It used to be easy: Patients with health insurance generally had enough coverage that a serious medical event didn’t put them in serious debt. Yet today, even for patients with commercial insurance, decisions about how to pay for healthcare, including prescription medicines, are not as simple as they used to be.

Evolution of patients into payers

Patients have been paying copayments for decades since the introduction of third-party health insurance in World War II. But the emergence of high-deductible health plans (HDHPs) shifting greater medical financial risks to patients (higher deductibles and lower monthly premiums), coupled with prescription drug copayments increasing, particularly for specialty medicines, have led to people developing ‘health consumer’ muscles and taking on the role of ‘payer.’

As stewards of their household budgets, each time they receive a prescription from their healthcare provider (HCP) they must decide if, and how, to pay for it. A decade or so ago, most would have asked, “Why would someone with insurance pay cash for a prescription treatment?” Today, with medication coupons and other cost-reduction options from companies like GoodRx, those same people have digital tools at their fingertips to help them decide when and where to apply their commercial insurance — or not.

A better solution to help cash paying-patients

GoodRx Assist is a proven point-of-sale (POS) rebate for patients who pay cash (Figure 1). This customized cash (card) program helps drive commercial success for pharma by attracting patients who require additional financial assistance to access, start, and stay on branded medications. GoodRx data show that lower out-of-pocket prices lead to more redemptions, e.g., the lower the drug price, the greater the number of patients who are willing to pay for a medication.

GoodRx

 

Benefits of GoodRx Assist include improved patient adherence by directly lowering patient out-of-pocket (OOP) costs; helping patients access, start, and stay on medication regardless of insurance status and formulary changes; and complementing existing brands’ savings programs. Note that because POS rebates act as discounts on top of GoodRx coupons, they cannot be used in conjunction with commercial or government insurance.

Impressive results across a range of therapies

When a pharma manufacturer ‘buys down’ the cost of its drug, the manufacturer increases the number of potential patients who can access, start, and stay on therapy. In reviewing coupons for all drug conditions on GoodRx.com over a rolling 12-month period, we see an increase in coupon printouts for medications costing less than $200 than for higher-priced medications, and this applies to both branded and generic therapies (Figure 2).

That’s the overall picture. Now let’s look at specific results from brands in different categories that used GoodRx Assist:

• Paid cash claims grew 2.7x YoY for diabetes medical device system

GoodRx is partnering with an innovative medical device company to offer an exclusive discount on its system for eligible people with diabetes. Currently, the system costs over $370 at major pharmacies using GoodRx coupons, but this GoodRx Assist program enables patients to save $200 or more. Historically, patients who chose to pay cash for this system, with or without insurance, had a low conversion rate. However, early GoodRx Assist results show a 2.7x increase in year-over-year cash claims.

• Reversal rates reduced from 80% to 20% for branded birth control

The average annual out-of-pocket cost¹ or birth control is between $240 and $600 for those without commercial insurance. Through GoodRx Assist, patients can access this client’s branded birth control device for an exclusive cash price of $48, which is lower than the brand’s generic equivalents. In addition to a positive effect on market share, this recently launched POS rebate program has already helped the client triple cash claims and reduce reversal rates from 80% to 20%.

As you can see from the results of GoodRx Assist programs in different therapy areas, offering lower prescription drug and device prices can lead to a consistent increase in incremental claims on GoodRx. GoodRx is proud to partner with industry leaders to help bring more access and affordability to important treatments for all patients. Click here to learn more about how GoodRx Assist can help more eligible cash-paying patients start and stay on your brand.