“It’s not really price transparency”: pharmacies push back Surescripts and the GoodRx agreement

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This article has been updated with a statement from Surescripts.

When GoodRx announced a planned integration with Surescripts, the two companies touted the deal as a victory for price transparency. Pharmacists, however, are not so sure.

A group of pharmacists oppose the deal, which they say does not reflect the true cost of drugs and could keep patients away from independent pharmacies. They asked the Surescripts board to cancel it in a letter dated August 13.

“The agreement was presented as a step towards transparency; when in fact the voucher programs are bought and paid for by the same opaque PBM-based pricing scheme that the deal claims to upset, ”they wrote in a copy of the letter obtained by MedCity News, which included 67 pages of signatures from independent pharmacies. , and pharmacists working for hospitals and retail chains.

Their concerns stem from the broad reach of Surescripts and the way drug voucher programs, like GoodRx, structure their operations.

Surescripts harnesses the technology that transmits an electronic prescription from a doctor’s office to a pharmacy, and it dominates that market. Its agreement with GoodRx would allow prescribing physicians to view drug prices negotiated by GoodRx, but only for patients who are uninsured or for whom pricing information is not available for an insured patient.

Independent pharmacies are concerned that this process will take patients away from their stores and to the big chains, which are more often listed on GoodRx’s platform.

“Every time they make this deal none of us like it, but we can’t say we’re going to be using this other (e-prescribing) platform,” said Kyle McCormick, founder of Blueberry. Pharmacy, based in Pittsburgh, who wrote the letter.

In an emailed statement, Surescripts wrote that the company is “aware that some pharmacies have concerns about our working with a prescription savings program provider, and we want to assure them that we have demonstrated this. diligence in pursuing a model that cuts costs for patients while retaining patient loyalty. choice of pharmacy and choice of drug by the prescriber.

GoodRx is negotiating with Pharmacy Benefit Managers (PBMs) to offer discounts on coupons. They lower the price of the inflated “usual, customary and reasonable” rate charged to patients, which can vary widely from location to location. When the prescription is filled, the PBM charges a fee to the pharmacy and GoodRx takes a portion of those fees. Through this process, he was able to earn $ 550.7 million last year.

But a growing number of people argue that prices shouldn’t be based on these negotiations at all. For example, the average retail price of imatinib, a leukemia drug, is around $ 9,600. With GoodRx, the price is reduced from $ 136 to $ 2,000, depending on the pharmacy. But the actual wholesale cost to acquire the drug is only $ 49, McCormick said.

“Instead of moving towards a transparent model where we know how much drugs cost or how much they should actually cost, it perpetuates the lack of transparency,” he said. “This number that is crossed out is a completely made up number.”

True, without the rebate, most uninsured patients would be forced to pay inflated cash prices.

“We are proud of our program with Surescripts and believe that this program will help many people pay for their prescriptions and help physicians, pharmacists and other prescribers do the best they can for their patients,” GoodRx wrote in a statement sent. by email to MedCity News.

Some companies are pushing for a different approach to drug pricing, such as using CMS’s national average drug acquisition cost. A startup, CapitalRx, takes this approach by offering discount cards, charging a $ 1 processing fee rather than part of PBMs.

“You are going to see legislative changes on the price of drugs. It’s a matter of when, not if in my opinion, ”said CapitalRx chairman Matt Gibbs. “Literally everything would be better than what we use today.”

Photo credit: z_wei, Getty Images


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