August 13 letter.
“The deal was touted as a move towards transparency; when in fact, coupon programs are bought and paid for by the same PBM-based, opaque pricing schema the deal claims to upend,” they wrote in a copy of the letter obtained by MedCity News, which included 67 pages of signatures from independent pharmacies, and pharmacists working for hospitals and retail chains.
Their concerns stem from Surescripts’ broad reach, and how drug coupon programs, like GoodRx, structure their businesses.
Surescripts operates the technology that transmits an electronic prescription from a doctor’s office to a pharmacy, and it dominates this market. Its deal with GoodRx would let prescribing physicians view GoodRx’s negotiated drug prices, but only for patients who are uninsured or where price information isn’t available for an insured patient.
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Independent pharmacies worry this process would steer patients away from their stores and toward larger chains, which are more often listed on GoodRx’s platform.
“Whenever they make this deal, none of us like it, but we can’t say we’re going to be using this other (e-prescribing) platform,” said Kyle McCormick, founder of Pittsburgh-based Blueberry Pharmacy, who wrote the letter.
In an emailed statement, Surescripts wrote that the company is “aware some pharmacies have concerns about us working with a prescription savings program vendor, and we want to assure them that we have been diligent in pursuing a model that lowers costs for patients while retaining patient choice of pharmacy and prescriber choice of medication.”
GoodRx negotiates with pharmacy benefit managers (PBMs) to offer coupon discounts. They drop the price from the inflated “usual, customary and reasonable” rate that patients are charged, which can vary widely from place to place. When the prescription is filled, the PBM charges a fee to the pharmacy, and GoodRx takes a portion of that fee. Through this process, it was able to make $550.7 million last year.
But a growing number of people are arguing that prices shouldn’t be based on these negotiations at all. For example, the average retail price of leukemia drug imatinib is around $9,600. With GoodRx, the price gets knocked down to anywhere from $136 to $2,000, depending on the pharmacy. But the actual wholesale cost to acquire the drug is just $49, McCormick said.
“Instead of moving toward a transparent model where we know how much drugs cost or how much they actually should cost, it perpetuates lack of transparency,” he said. “That number that’s crossed off, it’s a completely made up number.”
Admittedly, without a discount, most uninsured patients would be stuck paying inflated cash prices.
“We are proud of our program with Surescripts and confident this program will help many people afford their prescriptions, and will help physicians, pharmacists, and other prescribers do best by their patients,” GoodRx wrote in an emailed statement to MedCity News.
Some companies are pushing for a different approach to drug pricing, such as using CMS’ National Average Drug Acquisition Cost. One startup, CapitalRx, is taking this approach in offering discount cards, charging a $1 processing fee rather than a portion from PBMs.
“You’re going to see legislative changes on drug pricing. It’s a matter of when, not if in my opinion,” said CapitalRx President Matt Gibbs. “Literally anything would be better than what we use today.”
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