This article has been updated to clarify that Surescripts will only display GoodRx drug discount information for patients who are uninsured, or where pricing information from their PBM or health plan is not available.
GoodRx struck a partnership with medication data giant Surescripts that would let healthcare providers access drug discount information. Physicians could view information on GoodRx discount prices through Surescripts, but only for patients who are uninsured or where their health plan’s drug pricing information isn’t available.
At ViVE 2024, Panelists Share Prior Authorization Progress and Frustration in Payer Insights Program
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Arlington, Virginia-based Surescripts dominates the e-prescribing market, offering technology that routes clinicians’ electronic prescriptions directly to pharmacies. It’s owned by CVS Health and Express Scripts, and nearly 2 billion prescriptions were delivered through its software last year.
It also sells a service that lets prescribing clinicians view drug prices specific to a patient’s coverage and complete prior authorizations as needed.
While Surescripts can share price information on drugs as covered by insurance, and across retail and mail order options, the partnership would add information on GoodRx’s drug discount prices for patients where this information isn’t available.
“Independently, GoodRx has relationships with other EHRs where we’re built in, (such as Allscripts),” said Justin Fengler, senior vice president of corporate strategy and business development for GoodRx. “This broadens that reach. ”
The Impact Brands: Empowering Wellness Through Natural and Holistic Solutions
In an era of escalating healthcare costs and a growing preference for natural, holistic approaches to health, The Impact Brands emerges as a collective of diverse brands dedicated to supporting overall wellness through natural means.
The deal would significantly expand GoodRx’s footprint, as Surescripts has relationships with most major EHRs. It would also broaden the information healthcare providers have on cash pay drug pricing information.
This integration in particular would help offset cases where a provider might not have information on a health plan’s drug pricing, or where the patient doesn’t have health insurance. The goal is to make it easier to address drug affordability and coverage during the appointment itself instead of at the pharmacy counter.
“It’s impossible to ignore the affordability or coverage of a drug,” Fengler said in a Zoom interview.
GoodRx offers cash-pay discounts for medications. The Santa Monica-based startup went public last year, raising more than $1 billion in its IPO.
The service is often used by patients without health insurance or on high deductible plans, but could also be useful in the puzzling cases where the price of medications is higher with insurance than paid in cash. However, the way the Surescripts partnership is structured, providers wouldn’t necessarily be able to price compare in this way through their EHR.
Other competitors, such as Amazon, are building out their own price comparison tools for medications. After acquiring PillPack, Amazon rolled out its own pharmacy service last year, though it’s still largely focused on prescription delivery.
PillPack had used Surescripts’ medication data through a third-party company, called ReMy Health. But tensions rose between the companies, and in the year following the acquisition, Surescripts barred ReMy Health as a vendor, as Amazon threatened a lawsuit.
Photo credit: Stas_V, Getty Images
