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When the pharmacy charges $67 cash for a prescription, but the GoodRX "coupon" lowers the price to $8.90, who loses out on the $58.10 difference? The pharmacy? The drug company? Split?

That is, why don't pharmacies automatically apply the GoodRX "coupon" to all cash purchases?

On a related note, my mom started using a GoodRX coupon with a local grocery store pharmacy because their cash price with GoodRX ($66?) is less than the co-pay she was paying for the drug ($96?) with her insurance provider. It was her most expensive co-pay, so I was using the Internet to see if I could find a lower price. Blink, other pharmacies on GoodRX, and an on-line mail order pharmacy also had prices less than her co-pay.

When I went with PillPack for a few months several years ago, their price for those paying cash was claimed to be the lowest price on GoodRX. However, the prices were based on 30-day prescription prices. At the time, I found I could save money by going to 90-day prescriptions at CostCo.

I plan to contact PillPack again, because that on-line mail order pharmacy I mentioned is now often the cheapest price for medications I look at, and they charge by the pill, so there would be no per pill price change between 30-day and 90-day dispensing.
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At the time, I found I could save money by going to 90-day prescriptions at CostCo.

I have my doctors write 365-day prescriptions (the maximum allowed by US law) and get them in one fill. (I pay cash and don't use my insurance since the insurance price is 2x to 4x Costco's price.)

That will will save you at least $15 over four 90-day fills.

intercst
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why don't pharmacies automatically apply the GoodRX "coupon" to all cash purchases?

Same reason all gas stations don't charge the same price for gas. It is a "price match" game, and they only do it when they *have* to do so.

However, the prices were based on 30-day prescription prices. At the time, I found I could save money by going to 90-day prescriptions at CostCo.

Of course. Think it through--did you? A 90-day prescription could be a standard filled bottle sealed by the manufacturer, so how much work does the pharmacy do? Not much. Counting 90 pills out of a bottle of 500 takes time--ONE time every 90 days. Counting 30 pills every 3 months takes longer (and is done more often)--and has a higher cost. Pillpack has "free" shipping (cost buried in cost of drugs). ANY "free" delivery is not free--the pharmacy pays (actually, the CUSTOMER pays--as always). I am switching to Pillpack for 2020 to try it out. There is a learning curve, so we both learn if it is worthwhile. Cost is not an issue, as I use a Medicare Advantage plan--and all my drugs have a $0 copay for the entire year.

I will let the pharmacy do it any way they choose. The ONLY requirement they MUST meet is a simple one: I must have the drugs I need when I need them. Everything else is irrelevant.
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GoodRx and BlinkHealth.com saved me hundreds of dollars since they were much cheaper than my prescription co-pay before I had Medicare Part D.

Everyone taking prescriptions should do comparison shopping.
Wendy
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It is a "price match" game, and they only do it when they *have* to do so.

That's why I asked who loses the $59.10 difference in price.
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It is a "price match" game, and they only do it when they *have* to do so.

That's why I asked who loses the $59.10 difference in price.


PBMs negotiate prices--and they each have different prices for each drug (if they have it at all). What the "price match" does is tell the pharmacy *their* PBM is charging too much for that drug. Someone else has a lower price, so they "price match" using the info from GoodRx because their info {Rx Bin, Rx Group, etc} tells the pharmacy which code gives the lower price (which is shown on the screen). They don't all use the same PBM, so they do not normally have access to the lower-cost info of competitors.
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When I was in the IT business, I wrote a software tool which sucked in the entire price lists and inventory status of about a dozen major distributors on a daily basis to allow my procurement people to split orders and purchase each item from the lowest priced source. I also looked for "channel conflict" pricing where the manufacturer would, for instance sell a product cheaper to OEM.s than to re-sellers (call me whatever you want as long as I get the best price), or export at cheaper prices (which I could then re-import), or have the same item sold under a different part number for less.

While doing that took considerable work (and sometimes even required using a separate corporation to accomplish without violating contracts), it accrued significantly higher profit margins. I understand that the guys I sold the business to have ceased using these techniques because they were too much work for the employees (they are not as "hands-on" as managers than I was) and are now buying primarily from a single distributor for simplicity.

I suspect this reflects what's going on with the drug dealers as the major pharmacies have their own captive PBM.

Different strokes for different folks, I guess.

Jeff
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I suspect this reflects what's going on with the drug dealers as the major pharmacies have their own captive PBM.

Exactly. Pharmacies are in the retail business, so they are oriented to maximizing that profit with a limited product offering (cheaper to maintain a narrower range of products in stock) and sell it at a decent markup. Getting undercut on some items is expected, so they do not worry about it (much). They would oppose a national drug-buying program because it would undercut their overall profits.
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