
Prescription drug platform GoodRx has launched GoodRx Community Link, which uses a cost-plus pricing model based on National Average Drug Acquisition Cost to provide predictable pricing, and which allows independent pharmacies to contract with them directly.
This, said GoodRx, gives these pharmacies more direct control over pricing and promotes favorable margins. A direct contract means the pricing relationship is entirely between GoodRx and the pharmacy, with no involvement from a pharmacy benefit manager.
Entering into a direct agreement with GoodRx does not waive a pharmacy's right to participate in ongoing litigation against GoodRx, the company added.
WHAT'S THE IMPACT
When a direct contract is signed, independent pharmacies will have the ability to opt-in to GoodRx's Integrated Savings Program as an additional benefit.
Starting July 1, all independent pharmacies will be opted out of the ISP by default. ISP participation may offer more favorable rates than traditional commercial insurance reimbursement, said GoodRx.
Participants will also have access to more than 90 deals on brand medications. The manufacturer buys down the price of a brand medication via GoodRx, making it more affordable for the consumer and economically beneficial for the pharmacy, the company said. Examples include Lantus, a Humira biosimilar, and medical devices such as Dexcom.
"GoodRx Community Link is the result of a multi-year journey to evolve the GoodRx business model and deliver solutions tailored to the specific needs of independent pharmacies," Aaron Crittenden, president of Rx Marketplace at GoodRx, said.
THE LARGER TREND
The "Big 3" pharmacy benefit managers – CVS Caremark, Express Scripts and OptumRx – mark up specialty drugs at their affiliated pharmacies by hundreds or even thousands of percent, according to a January Federal Trade Commission report.
Such significant markups allowed the three largest PBMs and their affiliated specialty pharmacies to generate more than $7.3 billion in revenue from dispensing drugs in excess of the drugs' estimated acquisition costs from 2017 to 2022, the report found.
The American Medical Association released data in September showing that the four largest pharmacy benefit managers in the country control roughly 70% of the national market.
CVS Health is the largest PBM (with a 21.3% market share), followed by OptumRx (20.8%), Express Scripts (17.1%) and Prime Therapeutics (10.3%).
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.