When Yahoo and Facebook veteran Doug Hirsch’s son was four years old, he was denied health insurance due to a pre-existing condition. Forced to purchase his medication out of pocket, Hirsch was told at a local pharmacy that the prescription was $500, but a pharmacy across the street could sell him the same medication for $250. Frustrated by not being able to look up the retail price of common prescription medications online, Hirsch set out to help others and increase the transparency of drug prices.
Hirsch partnered with software engineer Scott Marlette (Facebook) and Stanford science graduate Trevor Bezdek (Bioware). Both agreed with Hirsch that the opaque drug pricing in the United States needed an overhaul. So in 2011, GoodRx was founded in Santa Monica, California, as a price comparison tool focusing on nationwide prescription drug prices.
Today, GoodRx has helped 18 million uninsured and underinsured consumers save $35 billion on prescriptions by providing a discount card for prescription drugs. Drugs that these consumers wouldn’t have been able to afford otherwise. GoodRx offers a premium subscription option for increased savings and same-day telehealth appointments. The company’s multi-structure business model allows the company to increase revenue year after year. Let’s take a look at how GoodRx makes money.
Bottom Line Up Front
GoodRx has four main revenue streams that make up its annual earnings. The four key profit categories include (1) Pharmacy Benefit Manager (PBM) kickbacks from consumer prescription drugs purchased using a GoodRx discount card, (2) GoodRx Gold and Kroger RX Savings Club membership fees, (3) GoodRx Care same-day telehealth appointments, and (4) selling advertising space to health care companies through the GoodRx platform.
GoodRx’s Financial Overview
GoodRx became a public company on the NASDAQ stock exchange on September 23, 2020, ten years after its inception in 2010.
In 2021, GoodRx Holdings, Inc. (GDRX) earned $745 million in revenue. Even with a grocery chain setback and a drop in stock prices, GoodRx still recorded a 27% increase in the 2022 first-quarter earnings. The company also had a net income increase of 637% and an adjusted net income increase of 30%.
Currently, GoodRx Holding, Inc. has acquired five companies, including Iodine (2017), HeyDoctor (2019), Scriptcycle (2020), HealthiNation (2021), and RxSaver (2021).
Good Rx has an average of 6.4 million active monthly consumers, and subscription revenue continues to rise.
How does GoodRx Make Money?
GoodRx may be known for its discount prescription drug card, but it has multiple facets, from its relationships with pharmacy benefits managers (PBMs) to licensed telehealth physicians to pharmaceutical companies. Unfortunately, several consumers fall uninsured or underinsured due to corruption in the United States healthcare industry. The company has positioned itself within the healthcare space to access services that every American should be entitled to, including quality healthcare and consistent, affordable prescription drug refills.
GoodRx has four main revenue streams:
1. Pharmacy Benefits Managers (PBMs) fees (coupon redemption)
2. GoodRx Gold (membership fees)
3. GoodRx Care (online health care)
4. Advertising (on the GoodRx platform)
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Below is a breakdown of how GoodRx generates revenue:
1. Pharmacy Benefits Managers (PBMs) fees (coupon redemption)
When consumers present a GoodRx coupon at a pharmacy, GoodRx makes a percentage of the fees collected by pharmacy benefits managers (PBMs).
PBMs are responsible for managing drug benefits with health insurers, corporations, Medicare Part D drug plans, etc. PBMs negotiate pricing from manufacturers to pharmacies and determine what prescription drugs are sold for. Doing so allows them to collect a middlemen fee, some of which goes to GoodRx or other discount prescription drug companies.
Independent pharmacies can lose money on a drug when a consumer uses a discount Rx card depending on the drug. Therefore, depending on their sales, an independent pharmacy may choose to have its discount service to lower middlemen’s fees.
2. GoodRx Gold (Membership fees)
Consumers who already take advantage of the savings received through GoodRx would be wise to consider GoodRx Gold.
Not having insurance to cover monthly drug costs can eat away at a consumer’s savings, but it doesn’t have to. GoodRx Gold unlocks additional savings with affordable monthly payments.
Consumers can save up to 90% on prescription drugs, often paying less than a standard insurance co-pay. The most significant discount is on generic prescriptions, which is what 85% of the American public is prescribed.
GoodRx Gold is $9.99 per month for individuals and $19.99 per month for families (up to 6 people or pets total). There are over 1,000 prescriptions that cost less than $10. Consumers can receive the savings by showing a GoodRx Gold card or mobile app at the pharmacy.
GoodRx Gold is accepted at CVS pharmacy (including Target store locations), HyVee, Albertsons, Rite Aid, Safeway, and Vons (among others). However, GoodRx Gold does NOT provide savings at Publix, Sam’s Club, Walgreens, or Walmart.
GoodRx Gold is available in 49 states, excluding Washington. GoodRx Gold currently has a 30-day free trial for new members.
Kroger Rx Savings Club
Along with an in-house subscription model, GoodRx also partners with grocery chain Kroger. The Kroger Rx Savings Club has an annual fee of $36 for individuals and $72 for families (up to six). The consumer benefits from a lower monthly subscription price, while Kroger pharmacy benefits from a cut of the subscription fee.
3. GoodRx Care (Online health care)
GoodRx acquired HeyDoctor in 2019, a physician-founded online medical care provider. The rebranded site, GoodRx Care, expanded the services of HeyDoctor by grouping telehealth services with discount prescription drugs, including home delivery (with Truepill).
An online appointment can be booked same-day (7 days a week) and costs $19 with a GoodRx Gold membership and $49 without a membership. Whether or not the consumer has insurance, the flat fee is the only out-of-pocket cost (insurance co-pays are not accepted).
A licensed healthcare provider facilitates all telehealth appointments. Appointments can include erectile dysfunction (ED), urinary tract infections (UTI), birth control, cold sores, acne, smoking cessation, eyelash growth, common cold, hair loss, and prescription refills.
GoodRx Care is available to consumers nationwide. However, not all services are available in all areas. Once a log-in is created, and a location is selected, consumers can see all the currently available services. GoodRx Care can be accessed through the website (goodrx.com/care) or a GoodRx Gold account.
Currently, the telehealth option is only available to the following states: Alaska, California, Georgia, Hawaii, Illinois, Iowa, Kentucky, Maryland, Michigan, Minnesota, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Texas, and Wyoming.
4. Advertising (On the GoodRx platform)
Using its tech expertise, GoodRx offers advertising options to pharmaceutical manufacturers in the following ways:
1. Web: affordable targeted digital advertising on GoodRx’s platform
2. Print: direct mailers sent to GoodRx and GoodRx Gold consumers
Pharmaceutical manufacturers spend $30 billion on annual advertising. According to the Los Angeles Times, the $30 million budget is spent on TV commercials, sponsorships of patients’ groups, promotional meetings for doctors, free drug samples, and perks for prescribers. GoodRx has tapped into this market using its member data to generate additional revenue.
GoodRx’s Business Model and Strategy
The GoodRx mission statement is to “help Americans get the healthcare they need at a price they can afford.”
To fulfill this mission, GoodRx has developed a free online platform and app so that all consumers can have an understanding and access to affordable healthcare. However, GoodRx can’t provide a reputable healthcare service without participating licensed physicians and pharmaceutical companies.
GoodRx developed a three-sided marketplace:
2. Healthcare professionals
3. Pharmaceutical companies
Consumers can save money on healthcare, licensed healthcare professionals can point consumers back to prescriptions, and health care services and pharmaceutical companies can educate consumers and physicians about their products.
GoodRx is a fixture in the online healthcare industry with access to over 70,000 pharmacies in the United States.
With its emphasis on tech development, GoodRx’s online and app model has the potential to be replicated globally. In addition, as GoodRx exponentiates revenue, it can continue acquiring healthcare and pharmacy industries as additional features for GoodRx or eliminate competitors.
GoodRx has helped consumers, pharmacies, licensed physicians, and even the economy. As the United States health industry continues to raise prices and exclude middle to low-class Americans from necessary health care, companies like GoodRx use their box of bandages to give affordable health care access to all.
1. Helped Americans, regardless of health insurance status, save money on their prescription drug purchases. As a result, consumers save 79% off cash prices. And over half the time, consumers paid less than insurance co-pays.
2. By offering consumers a discount without any affiliation (health care insurance or otherwise), more consumers adhered to their doctor’s prescription recommendations. This means that more prescriptions are getting filled and taken on time as consumers choose their health over a corrupt health care system.
3. By providing discount prescriptions, same-day telehealth, and medication education, GoodRx has lowered consumer hospital bills and essentially saved lives. By providing this service, GoodRx takes the pressure off the overall healthcare system and improves the health and longevity of countless Americans.
4. Over 60% of bankruptcies in the United States can be tied to medical debt. By reducing the cost of prescription drugs and general medical care, GoodRx can take the financial burden away from consumers with high out-of-pocket medical costs. In addition, the money saved can prevent consumers from seeking high-interest personal loans, having money to start savings, or even contributing to the economy.
There are three main ways GoodRx spends money to make money. Key items include the cost of revenue, technology, and customer acquisition.
1. Cost of revenue
- Customer support outsourcing
- Telehealth licensed health care providers
- Personnel costs (customer support, employees)
- Hosting/cloud usage
- Cyber security
- Web development (in-house, outsourced)
- Third-party applications and software
3. Customer Acquisition
- Advertising (TV, paid search)
- Marketing (paid, organic, viral)
- Affiliate (AAA)
Amazon Pharmacy (PillPack)
Provides a medication sorting and delivery service through PillPack. The service offers individual pill packs marked with each medication, day, and time consumers should take the prescription drugs.
CVS Health offers same-day health appointments (in-person and virtual), health insurance plans, pharmacy savings, and delivery options.
Express Scripts offers insured consumers options regarding how they receive their medication addition, including multi-month refills, pick up at a retail pharmacy, or home delivery. The company also offers discount prescription savings.
OptumRx is a pharmacy care services company. It provides a tiered prescription drug system to help consumers get the best prices on necessary medication. OptumRx implements prior authorization, step therapy, and quantity limits. In addition, the company offers home delivery and a saving card to choose a preferred pharmacy.
GoodRx’s Business Model Downfalls
GoodRx has built a multi-faceted business with four clear revenue streams but still receives most of its funds from PBMs. While this revenue method is likely to continue, it is easy for competitors to imitate this business model affordably.
Both pharmacies and health insurance companies are interested in increasing their features to remain competitive and profitable. As a result, they integrate discount prescription drugs, telehealth, and medical information as part of their drug store benefits or insurance programs.
As the discount prescription drug company GoodRx continues to scale, it will also be under scrutiny by the United States government. The federal government could require GoodRx to comply with additional laws and regulations. While this is generally done to keep the American population safe, it could be a significant expense for GoodRx, possibly stifling growth and market share.
Additionally, GoodRx could lose relationships with major pharmacies or PBMs due to fee negotiations. If key partners were to use a competitor exclusively, GoodRx could potentially lose significant revenue.
Question: Do pharmacies make money with GoodRx?
Answer: No. GoodRx does not receive revenue from direct and indirect remuneration (DIR) fees. The DIR fees are determined by pharmacy benefit managers (PBMs). Therefore GoodRx does not earn a profit from this method.
Question: What is the catch on GoodRx?
Answer: GoodRx is only available to the uninsured. In addition, less than 5% of prescriptions are paid entirely out of pocket, so GoodRx is not an excellent way to save money on prescription drugs for the vast majority of people.
Question: Who pays for the GoodRx discount?
Answer: A pharmacy benefits manager (PBM) collects a fee from the pharmacy every time a consumer purchases a prescription drug using GoodRx. The PBM allocates part of the fee collected with GoodRx as a marketing fee for sending the person to their pharmacy.
Question: Where does GoodRx revenue come from?
Answer: Most of the revenue comes from the shared PBM fees through prescription drug transactions. GoodRx also has a premium in-hoAs a result, every subscription is called Gold and is affiliated with grocery chain Kroger. Subscriptions can unlock additional savings and encourage repeat transactions, increasing PBM fees.
Question: Can GoodRx be used with insurance?
Answer: While GoodRx is geared toward consumers without insurance, it can also benefit those with insurance. If consumers have a high prescription drug co-pay or the drug is not covered, it is wise to check the GoodRx website. The GoodRx price comparison tool can help consumers determine if the prescription drug needed is cheaper than what the pharmacy has quoted.
If the cost is lower than the consumer’s insurance co-pay, ask to use the GoodRx coupon barcode and not bill the insurance provider.
Consumers should have transparent healthcare pricing so they can proactively manage their health. Although GoodRx is far from fixing America’s health care system, the company is fulfilling its mission of providing all Americans access to affordable healthcare and prescription drugs. Unfortunately, nearly a third of U.S. prescriptions are not filled, and every four minutes in the U.S, a person dies from not taking their prescribed drug or not taking it as directed.
While GoodRx has its share of fierce competitors in the marketplace, it continues to be a top provider for the uninsured and underinsured. By offering appointments seven days a week, a premium savings tier for consumers who purchase multiple medications monthly, and up-to-date vetted medical information, GoodRx is a wise choice for those with or without insurance. While it doesn’t make sense for every consumer (especially for those who already receive free medications through their insurance plan), it is worth looking for most Americans. Why pay more than the co-pay or naively pay pharmacy cash prices when consumers can leverage GoodRx’s discount prescription drug card for free?
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