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There are a variety of prescription discount card programs; I use GoodRX only as an example but my question applies to them all.

How do these things make money?

My local pharmacy just keeps a couple of discount cards at the register, and if a prescription is particularly expensive they'll ask if I want to try a discount card. Recently one of these cards brought a prescription down from $700+ to ~$22. I suppose GoodRX gets some amount of demographic info about me when I use the card but can they really make hundreds of dollars off of that info??? I just don't see where there's a viable revenue stream.

Chris W. Rea
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Crash Gordon
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1 Answers1

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Nothing's off topic at reddit. If this is to be believed, https://www.reddit.com/r/pharmacy/comments/twfgh8/how_do_discount_cards_work/?rdt=54320

  1. the PBMs (Pharmacy Benefits Manager, a.k.a. 800 billion dollar trio of gorillas in the pharmaceutical industry) contractually require pharmacies to charge $700 for prescriptions, then offer it at the realistic price of $22 to their (the PBM's) customers' (typically health insurance providers) customers (insureds).
  2. The same PBMs then offer a discount card program to let non-customers get the discount too.
  3. Why? Because then the PBM gets to charge fees to the pharmacy as clawbacks/DIR Fees for the privilege of inserting themselves into the transaction. For example, fees can be as high as $8.50 for the $22 prescription.
stannius
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