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Pharmacies and Good Rx (1 Viewer)

jm192

Footballguy
Had a weird experience, and just thought I'd pass it along in case anyone else is in the same situation.

Because neither my wife nor I had regularly taken medicine, we signed up for the high deductible plan with the HSA.  It has no insurance coverage for prescriptions.  You pay 100% out of pocket up to a certain point--and it's a high point.  I've had to start taking a medication that is expensive but not to the point it's worth paying for the lower deductible plan.  The first few times it was $50 at CVS.  Then I went back for a refill the 3rd time and it was 95$.  I asked the lady about the price difference and she said she could apply a coupon to get it down to 67$, but that's the best they could do there.  

I'm familiar with GoodRx but honestly just didn't think about it.  I googled prices for the medication and GoodRx popped up.  The prices were better.  I decided the next time I had to refill it, I would give the Good Rx stuff a shot.  Apparently the big chain pharmacies have a contract negotiated with them and are even required to accept it.  

Wal-Mart had the best price.  I asked my doctor to send it there.  He called it in.  Wal-Mart called me to ask for some personal info that he didn't provide:  Address and insurance info.  i explained the insurance situation She told me they would have it ready in a bit.  I get there, wait in line and am told they don't have the medicine.  They now have to order it.  That's entirely possible.  Honestly, telling someone that we'd have it ready before checking to make sure we actually have it is something I've been guilty of in my life.  

I guess the thing that gives me pause in this instance is google.  I was reading about why pharmacies hate GoodRx.  I read on Reddit that some pharmacies will say they don't have the medication to avoid filling it when GoodRx is involved because they money on some of those transactions depending on the medication.  I couldn't help but wonder.  But it's entirely possible this was just an honest mistake.

I have it sent to CVS again.  They've never NOT had the medicine.  They send me a text saying it's ready.  I walk in with Good Rx on my phone.  When it's my turn in line, I ask the lady about it.  She tells me "Oh, there's already a discount card on there for you."  I look at the price.  93$.  I got it for 67$ after a discount card last time.  And I had to ask why the cost had gone up 45$ to get to that point.  Now you've applied a discount card and the price is 26$ higher than last time?  The Good Rx price is 51$.  

I've dealt with a lot of customer service Reps and learned that the majority of cases they hope you won't question what they say.  This "I've already put a discount card on there for you" feels like a tactic.  "Maybe he won't question it."  And I think a more shy person probably says "Oh, Ok."  But I ask again if she can use it.  "It will be 10-15 minutes."  I've got 10-15 minutes for 40$.  5 minutes later she calls me back up there, I pay the 51$.  

This isn't meant to be an "all pharmacies are bad" post.  I don't think my local CVS represents all CVS.  I'm not even certain Wal-Mart was doing what I'm wondering if they're doing.  There are a lot of great pharmacists and pharmacies out there.  They're probably even in the majority.  But since this happened the first time I tried to use it, I thought I'd share the story in case anyone else ever runs into it.  

 
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Seems to be the same game with rebates - hope that people don't send them in, then maybe forget you sent them in.  

BTW, how you tried the new Amazon pharma thing?  I think you have to be a prime member, but it may be worth looking at the price there.

 
Seems to be the same game with rebates - hope that people don't send them in, then maybe forget you sent them in.  

BTW, how you tried the new Amazon pharma thing?  I think you have to be a prime member, but it may be worth looking at the price there.
Funny you should mention rebates.

We bought something at Menard's with a 50$ rebate and I still haven't heard back on it haha.  Forgot about it until you said that just now.  Going to have to figure out what's up with that.

 
Yeah, rebates are a very old tactic and I really think they intentionally set up their systems to accidentally lose or screw up frequently enough that the promised money often doesn't go out, all hinged in the fact that a predicable percentage of customers will forget about it or never call or will call but eventually give up after being on hold forever, transferred to different departments, etc.

 
Pharmacies and insurance and drug companies are the devil. Pure and simple.

I have stories and I'm sure we all do and I hate them all with a passion. I don't even want to think about how much money I have to waste because of policies and procedures and billing errors and blah blah blah.

 
I'm on a few meds.  I get most of them from CVS (at Target), but there's one that ends up being extremely expensive there, so my doc had me go through a "discount pharmacy", which gets it for me for super cheap... like $15 a month.  I'd rather not be on any of 'em but oh well.

 
We started using GoodRx last year. We were getting notices from our insurance that uses ExpressScripts to use mail order to reduce our cost but the cost was actually higher than our local pharmacy.

Last month the same local pharmacy would not honor a Goidrx price and the tech behind the counter was a "b" complaining of GoodRx. We talked to the pharmacy manager and they got the price down to about 10% over GoodRx. Contacted Goodrx and they were furious at local pharmacy (which is a chain with many other locations). 

 
Funny you should mention rebates.

We bought something at Menard's with a 50$ rebate and I still haven't heard back on it haha.  Forgot about it until you said that just now.  Going to have to figure out what's up with that.
I do Menards rebates all the time.  They always come but are often slow.  There is a way to check on the status if you create an account with the email you put on the rebate form.  

 
This is interesting about GoodRX and other RX rebate plans.  My family isn't on any monthly meds and I'm on one of those mega health plans that costs a kidney and 25% of my check.  But all RXs, when we do need one, are like a $1 co-pay.  Been thinking of switching plans because we don't ever use most of the benefits.  

 
Used GoodRX briefly but the pharmacies basically told they flat out won’t honor the prices GoodRX listed. 

 
This is interesting about GoodRX and other RX rebate plans.  My family isn't on any monthly meds and I'm on one of those mega health plans that costs a kidney and 25% of my check.  But all RXs, when we do need one, are like a $1 co-pay.  Been thinking of switching plans because we don't ever use most of the benefits.  
You can use Goodrx and not change your current plan. Any Goodrx use won't go against your health care/prescription plan deductibles.

 
Used GoodRX briefly but the pharmacies basically told they flat out won’t honor the prices GoodRX listed. 
Seems they have an agreement with Goodrx. I don't know the details but you may want to contact Goodrx or look at another pharmacy close by that accepts Goodrx. Pharmacies could be losing some kickbacks or "rebates" from the insurance providers. 

 
Seems they have an agreement with Goodrx. I don't know the details but you may want to contact Goodrx or look at another pharmacy close by that accepts Goodrx. Pharmacies could be losing some kickbacks or "rebates" from the insurance providers. 
It was every pharmacy in the 3 cities around me, included CVS, Walgreens, Rite-Aid and Walmart. It was either, "we don't accept them anymore" or they would scan the code and say "sorry it's not coming up in the system" or would say "that coupon had a limited supply and that supply is gone, we can't get you any more for that price." 

 
Kroger always gives me the GoodRX price and I don't even have to ask anymore.
Same here with the Publix pharmacy and cialis. Walgreens was gonna charge ~$95 then when I asked if there are any discounts, the assistant said it would be $70. I checked on my phone and saw that the GoodRx discount price at Publix was ~$17, so I asked Publix to request the prescription from Walgreens. When I went to Publix, I was charged $17, without showing my GoodRx card. About 3 years ago I filled another prescription at Costco Pharmacy and they did asked for my card.

I'm still not sure what GoodRx does, but I approve. 

 
Here’s the GoodRX take from the pharmacy side:

-It costs the pharmacy money every time someone uses GoodRX. The reimbursement is negative, we have to pay them to be able to bill them. And the co-pay that you pay is usually less than the cost of the medication.

-GoodRX works with other insurance companies and PBMs. When pharmacies sign contracts with big insurance companies, they put in requirements that the pharmacy has to accept the GoodRX prices even though they are losing money or risk losing the whole contract.

-As usage of GoodRX increases, it decreases the margins of the pharmacy which usually leads to cutting of staff hours which leads to many other issues.

-With that being said, I accept and will look up GoodRX prices for people. I work for a corporate pharmacy- my priority is the patients.

-Some pharmacies may ‘play games’ to try and avoid using GoodRX but I wouldn’t assume that this is one of them. Saying that it will be ready before making sure we have it happens all the time. In the current environment of retail pharmacy, if I’m answering the phone, I’m probably in the middle of finishing one order, processing the next one or trying to remember the next thing that needs to be done while also jumping between immunizations. I try to make a point of preventing future problems by looking at things like if we have it in stock, need to contact the doctor, etc but it’s hard to do that 100% of the time and many don’t have the forward thinking that I do.

-tl/dr - GoodRX is great for patients but horrible for pharmacies.
 

-What Mark Cuban is doing right now might be a game changer if done right. Currently he’s lowering the prices of prescription by cutting out the wholesaler. Next he’s working on lowering the manufacturing costs then he’s working on the PBM side. He’s essentially working to cut out all the middlemen that drive costs up.

 
Here’s the GoodRX take from the pharmacy side:

-It costs the pharmacy money every time someone uses GoodRX. The reimbursement is negative, we have to pay them to be able to bill them. And the co-pay that you pay is usually less than the cost of the medication.

-GoodRX works with other insurance companies and PBMs. When pharmacies sign contracts with big insurance companies, they put in requirements that the pharmacy has to accept the GoodRX prices even though they are losing money or risk losing the whole contract.

-As usage of GoodRX increases, it decreases the margins of the pharmacy which usually leads to cutting of staff hours which leads to many other issues.

-With that being said, I accept and will look up GoodRX prices for people. I work for a corporate pharmacy- my priority is the patients.

-Some pharmacies may ‘play games’ to try and avoid using GoodRX but I wouldn’t assume that this is one of them. Saying that it will be ready before making sure we have it happens all the time. In the current environment of retail pharmacy, if I’m answering the phone, I’m probably in the middle of finishing one order, processing the next one or trying to remember the next thing that needs to be done while also jumping between immunizations. I try to make a point of preventing future problems by looking at things like if we have it in stock, need to contact the doctor, etc but it’s hard to do that 100% of the time and many don’t have the forward thinking that I do.

-tl/dr - GoodRX is great for patients but horrible for pharmacies.
 

-What Mark Cuban is doing right now might be a game changer if done right. Currently he’s lowering the prices of prescription by cutting out the wholesaler. Next he’s working on lowering the manufacturing costs then he’s working on the PBM side. He’s essentially working to cut out all the middlemen that drive costs up.
Thanks.  If in a grocery store they still make money: "Your prescription will be ready in 30 minutes, do you have some shopping you can do?" 

 
Thanks.  If in a grocery store they still make money: "Your prescription will be ready in 30 minutes, do you have some shopping you can do?" 
Big picture that’s very true but they only use pharmacy sales to determine our staffing budget. I’m ok with the pharmacy being a loss-leader if they treat us like one.

 
Interesting.  And I didn't know pharmacies are pushing back on this.  I only have one script and it is fairly inexpensive.  However I do use GoodRX to price shop it.  Usually one of the big boys will have a 90 day supply for cheap, and that big boy seems to rotate.  Sometimes Walmart, sometimes Target, etc etc.  So I do use it to check because the non cheap price can be pretty darn expensive.  

I also like to pull it up when there is a drug commercial on TV and check Good RX for the price.   Try to guess how much it is.   That was more fun to do when there weren't eleventy billion drug ads on tv.  Now it takes too much time. 

 

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