Real Rx affordability will come when supply and demand enter the equation in a meaningful way - here’s how

While efforts like TrumpRx and GoodRx should be applauded for their attempts to improve the affordability of prescription medications, they don’t go far enough. TrumpRx, heralded as a major breakthrough in medication affordability, has proven useful only to cash-pay patients — representing just 15% of all patients — with most pricing simply matching already-existing direct-from-manufacturer programs. TrumpRx also covers only a few dozen drugs out of 24,000 FDA-approved medications — very few in the grand scheme of things.

GoodRx, meanwhile, has become a go-to coupon tool for patients seeking discounts. But like TrumpRx, it largely targets cash-pay scenarios and operates without visibility into a patient’s insurance coverage. That’s a critical gap. In most cases, insured pricing is lower than what patients would pay with a coupon alone.

What's needed to make a real impact is a solution that brings together details on insurance coverage, coupons, direct-to-manufacturer programs and cash-pay options, so patients can see the full picture and all of their options.

Today, the typical patient experience goes something like this: a physician prescribes a medication, asks the patient for their preferred pharmacy, and submits the prescription. Pricing is never discussed. Alternative pharmacy options are never raised. A small number of patients may try to use a coupon app like GoodRx once at the pharmacy to land an additional discount.

What I'd like to see — and what more providers are beginning to do — is a conversation about pricing and fulfillment options at the point of prescribing, so patients can compare pricing and make an informed decision.

Here’s the overlooked reality: providers already have access to this information. Through their ePrescribe platform, which virtually every medical practice uses, they can see multiple pharmacy options with different pricing and stock availability — and they can view those prices through the lens of that specific patient's insurance coverage.

Why not say to the patient, "This will cost $45 at your usual pharmacy, but it's available through this mail-order pharmacy for $22"? That's how real cost savings happen. And that's how real pricing change will come — when patients have accurate data and supply and demand enter the equation in a meaningful way.

The data support this shift:

• Approximately one-third of patients who are given the opportunity to view pharmacy options before their prescription is filled choose to transfer it — for a better price, better convenience or both.
• In 63% of cases, patients have access to their prescribed medication for $10 or less—but most never realize it because that information isn’t reviewed during the clinical encounter.

Giving patients real-time prescription benefits information at the point of prescribing makes it both easier and more likely for them to to fill their prescription. Patients who can afford and access their medication are far more likely to take it, improving adherence and overall health outcomes.

Transparency information is available; we just need providers and their staff to access and use it. Only when we arm patients with accurate, transparent pricing and availability information will supply and demand become meaningful forces in prescription drug pricing, leading to affordability for all.

Josh Weiner is CEO of Interra Health.