Unscripted - The AMCP Podcast: Inside GoodRx Community Link: A New Program for Independent Pharmacies

Fred Goldstein  0:01  
Welcome to Unscripted. The AMCP podcast, a look inside managed care pharmacy. Listen in as experts explore the challenges, innovations and opportunities shaping healthcare for millions of patients. Welcome to this episode of Unscripted, the AMCP podcast sponsored by GoodRx. GoodRx is the leading platform for medication savings in the US, used by nearly 30 million consumers and over 1 million healthcare professionals. In this episode, we'll discuss issues facing independent pharmacies today and a new offering called GoodRx community. Link with Aaron Crittenden, president of RX marketplace at GoodRx welcome Aaron, Thanks, Fred, thanks for having me. Yeah, it's really a pleasure to get you on and obviously we're seeing a lot of stuff in the press and hearing a lot of things around pharmacy, pharmaceuticals, and what's going on in the industry. Can you begin by giving us a little introduction to what's happening with these independent pharmacies from your perspective?

Aaron Crittenden  0:55  
Yeah, so I think independent pharmacies have been struggling for a long time as it relates to reimbursement, primarily with with PBMs, they've also, we've seen a lot of store closures and challenges in keeping the doors open, and I think a lot of that stems primarily on really two fronts. One is, how are they reimbursed? On on their third party contracts with PBMs, either on the commercial or government side also in their buying power, right? How well are they buying and how well are they able to stem some of these tides? And I think it's gotten perhaps more challenging, as you've seen some of the blockbuster drugs like glps and things of that nature, where reimbursed, it may not be great cost of the drugs certainly not cheap, and a lot of consumers want it, and those just exacerbate their profitability concerns. 

Fred Goldstein  1:48  
Yeah, you think about it, it's an independent they obviously maybe don't have a bunch of staff to help them negotiate these things or actually have a big enough marketplace issue. So how are you working to help that?
 

Aaron Crittenden  1:59  
Yeah, so, so GoodRx rolled out community link to your point in the in the opening and our work there is really to directly contract with independent pharmacies. We've been about 18 months ago we started directly contracting with bigger retail chains, and the purpose of that was to enable those retailers to set a margin that they were comfortable with. So as you can think about retail in general, right? Some view it as, hey, I want to be more aggressive on patient pay. Take lower margin because I want more foot traffic through my doors. Some say I want to maximize my margin on every fill. So we've started down the direct contracting path. Historically, we were all through PBM contracts, and so we rolled that out to independents and allowing them to directly contract with good orecs on a cost plus basis, and then also enabling them to control their participation in integrated savings programs, which are our integrations in the PBM. So we can get into that, if interesting, whether they'd like to participate or not. But I think the most exciting opportunity there with independence is to allow them to participate in our 90 brand programs that we have directly with pharma, and have positive reimbursement there, and let the manufacturer buy down the cost of the drop for the consumer all through that transaction. So we're trying to reach out and make sure that number one, they've got profitability, but also can participate in in broader programs that we're working on. 

Fred Goldstein  3:34  
So can you talk a little bit more and take us a little deeper into that process about how that works, and then they buy down the cost for the individual, et cetera. Yeah.

Aaron Crittenden  3:41  
So again, on 90 brand programs and growing, we just recently announced our program with Wegovy and ozempic with Novo Nordisk. That price point is 499, so we work with the manufacturer, and we say, what price point would you like the patient to pay, and then we work with the pharmacies on our reimbursement schedule, right? So the manufacturer gives us funds in escrow, if you will. We set that 499 price, and then we flow funds to the pharmacy to make them whole on that purchase. So patient shows up, they can pay 499 and we then send funds to the pharmacy to make them whole on that transaction. Wow.

Fred Goldstein  4:24  
And as you've rolled this out, obviously early, what's sort of been the response,

Aaron Crittenden  4:27  
I mean, as you can imagine, to GLP, or the website didn't shut down, so that's good, but there's a lot of use of it, so that's positive, fantastic.

Fred Goldstein  4:37  
So as you think about some of their issues, and how do we ultimately, this is, you know, one solution, obviously, a bunch of what are some of the other things we need to be thinking about for these independent pharmacies, or ways they can be helped? Yeah.

Aaron Crittenden  4:49  
I mean, there's a lot there, right? I think certainly the contracting is kind of the first step, right? Because if you're going to accept something, you want to make sure that you're. Profitable, or you're okay with what that means, right? Doesn't if you want to, if you want to dread more foot traffic and have a lower margin, you at least need to be in control of it and make that decision. So I think that's step one. There's other things as we think about and maybe I'll bifurcate some of the independence, right? There's, there's rural, right? How are how am I doing with rural healthcare? And a lot of things that we're looking at are, how do we enable consumers to transact online and choose how they want to get their medication? And I think independence play an important role there. So not everyone wants to necessarily walk into the pharmacy all the time, right? And so we've developed what's what we call is E commerce, right? Which enables a consumer to go and select their pharmacy, they can do an inventory check to make sure that they actually have it, and then purchase that online, and then choose how they want to receive it. So if they want to go to the pharmacy, that's great. They want to do courier, that's fine. If they want it shipped to their house, that's fine. And enabling some of those additional feature sets, I think, are also important, especially as you think about certain patient populations, and then also in rural America, where it might not be right around the corner that you're going to get that script. 

Fred Goldstein  6:20  
Yeah, I think it's great that you really come at this from the patient or consumer side and bring that in, whereas most people look at this from the other side and say, how do we sort of take it out? But you've gotten the feedback and the input from the individuals themselves who are trying to access these drugs, which obviously changes the approach. And if you meet their needs, you're going to improve your business and get more folks in the door, right?

Aaron Crittenden  6:39  
That's exactly right. Yeah. 

Fred Goldstein  6:42  
So what about the patient experience? You talked a little bit about it, the website and things like that. So they go in, they can choose what they what they're trying to get filled, how they want it. And all of that is just a walk through. And the and the local pharmacy can then link into that system and play a role in that.

Aaron Crittenden  6:57  
Yeah, exactly. And we've got a couple different models here, right? So of course, goodrex.com is, is where the vast majority of our consumers go, in traffic and and they hear about good or x from various different points, right? You might see our ad on TV. You might have got a mailer in the car, in the mail, their physicians send giveaway our cards, etc. So anyway, consumer goes to the website and they type in the drug that they've been prescribed, and they can find a coupon there, and they can select the pharmacy in which they want to go and get that. So it could be on top, on Fifth and main, it could be Walmart, wherever they're going, and we show those prices for that consumer. We also are integrated into a handful of benefit plans, right? So if you're a patient and you show up with your insurance card, it will check the price amongst good or x versus the price of your insurance and and that's that integrated savings program that that I think has been painful for for independent pharmacies, and again, why we gave them control over this and but again, trying to help the patient there the consumer. And then within some pharmacies, like Kroger as an example, there's actually assets at the counter where a consumer can scan a code and find savings at the counter as well. So a lot of different touch points for a consumer to engage with those. Yeah, I'm

Fred Goldstein  8:23  
looking at this sort of from the population health perspective, and thinking to myself, this is something that can really improve adherence for individuals. Obviously, because this access has been such a big issue we face when we see adherence rates drop at six months to 50% or something

Aaron Crittenden  8:38  
like that, absolutely and especially around our brand work, right? If you think about they don't want to say generics affordability isn't a problem. It is, right, and generics is a big term, right? There's, there's pricing of generics all over the board, but a lot of the affordability issue resides in those brand medications. And so the more we can do to help bend the cost curve there, I think is, is certainly disproportionately impactful for those individuals who are using those and a lot of that is, you know, it's a not covered transaction. It's a step therapy, whatever those are. And to your point, either first fill, abandonment or persistency remains a challenge. The higher price that gets

Fred Goldstein  9:24  
from a pharmacist perspective, obviously, like you talked about, if it's sitting there at the counter, it makes the pharmacist look better. The pharmacy look better to be able to offer services like that, yeah, absolutely.

Aaron Crittenden  9:34  
Especially if you think about no pharmacist wants to tell a patient not covered, right? That's not a great experience, or, Hey, go to brand.com and see what you can find, right? That's that's a disruption in their workflow. It's a disruption to the patient. The patient's ultimately frustrated. So that patient can scan that and go and find the manufacturer support, whether that's a copay card, we have over 100 of those in a. Rate it into the asset as well, or 90 print buy downs. We also have patient assistance programs, so free, good links in there if you were to qualify for those programs as well. So yeah, certainly trying to help alleviate some of the workload from the pharmacists and staff at the counter. 

Fred Goldstein  10:18  
I don't really want to set you up, but anything new or further on you're going to come out with, you think around this area, I know you've obviously expanded from 70 to 90 drugs I've seen on your website and things like that, yeah.

Aaron Crittenden 10:30  
So I think we're certainly going to continue. you're going to see continued rollout of more brand drugs, right? I think part of that is this move of direct consumer that Pharma is pursuing in various different ways, amplified probably by the Trump administration's MSN and D to C letters that he sent to the top 20 manufacturers. Right? So I think you're going to see continued push there. And we personally believe that retail needs to be a part of that right, community independence chains. They need to be there because it's more than just where you get your script filled, right? It's a site of care, and if it's available in a bespoke mail order pharmacy, we're worried about that at scale, right? So our job is to make sure those are available at retail, so you'll you'll see a lot more of those, hopefully soon, and then we're going to continue to invest in ways to make the experience more seamless for the patient and the pharmacist, right? I leaned in on E comm a little bit, and that's not just about the ability to pay right, but it's also, if you think about a fast lane at the pharmacy where it's already adjudicated, the payments there, I don't want to wait in line. I just want to come in and get it right. Things of that nature, Courier, things that remove friction from the system. In general,

Fred Goldstein  12:01  
yeah, it's sort of been, healthcare has been the last place to do that. You know, banking, everything else has moved into that. And obviously you've set up this system that people can access and use, similar to you would with an app, and just work that process through, through the pharmacy and get your meds. That's exactly right, yeah. Well, Aaron, I'd really like to thank you for coming on. It's been fantastic. Thanks for having me. Enjoyed it, and thank you all for listening to this episode of Unscripted, the AMCP podcast. This episode was sponsored by GoodRx. For more information about GoodRx community, link, go to www.goodrx.com/community-link