Note: In updating our blog post on prescription discount cards, we determined it would be more useful to our readers to split this material into several posts. This blog covers prescription discount cards. Check back in the next few weeks for a follow-up on manufacturer cards and another on generic drug savings programs.
For many Americans, it started with a mysterious envelope in their mailbox.
Inside was a thin, white-and-yellow card that said “GoodRx” and looked a bit like a health insurance card. Perhaps the recipient threw it out. Perhaps they were intrigued. Regardless of the recipient’s initial reaction, GoodRx soon became impossible to ignore.
GoodRx is just one of many prescription discount cards which helps patients afford their medications. Other highly-rated cards include ScriptSave WellRx and SingleCare. You may have seen these cards at your doctor’s office, at the pharmacy counter, or in an advertisement.
While their long-term impact on the healthcare industry cannot be certain, the positive impact of discount cards on patients is impossible to ignore. Let’s clear away the mystery around this popular patient tool.
How do discount cards work?
First of all, prescription discount cards are not insurance. While drug manufacturer coupon cards (which we’ll discuss in a separate blog post) may interact with drug coverage, cards from independent benefit companies – like GoodRx and the rest – are used instead of insurance.
This means anyone can use them. People with employer insurance, federal insurance, or no insurance can all get a discount. This also means that if you do have insurance, whatever you pay will come out-of-pocket and will not contribute to your deductible.
Here’s how it usually works: patients show the physical or digital card to their pharmacist. The pharmacy processes the prescription using the discount card information rather than the patient’s insurance information. The patient then pays a reduced cash price instead of paying their usual copay. If the cash price is less than the patient’s copay, then it’s a good deal.
The pharmacy then pays a transaction fee; that’s how the discount card companies benefit. Pharmacies are willing to do this because lower prices entice patients to return to that pharmacy and fill their prescriptions rather than abandon them. (Using ScriptDrop delivery can also reduce abandonment!) In addition, the pharmacy gets paid up front rather than having to wait for reimbursements from the patient’s insurance.
What are the benefits?
Discount cards are powerful tools for patients on plans with high deductibles, high copays, or limited drug formularies. They’re especially useful for patients who are uninsured or between insurance plans. Without a discount, the cost of prescriptions could keep patients from even starting therapy.
The savings can really add up. Imagine you have a household with numerous family members on multiple medications and your yearly deductible is impossible to meet. According to Physician’s Desk Reference, if you used their PDR card you could see an average discount of $20 per prescription. That’s money back in your pocket to put toward whatever you choose.
Keep in mind that the final price of your prescription depends on the price set by the pharmacy, not on the discount card that you use. For example, a prescription for atorvastatin could cost nine dollars at one retailer and twenty dollars at another – even when using the same discount card. If affordability is paramount, you may need to shop around for the best price.
What to keep in mind
Not every card is equally useful and reliable. It’s always best to do one’s own research rather than using whichever card seems convenient. Investigate the following:
- Is there a membership fee? If so, don’t use it. Look for a free card instead.
- Is the card company HIPAA compliant? If not, your personal health information may not be secure.
- Where can the card be used? Every card has a slightly different network of pharmacies at which it is accepted. If you have a trusted local pharmacy, ask which cards they accept.
- How is the card made available to patients? Some are physical cards you can carry in your wallet, others require you to download it from a website and print it out, and some are available as smartphone apps. Apps may have additional features, like a pharmacy look-up tool to find the cheapest prices in your area.
Discount cards are an impactful part of a complex and nuanced healthcare landscape. Stay tuned as we continue the conversation on how to navigate these useful tools and find the affordable paths toward therapy.