this post was submitted on 15 Jun 2024
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[โ€“] [email protected] 13 points 2 months ago (1 children)

Alright, you didn't ask for any of this, but I have some thoughts about GoodRX.

GoodRX is an ok stop-gap to get people medications they need, but it's still not great. They set their prices based on agreements with PBMs (pharmacy benefit managers), which are the companies that actually provide prescription insurance benefits if you're commercially insured (not your insurance company). Actually, on the computer side, there's no difference between GoodRX and insurance, they are used the same way. The GoodRX coupon has the same numbers on it that a commercial insurance card would have (ID number, BIN, PCN, group number) and a "claim" gets submitted the same way it would be submitted to your insurance company (which is actually the PBM, not your insurance company). The pharmacy has to pay the PBM to process the claim (which is kinda BS, right?) regardless of if the patient is using insurance OR GoodRX, so a lot of local/independent pharmacies can't or won't take GoodRX because they end up actually taking a loss on dispensing the drug due to PBM fees.

I am a pharmacy technician that used to work in outpatient pharmacy; I've helped a lot of people save money with GoodRX, but I usually try to find literally anything else I can do to lower the price first. Prescription billing in the US is absolutely FUBAR.

[โ€“] [email protected] 8 points 2 months ago* (last edited 2 months ago)

Used to contract with a PBM and saw how the sausage is made. It's not pretty people.