GoodRx? More like BadRx!

GoodRx is a company born of the fear of prescription drug prices. To sell its product, it needlessly exacerbates that fear.

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A tale of two stories

At some point every week, either on a YouTube pre-roll, or a Hulu mid-episode interruption, I see the same advertisement for GoodRx

The advertisement tells two stories. One is the story of a mother concerned about affording her son’s medicine, ultimately saved by GoodRx’s power to reduce the cost of prescription medicine. The other is the story of a company that exploits the fear that arises from participating in a market so distorted by price gouging, regulation, and intermediation to present itself as a savior, rather than a malignant outgrowth.

Let me describe it to you, k?

The advertisement begins with a mother, who because she’s dressed in a baby-blue diner-waitress one-piece, must’ve just gotten off her shift in 1960. 

Her face wears a look of nervous determination as she escorts her young son and daughter towards the CVS/Walgreens/Duane Reade through a darkened and empty parking lot. The silhouette of a man, the only other person shown besides the mother and children, pushes a shopping cart across the entrance of the store:

Mother, crossing the parking lot, to herself: “My son needs this drug, I hope it doesn’t cost too much. I hope my insurance pays for it.”

The mother enters the store, approaching the pharmacist counter with caution:

Mother, to herself: “I hope my insurance pays for it.”

Mother, to the Pharmacist behind the counter as she hands her a prescription note: “Can you tell me how much this’ll be? (hands pharmacist a script)”

Pharmacist: “$67”

Mom: “Sorry. (Dejected, turns to walk away)”

Pharmacist: “Wait, have you heard about GoodRx?”

Voice Over: “Good Rx finds coupons to help you save up to 80% on your prescriptions.”

*Camera goes to GoodRx up on the mother’s phone, price on register drops from $67 to $8.90*

Mother: “Wow, I had no idea.”

Voice over: “Good Rx. Stop paying too much for your prescriptions.”

Threat pervades the advertisement. Importantly, it’s conflated with something unrelated to the cost of medicine or insurance—the threat of assault in a darkened parking lot. The perspective above is shown at the same time the mother begins her inner monologue expressing her son’s need for the drug. Conflating these threats amplifies the redemptive qualities of GoodRx, implying that using it will somehow help users to avoid a similarly dangerous situation.

The other threats presented are more intuitive to the nature of buying drugs in the United States: the threat that the purchase of a child’s medicine will empty your checking account and the threat that your kid will go another night with whatever discomfort ails them. 

Why’s this even exist?

Doug Hirsch, one of the founders of GoodRx, attributes his founding of the company to his personal experience with some of the aforementioned fear: 

“You’re afraid to go and purchase because you have no idea what you’re going to pay.”

There are two routes to buying prescriptions: with insurance and without. PBMs (Pharmacy Benefit Managers) are intermediaries who work with pharmacies to provide insurance groups discounted drug pricing. The prices set by PBMs are lowered in exchange for the pharmacy gaining access to the people the insurance covers (its network). PBM’s get a fee from the pharmacy each time an insurance card is used. So, purchased with insurance, you get a discount. 

Purchased without, you’re subject to the retail price, which often adheres to an alternate reality. One study of retail drug prices found: 

“cash prices for a basket of five prescriptions ranged from $66 to $1,351—a 20-fold difference.” 

Another study...

“...of two generic antibiotics found that cash prices varied from $4 to $229 for one product and from $2 to $134 for a second product.” 

-How GoodRx Profits from Our Broken Pharmacy Pricing System, Dr. Adam J. Fein

GoodRx gives uninsured shoppers access to PBM drug rates, then takes a percentage of the fee paid to the PBM by the pharmacy. According to its S-1 filed in August 2020:

Revenue from our prescription offering represented 97% and 94% of our revenue for 2018 and 2019, respectively, and 95% and 91% for the first half of 2019 and 2020, respectively.

Because of the disarray amongst PBMs, drug companies, and pharmacies, the way prescription drugs are priced often feels as though the parties sit in a room, spin a wheel numbered 1-2000, and use whatever lands. GoodRx took a look at this model and realized it could make money by exploiting the companies that suck at exploiting consumers. 

If you’re good, then why be bad?

GoodRx means to give off Robin Hood vibes: Rob from the rich, give to the poor, look as handsome as Kevin Costner in the process.

Instead of handing you a sack of gold coins, no questions asked, GoodRx points an arrow at your chest, forces you to take the sack, and then kindly asks for a kiss on the cheek afterwards. Like so much about the insurance and prescription drug industry, the threat of violence is extraneous and cruel.

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