GoodRx promotes itself as a company that allows you to compare drug prices and find coupons at over 60,000 pharmacies across the country.
Sounds great right? Well, unfortunately there is a catch.
GoodRx only works if you are paying without insurance, which is how less than 5% of prescriptions are paid for.
I thought GoodRx promised to save customers money on thousands of medications.
Well yes, and in some cases they certainly do, but it depends on the situation.
So let’s take a look at when to use GoodRx and when to avoid it.
How is the Price of my Prescription Set?
Before we dive into GoodRx, it helps to have a basic understanding of how prescription pricing works.
Now understand this.
Prescription pricing is extremely complicated in the United States.
It would take pages for us to adequately cover all the intricacies. So instead, we are just going to cover some basics.
Simply put, if you are paying for a prescription with insurance, your insurance company sets the price you pay. Or more specifically, your pharmacy benefits manager (PBMs) does.
Typically, this comes in the form of a copay, which is just a fixed amount you pay for medical services.
Generally, the copay is much less than the actual cost of the medical service and your health insurance covers the difference.
Here’s an example.
You go into the pharmacy to pick up a prescription medication.
You show the pharmacy your health insurance card.
The pharmacy submits a claim to your insurance for the prescription and, if approved, your insurance tells the pharmacy what copay to charge.
For example, on a medication that costs $200, they might say your copay is $20.
The pharmacy would then “bill” your insurance company for the remaining $180 and the insurance company’s PBM would decide how much to reimburse the pharmacy.
This is just one example, but the point is you don’t usually pay the actual cost of the drug.
You pay the amount set by your insurance company.
What is GoodRx?
Founded in 2012, GoodRx is based out of Santa Monica.
Their website and app allow you to “compare prescription drug prices and find coupons at more than 60,000 pharmacies.”
However, when they say compare prescription drug prices, they really mean the price of a prescription if you aren’t using insurance.
Why does this matter?
Well, because this price isn’t what you would actually pay at each pharmacy since you are likely using insurance.
In order for them to help you compare the price you would pay at each pharmacy, GoodRx would need to know things like your health insurance, prescription plan, etc.
How Does GoodRx Work?
Using the service is simple enough.
If you plan on paying without insurance, just go to the GoodRx website and type in your medication.
GoodRx then shows a list of “cash” prices and coupons at participating pharmacies near your location, which you can print or save on the GoodRx app.
Then, similar to using a coupon at the grocery store, you just present the coupon at the pharmacy counter when you pick up your prescription.
How Does GoodRx Make Money?
GoodRx makes money in two main ways.
Advertisements on their site and a percentage fee every time a GoodRx coupon is used at the pharmacy.
The advertisements are paid for by pharmacies that want to appear higher in the GoodRx search results.
But where does the referral fee come from?
Pharmacy Benefits Managers or PBMs that GoodRx partners with.
When a customer uses a GoodRx coupon, the process from the pharmacy standpoint is a little like insurance.
Pharmacies input the BIN and PCN number on the coupon and the PBM tells us the price to charge.
Then, based on that price, The PBM then takes a percentage fee of that transaction and splits it with GoodRx.
Do Pharmacies Lose Money With GoodRx?
The sad reality is that many pharmacies lose money when they accept GoodRx.
Prescription margins are already razor thin and the fee that GoodRx takes on top of the PBM likely puts them in the red.
So why do they do it?
Well, for some pharmacies, the idea is that by accepting these coupons a pharmacy will attract more customers to their business, which gives the pharmacy a chance to sell other non-prescription products and potentially earn future business from that customer.
And so, despite the pharmacy losing money on the individual prescription, the hope is that the additional business will make up for it.
This is also why many independent, non-chain pharmacies won’t or hate to accept GoodRx.
They make most of their revenue on prescription medications.
Unlike a CVS or Walgreens, if an independent pharmacy loses money on an individual prescription, it is unlikely they will be able to offset the loss by selling convenience store products (i.e. greeting cards, snacks, etc.).
This can really hurt smaller pharmacies who are unable to absorb these types of losses.
When Should You Use GoodRx?
If you are uninsured or if you will be paying without insurance for a particular medication, then GoodRx could be useful.
In these cases, GoodRx can help you get a baseline for how much you might need to pay out of pocket, in addition to potentially helping you save money with a coupon.
Just remember, the prices GoodRx lists on its website are not necessarily the best prices available since they only display and offer coupons for partners and paying advertisers.
So use it more as a guide than an absolute truth.
Summing it All Up
GoodRx can be a great tool, especially if you are uninsured or will be paying without insurance for prescription medications.
But it’s important to understand what GoodRx really is and when it is appropriate.
If you need to pay for prescription medications without insurance, make sure to do your research and avoid paying too much at the counter!
If you have additional questions about drug pricing, send us an email at firstname.lastname@example.org or go to https://nowrx.com/faqs/ and submit a custom question to our pharmacy team!
About NowRx Pharmacy
NowRx Pharmacy is a new kind of local pharmacy built from the ground up to deliver a better pharmacy experience. We use modern technology inside the pharmacy to provide better pricing, better service, and better convenience. Visit our NowRx Pharmacy Frequently Asked Questions to learn more.