GoodRx, a prescription savings platform, has launched a direct contract offering for independent pharmacies. The goal is to offer more predictable pricing and brand medication partnership deals.
Community Link is designed to address industry challenges that independent community pharmacies face around reimbursement and competitive pressures. Independent pharmacies can now enter into a direct contract with GoodRx without pharmacy benefit manager involvement.
Historically, GoodRx has worked with PBMs, allowing pharmacies to leverage coupons for savings. A few years ago, the company began partnering directly with big retailers on fully transparent and sustainable economics, executives said.
“The impetus here is we want to extend this offering and what we’ve built with big retail into independent pharmacies, and make sure we can try to build long-standing relations with them,” Aaron Crittenden, president of Rx Marketplace at GoodRx, told Fierce Healthcare.
Community Link operates on cost-plus pricing, based on a NADAC (National Average Drug Acquisition Cost) dispensing fee plus a GoodRx admin fee. Entering into a direct agreement with the company does not waive a pharmacy’s right to participate in ongoing litigation against GoodRx. “It's very straightforward on the cost-plus basis,” Crittenden said. “In a world where multiple contacts are being played on by PBMs, this simplifies it drastically.”
Additionally, starting July 1, all independent pharmacies will be opted out of the GoodRx Integrated Savings Program (ISP) by default. It will be optional for pharmacies directly contracting with GoodRx. This program may offer more favorable rates than traditional commercial insurance reimbursement, Crittenden said. But whether a pharmacy will want to participate or not comes down to what their commercial rates are and if they are comfortable with the concept.
“I think everyone needs to make their own decision and work through that,” Crittenden said. There is no administrative burden that comes with participating in ISP, he added.
Through Community Link, pharmacies can access more than 90 brand medication deals where the manufacturer buys down the price for the consumer via GoodRx. Pharmacies will get funds from participating manufacturers through the GoodRx direct agreement. These transactions make drugs cheaper for the consumer while the pharmacy still retains full reimbursement, per Crittenden. The goal is to lower what the patient pays and support medication adherence. Drugs in these deals include Lantus, a Humira biosimilar and medical devices like Dexcom. There will be no admin fee for pharmacies in these transactions.
In March, OptumRx declared it’d fully move to a cost-based model by 2028. This move did not influence GoodRx’s decision to launch Community Link, per Crittenden. “A lot of the industry is moving this way,” he said. CVS, for instance, has already been shifting toward cost-plus. “Do I think it’s revolutionary? No,” he said of OptumRx’s announcement, “but I think it’s a good step in the right direction.”
In the future, Crittenden has doubts that cost-plus will ever become the sole way of doing business. “Healthcare’s so complicated. There's a lot of different models. Cost-plus is certainly having a moment and we are seeing some big pushes there across the board. Do I think it will ever be everywhere? Probably not. And I think there’s good reasons for that.”
For GoodRx, cost-plus is aligned philosophically with the company’s mission, he added: a simple way to explain pricing with transparency in the process.
The “cost-plus” approach mimics that of Mark Cuban Cost Plus Drug Co., which aims to offer transparent and lower prices than traditional pharmacies. Cost Plus Drugs sells prescription medications at a 15% markup over their costs plus pharmacy fees. Payers are also jumping on the bandwagon to try to keep costs down for members, from Select Health working with Cost Plus Drugs to Blue Cross Blue Shield plans partnering with Civica Rx, a nonprofit pharma.