How GoodRx Brings Low Drug Costs in Vexing Healthcare Landscape

February 07, 2024 - The cost of healthcare is getting to be a nearly insurmountable problem for patients, leaving the healthcare consumer with a pretty hefty homework assignment if they want to get the best buy for their services and medications.

At GoodRx, it’s their goal to at least help with that homework, even if it’s impossible to change the assignment.

“Healthcare continues to ebb and flow, and policies continue to get passed,” Tori Marsh, GoodRx’s director of research, said in a recent interview. “What GoodRx does well is, we focus on the consumer, and we focus on saving them money, on educating them, on informing them.”

There’s a lot the consumer needs to know along their healthcare journey. More often than not, the burden of care coordination across different healthcare providers falls on the patient, much to the detriment of the patient experience. And with the growing prevalence of high-deductible health plans, patients bear the brunt of high healthcare costs now more than ever.

This includes prescription drug costs, which is where GoodRx is focused.

In May 2023, researchers wrote in JAMA Network Open that about a fifth of patients have cost-related medication access barriers. This means that they did not access their medication as prescribed due to the high price tag.

A similar study, also published a few months earlier in JAMA Network Open, found that high prescription drug costs bar medication adherence. Around a fifth of diabetic patients included in the study did not maintain use of glucose-lowering medications between 2005 and 2018. Meanwhile, an average of 17 percent and 43 percent of patients did not consistently take their blood pressure- or lipid-lowering medications during that same period, the researchers added.

To be sure, many healthcare advocates and researchers have called for a second look into how changing drug pricing policy can affect patient access to their medications. But on a pragmatic and tactile level, GoodRx indicated that its goal is to help patients manage their healthcare costs as they stand right now.

In order to navigate the current landscape while balancing medication access with good finances, consumers need to know that they have different options for shopping for medications.

“For years, [insurance has] been the narrative,” Marsh explained. “If you have insurance, then you're paying the best price, and you don't really need to shop around. You're getting as best of care as you can get. That narrative is changing, and people are finding that their insurance is covering less and less. There are higher deductibles, higher co-pays, and co-insurance.”

All of this means that patients might have a little more work on their end, Marsh conceded.

“Consumers now need to be a little bit more of their own advocate with regards to affording their medication, affording their healthcare, affording their visits,” she explained. “Unfortunately, that means a little bit more homework and research on their part, especially if they're finding that something's not covered or something's more expensive than they thought it would be.”

Marsh said GoodRx sees itself as a tool to help consumers with that homework. The technology generally serves two functions. First, it lets users compare the cost of a medication at multiple different pharmacies: what it will cost at CVS or Walgreens or Rite Aid. Second, it offers discount cards, which the company negotiates with drug manufacturers itself.

Patients may present those discount cards to the pharmacist to purchase their medications at a lower cost. This is a boon for patients without any insurance coverage, but in recent years, it’s also proven useful for patients with insurance who see their plans cover less and less.

In some cases, the GoodRx discount is better than what insurance offers, Marsh recently found. In an assessment of GoodRx’s impact over the past year, Marsh and her team in the research department found that the GoodRx discount is better than the insurance discount half the time.

“We're seeing more and more is a lot of issues around affordability with insured patients,” Marsh stated.

This is a new trend, she indicated. Perhaps one of the first things one thinks of when hearing about GoodRx is how it can serve the uninsured, cash-pay patient. This data shows that healthcare costs, in particular prescription drug costs, are impacting everyone.

“An emerging trend that we're continuing to see, and we point out in the report, is that this sticker shock at the pharmacy is also happening for insured individuals, as well,” Marsh said. “No one's really safe from it.”

Critics of the nation’s healthcare and drug pricing policies might argue that the US is in need of reform.

But within the current landscape, Marsh’s data shows that GoodRx has made an improvement in how many people can access their medications.

Also in that report, Marsh and her team noted that the tool saved users an average of 82 percent on retail prices for their prescriptions in the last year. From there, the researchers could estimate the technology helped patients fill at least 184 million prescriptions that they'd otherwise be unable to afford.

That’s naturally had an impact on health outcomes. Marsh and the research team estimated that GoodRx helped avert more than 927,000 emergency department visits and hospitalizations in the past year, generating more than $5 billion in healthcare system savings since 2012.

More specifically, Marsh estimated that GoodRx has contributed to the prevention of around 590,000 ED visits and 336,000 hospitalizations for common chronic illnesses such as COPD, depression, diabetes, and major adverse cardiac events like heart attack and stroke.

It all boils down to enabling good medication adherence, Marsh said.

“When someone goes to the pharmacy and they can't afford their medication, more likely than not, they're going to leave that medication at the pharmacy,” she explained.

“And it could be something for acne, where it's not as essential that they pick it up,” she reasoned, “or it could be for a really important medical condition, or a chronic condition like heart health, like COPD, like asthma, where them not taking that medication can have really detrimental effects, from a disturbance in the quality of life to even hospitalizations and ER visits.”

It's not just the dodged ED visits and hospitalizations that are moving the needle on patient health and well-being, the report furthered. When looking at the 200 most-filled medications in the US, GoodRx found that it saved users around $72 per prescription.

That’s a lot of money that can go pretty far for patients feeling the pinch in other parts of their lives, like housing costs and grocery and food security. That’s a big deal as healthcare acknowledges affordability limitations affecting other social determinants of health.

Marsh said that GoodRx gets these results by truly knowing the consumer and keeping them at the center of its work. She said that’s most exemplified by the company’s investment in the research team she’s on, which looks not just at drug costs but the entire consumer healthcare experience.

“Our main goal is to really cover anything regarding healthcare accessibility, equity, and affordability,” Marsh said of the research team. “We are following trends with what consumers are experiencing in the healthcare space, whether that be insurance trends, drug pricing, accessing hospitals, accessing providers.”