Hacker Newsnew | past | comments | ask | show | jobs | submitlogin
GoodRx S-1 (sec.gov)
143 points by xoxoy on Aug 28, 2020 | hide | past | favorite | 131 comments


GoodRx/Coupons creates some odd problems/interactions with insurance.

We were prescribed liquid Tamiflu (Oseltamivir) for a child with the flu. We have high deductible health insurance. The insurance "discount" cost was $105. The GoodRx price was $40.

But this creates an odd and illogical conflict: Hypothetically we should always pay the lower price, but the higher price counts towards our insurance yearly deductible and out-of-pocket maximum, whereas the GoodRx price does not.

So we have a type of insurance specifically designed to encourage us to find cheaper medical services, but GoodRx undercuts the insurance itself, forcing us to choose between our deductible and the rational price.

The US should just outright ban insurance "discounts" (which are a fiction anyway). That way everyone pays just one price: Cash, insurance, Medicaid, or whatever. Plus then medical providers can actually publish realistic price lists instead of fiction with "discounts" on the fiction.


I'll give you a funnier example.

When my wife was pregnant last year, one of the genetic test we needed to get would have costed us somewhere around 3-4K$ (and we also heard people on same insurance being quoted for up to 8K$). I asked the cash price, they told us something like 250-300$. We paid cash price, even if it costed us more since birth alone would have hit oop maximum rightaway. IT still felt good for that particular one since the disparity was too big.

Us insurance system is a racket.


Obnoxious fact: the past tense for "cost", when referring to price, is... "cost": https://ell.stackexchange.com/questions/88872/which-one-is-c...

"Costed" is something of a hypercorrection, only used in some rare business contexts.


You are right. non-native speaker with occasional tense errors here! Thank you.


I've heard native speakers make this mistake too.


From this[1], seems like their prices can go toward the deductible. Anyway, I agree with you regarding the fake price gouging, so you can get the insurance "discount".

If we could pay prices that insurance pay, well, they are expensive, but they aren't "ruin you financially" expensive. And if the prices would be clear and same of everyone we finally could get them down through competition.

[1] https://www.goodrx.com/blog/how-to-use-goodrx-with-high-dedu...


I'm not from the US and I know people love to criticise the US healthcare system.

What's crazy to me about this is that the insurance doesn't work like a normal home or car insurance: your car gets destroyed, you buy another car of the same replacement value, you send the insurance company the receipt. Maybe you fight with them over the exact replacement cost, but you get pretty close.

Instead, it sounds like the insurance company provides you with an opportunity to buy medicine from them at a hopefully discounted price. Or if not technically from them - from their business partner.

Private health insurance in other parts of the world looks a bit like this with regard to hospital treatment. There's a private hospital who's partnered with the insurance company, and you can only get treated there if you have private insurance. Which makes a certain amount of sense as hospital treatment is not a commodity. But to apply the same logic to the part of the treatment that is commoditized - the drugs - is a real triumph of capitalism.


In the us insurance is like joining Costco so you can get access to prices and service it’s not actually insurance


More and more it's that the insurance company lets you pay them a premium while you also pay your bills in full. Then if you hit your obscenely high deductible they start helping. Then if you hit your out of pocket maximum they cover it fully. At the end of the calendar year, everything resets, though your premium and deductible probably increased by a greater rate than your wage did.


Many drugs are not commoditized (some might be). Often you have only one or two manufacturers for some ingredient of a drug and if one of them has issues, the entire supply chain collapses.


You mean like Enron where they paid power companies to shut down to increase spot prices and manipulate markets?

Monopolization of commodity drugs and the large price increases in the US mirrors the cartel/monopoly conditions that have pervaded practically every major market in the US.

Insulin and Epipens are two common examples of this, and it has killed people. And the entire drama around Martin Shrekli.


We don’t have insurance. We find the lowest price and pay it. This year alone we’ve saved thousands using stuff like GoodRx and just paying cash.

Edit: not to mention no premiums.


It's a strategy that works for the small things: a doctor's visit for the flu, ubiquitously manufactured cheap prescription drugs, etc.

It's when you face a real medical emergency and have a six-figure hospital bill, that you truly need health insurance.


Of course even with insurance you might end up owing huge amounts. A friend of mine was in a terrible accident, had insurance, and still racked up massive bills. The last number I heard from him was $800k and he was wondering if it would get over a million.

I have insurance now but have gone without it at times and really don't know what the best route is. If I get injured badly with insurance I know there's still a decent chance I'm ruined financially.


NPR reported a story like this this week:

https://www.npr.org/sections/health-shots/2020/08/25/9045178...

They are not hard to find. This one also included some dodgy billing practices by the medical provider. Consistent with industry standards.


You can do both: carry insurance and not use it outside of catastrophies, and just pay cash for most minor/routine things. This is what I do.


Which is helpful, but you shouldn't be in that position and it is really just a dice roll away from becoming unsustainable.

The system is horribly broken. GoodRx helps people, but GoodRx are a symptom of a much bigger problem rather than a solution.


What else do you use besides GoodRx?


Even though the lower price means you have more room in your deductible, it's it case outlay that matters? You may never hit your deductible for the year.


> “ Our revenue has grown at a compound annual growth rate, or CAGR, of 57% since 2016, and reached $388 million in 2019, up from $250 million in 2018. Our net income was $66 million in 2019, up from $44 million in 2018, and our Adjusted EBITDA was $160 million in 2019, up from $128 million in 2018. Our revenue grew 48% in the first half of 2020 to $257 million, up from $173 million in the first half of 2019. Our net income was $55 million in the first half of 2020, up from $31 million in the first half of 2019, and our Adjusted EBITDA was $101 million in the first half of 2020, up from $75 million in the first half of 2019.”

Wow, that’s some healthy margins. Profitable for the last few years with strong growth on both top line and bottom line.


Those numbers are incredible. It’s amazing how much fat there is to skim in the pharmacy benefits scamola^Wbusiness.


What command is ola^ ?


"scamola" -- as in, scam. ^W implies closing the window and starting over.


^W (control W) is actually delete the last word in Unix systems.


And ^H is ASCII control character BACKSPACE. Back in the day, the ^H actually happened, accidentally. From jwz:

>Most people who understand what ^H means must have some sense that it is somehow the same as "backspace", right? Well, what would happen is, someone is typing on a dumb terminal that wasn't configured right, and as they typed backspace, that character would go up to the server, not be interpreted as "delete the previous character", and would be dutifully echoed back to the tty. The tty would then itself interpret that as "delete the previous character on the screen." So the person typing thought the characters were gone, but oh no no.

https://anon.to/?https://www.jwz.org/blog/2004/03/the-unfroz...


oof, face-palm for me.


I believe koolba was perhaps referencing Payola, the now-illegal practice of paying a radio station to play a song repeatedly, thus manufacturing a "hit".

https://en.wikipedia.org/wiki/Payola

There are many payola-adjacent business practices in the pharmaceutical industry, not all of which are currently illegal.


Ha! No, by scamola I meant a regular scam, just scammier.


^W is delete-word


And not just gross margins, actual ebitda profitability!


seems like it'd be sensitive to changes in healthcare policy as someone else mentioned eg step changes in drug pricing regulation that would make it less useful for someone to comparison shop drugs even with insurance.

in a sense, they try to solve a huge problem with our healthcare system with duct tape when fundamental change needs to come from policymakers to create "real" change.


They are also dependent on large pharmaceutical chains to accept GoodRx. Walgreens and CVS make little money on those prescriptions, and may lose money, and on top of that need to do more POS data entry to accept the coupon, so they only accept GoodRx to make customers happy and get store foot traffic. That’s not to say the situation is unstable for GoodRx but it is a risk.


Interesting. When I've checked GoodRX, Walgreens and CVS have had much worse GoodRx prices than grocery stores or Walmart. I can't see it driving foot traffic to them - it led me away from them!


Indeed. Have used GoodRx since inception, plus Canada-UK. Costco is best, especially when you get your MD to prescribe 365 pills. Then come the supermarkets. Rarely CVS or Walgreens.

Going on 8 years, I realized insurancee pharma was a total scam. With United Healthcare, I paid less in cash than their OptumRX bullshit benefit.

I keep a spreadsheet of drug quotes and purchases.

Finally beware of Walmart. Every indication is that they have a team to game GoodRx. Satisfaction less than 50% of the time. I once contacted David Hirsch via LinkedIn and got an immediate reply.


Very interesting. Thank you.

Do you happen to have data on asthma medicine (albuterol or steroids?)


It's not much more data entry than entering in an insurance card. But yes, they are dependent on being accepted by large chains. I believe GoodRX was not accepted at CVS for a long time


It is more entry per customer because GoodRx must be entered for each transaction (or at least the initiation of each new prescription.) One insurance card stays on a customer’s file for a year or more.


If anyone else is curious on GoodRX’s business model, here is a good write up I found from HBS https://digital.hbs.edu/platform-digit/submission/goodrx-or-...


I don't think that is the full truth. Everyone in the industry seems to see goodrx as dishonest and they all state the same story similar to this recent one from reddit[0].

In my personal experience, the goodrx "coupon" for my drug was $30. Sure enough, at the pharmacy, I was charged $30. But if I use the same coupon the next month, the price is magically $57. I could print out a new coupon every time, but the process with the pharm tech to change to a different "drug card" (which is what they see it as) is nearly a 5 minute process. By contrast, my state offers their own group drug card, and the charge is usually around $45. It might go up or down by a few dollars every 6 months, but that is it.

[0]: https://www.reddit.com/r/explainlikeimfive/comments/ih4ziy/e...


That comment does not understand how pharmacies get paid. The patient pay amount is irrelevant to how much the pharmacy makes. Pharmacies make money from prescription dispensing fees, which are generally around 1-2 dollars. PBMs are the ones that make money on patient pay amounts and are the same ones that pay the wholesalers, and they have different payout contracts depending on which card is being used. GoodRx relies on these PBMs for business, who have done the math on the arbitrage being in their favor. Source: I worked at a GoodRX competitor a couple years ago.


I worked with PBMs in the past and it's more than just the dispensing fee.

Typically a pharmacy will enter into a contract with a PBM and the PBM will reimburse the pharmacy for each drug at a set amount. That amount does include a dispensing fee, but the pharmacy can also make money off the margin between acquisition and reimbursement.

So if a months supply costs the pharmacy $30.

The PBM might pay $23 for the drug, $2 dispensing fee and tells the pharmacy to collect a $10 co-pay ($35 total).

Pharmacy makes $5.

However, what I've heard is that it's never that simple. PBMs are constantly trying to pay as close to acquisition cost as possible and when you have multi-source drugs (generics), they often just pay the lowest price.

So I've heard from pharmacies that some drugs have a 50% margin and other have a -20% margin. The PBM tells them it "all evens out" which is BS. The PBMs also have DIR fees, where a couple quarters later they claw back additional money, again arguing that the prior reimbursement was too high. The PBM model is really trying to squeeze pharmacy margins as much as they can.


The drug price changed, independent of your usage of the coupon. In my experience, I have used GoodRx for years and paid the same price always.


I’ve seen ca. 6-month price changes, and a complete reordering of the price ranking among pharmacies. Just go to the new pharmacy and have them transfer the Rx.


This is standard pharmacy behavior. Has nothing to do with GoodRx, which is an advertiser. Pharmacies determine all prices. Different pharmacies have different loss leaders each month. You go to the GoodRx “best” price pharmacy with your bottle. That pharmacist will take care of the transfer, using the RX# and possibly calling the Dr. I will always do the legwork, to me it is a “dollar vote.”


That comment doesn't appear to explain anything about GoodRX changing their prices. It's ranting about how pharmacies lose money on the coupons, but I don't think that's how drug pricing works. If a pharmacy has a $100 drug and the coupon brings it down to $80, nobody "lost" $20.


The business model is simply to collect referral fees from Pharmacies and PBMs. Also to sell data back to insurers and pharmaceutical companies.

There are companies known as PBMs (Pharmacy Benefits Manager) whose sole purpose is to negotiate rebates and group discounts on behalf of insurers and employers.

GoodRx operates as PBM at scale or more exactly as an aggregator of deals from PBMs + Pharmacies. The pharmacies pay them because they drive volume and the PBMs pay them because they help to lower the cost of their medication programs which is one of the reasons they exist.

It's the same model of a coupon website.


>There are companies known as PBMs (Pharmacy Benefits Manager) whose sole purpose is to negotiate rebates and group discounts on behalf of insurers and employers.

All the big insurers have their own PBMs now so I'm not bullish on their business model lasting. Insurance companies hold the trump cards as they are the ones collecting the premiums and have the money. There's no reason for any of the big companies to give up margin to GoodRx. Maybe some of the smaller health plans might have to make deals with them.


Yeah. But insurance companies are more profitable when they don’t cover the medications of their customers. They have PBMs because they don’t want get charged more than they should. Insurance companies would love everyone going through GoodRx because then they don’t have to pay for those medications.

There’s really no margins in paying for medications. This is always a red number for the insurance.


> But insurance companies are more profitable when they don’t cover the medications of their customers

This isn’t accurate. Insurance companies have legal fixed profit margins as a percent of spending, so they want this to be as high as possible. This creates a vested interest in both maintaining high prices and spending.


In an area with multiple health insurance companies, they can’t just keep spending more and keep raising premiums otherwise a competing insurer will take their business with lower premiums.


GoodRx is taking up the same role as a PBM. If you use them, insurance is not involved in the transaction.


Insurance is involved with a PBM, just not directly. Insurers are the end payer. They just hire the PBM to manage their pharmacy coverage and spend.


At least the 5 biggest insurers operate their own PBM, so I don’t see the distinction between PBM and insurer to be useful.


In second sentence, them=GoodRX.


Wow...an S-1 with positive net income.


Yes but they don’t really have a way to expand outside of the US, they are basically an answer to a uniquely American problem unless they’ll go they’ll target the self medicating crowd that uses the relatively dodgy online questionnaire/chat prescription pharmacies.


Why is that a problem? Companies don’t need to be international.


This is not really a problem. If they were in a situation where they didn't have a way to expand outside of say, Burundi, that would be a problem, but the US is 25% of the global economy.


> Yes but they don’t really have a way to expand outside of the US, they are basically an answer to a uniquely American problem

The US accounts for 45% of global pharmaceutical sales. Even if they're limited to "only" half of the global pharmaceutical market, that doesn't sound like the worst position to be in.


I think that’s for North American and it’s in revenue not in actual sales, but yes that is currently the case but it’s also clear that the US health system cannot continue as it does for much longer. So overall while they can clearly profitably operate in the current market I’m not so sure about their longevity.


The market size and business opportunity is not measured by units sold but by overall revenue. Am I missing something?


Yes you are missing the point that this company can only operate because of just how utterly broken the US healthcare system is, and sooner rather than later there will be sufficient political pressure to change that.


Because their risk is dramatic health-care reform? In the USA?


Medicaid for All almost made it into the Democratic Party manifesto this time, it was cut but realistically it will make it into the 2024 or 2028 one especially once the longer term effects of COVID-19 will be more apparent because many of the recovered will suffer long lasting effects potentially for the rest of their (hopefully long) lives, and overall once all the bullshit settles down people will see it as a pretty good wake up call.


You're almost proving my point. Look at the numbers; between now and any reform in 2024 they'll be making $100MM/yr in Net Income -- by 2028 they'd have a war-chest of $800MM -- cateris peribus.

"sooner rather than later" won't be in 4 and could take 8! years (that's seems later to me)

If you're concerned about their longevity it looks like they'll have plenty of cash to figure it out over plenty of time.


It depends on the time scale you are looking at 4-8 years isn’t a lot, and also there are plenty of other changes that could happen in the prescription drug market and there have been many pushes for that which don’t require a full on single payer system.


Most of these changes still maintain the necessity for price transparency, which GoodRx still offers. There will always be some need for an online portal through which to shop for medication, regardless of whether or not there are price controls or if the payments are reimbursed/subsidized by the state.


8 years is a bit less than half of Google's existence.


A political “manifesto” is meaningless.


GoodRx doesn't cover physician administered drugs, which makes up a sizable proportion of that 45%.


So they're a mature, profitable company going public and that's a "Yes, but..."?


They seem pretty vulnerable to being obsolete if there is any sort of substantial change in the prescription drug market. And there seems to be quite a push to change the prescription drug market. Just look at how convoluted their revenue generation is, there are like 5 middle men.


That's why they use the money that they mad to hire lobbyists to ensure that policies won't change in any meaningful way.

I hate how this world works :/


This is true of basically any major healthcare play. On the (at this point extremely) off chance that we move to single payer, for instance, insurance companies face an existential crisis. On the off chance that we fix prescription drug price gouging and absurdly inconsistent pricing and all of these problems that GoodRx solves for patients simply by _cutting them in on the scam a bit_, then GoodRx faces an existential crisis.

The fact that there are 5 middle men is... more of a moat in this case? They've solved a complex, intractable problem profitably. Does this mean they're a 20-year company? Eh, not without some significant additional revenue streams or pivots into different areas, and to that point I agree with you about their vulnerability. But for the next 10 years? These are good margins building a business that only incrementally reduces the fucking over of the consumer.


[flagged]


The issue I’m seeing is that many people would prefer a US where a company like that couldn’t exist, and yes the Dems killed Medicaid for All from their manifesto for this round but I’ll wager that the US will move towards universal and single payer system within the next 10 years.


> yes the Dems killed Medicaid for All from their manifesto for this round

“Medicare for All”, and while it's not part of the current platform (which focussed on a public option), removing federal program barriers to states enacting universal plans while participating in the various federal plans is part of the platform, and state policies providing models for federal progress is a common thing.

But, more immediately, even without Medicare for All, the Democratic 2020 has a plan for universality centered around a public zero-deductible option that all Americans would be able to buy into via existing exchanges and with existing exchange subsidies and some low income Americana would be enrolled in automatically with no premiums.


Admittedly my comment was snarky, but you're speaking of ideals and we're speaking of solutions. Right now GoodRx is a very successful company solving a very real problem. Meanwhile the US government has completely fucking failed to fix it's healthcare issue.

You can keep waiting for a government solution. In the meantime I will continue to be a happy customer of GoodRx.


My father went into his chosen profession because he expected the US to get on the universal health care bandwagon imminently. That was in 1970.


I know a few pharmacists and they hate GoodRx. Why? Because of the added fee on top of the discount. They often end up underwater (losing money on the Rx).

I've even heard of some pharmacies doing a "cash price" match of GoodRx. Customer is happy (still get lower price) and the pharmacy is happy (they don't pay the GoodRx fee).

Makes me wonder about the longevity of the business model.


Reading comments like this always reminds me how fucked up US healthcare (and not only healthcare) system is. God bless CoMmUniSt EU


Imagine the wild level of data they have on the US population, every person with an illness or disease, their name, address, dob, everything in a billing requirement.

The only problem is it is likely many more people without insurance than with because of the nature of their product.

If that database ever leaks, wow there will be hell to pay, or maybe not, hasn't really been in the past, did people ever get their $100 payout for the other leaks?

https://www.consumerreports.org/health-privacy/goodrx-shares...


one of the few companies to file an s-1 recently with healthy numbers. cash flow positive. profits. and considering state of us health care, I would buy stock in this company


There you go. Actual numbers showing profitability on day 1 on IPO and none of that "We may never reach profitability" disclaimer notices from bullshit hyped startups out there racing to the stock market with only gigantic losses to show; quarter after quarter.

What I see about GoodRx is sustainable and they are not even trying. I would gladly buy this stock.


I was searching for their revenue model. Here is what page 21 of S1 says:

"To date, the vast majority of our revenue has been .. derived from our prescription offering. When a consumer uses a GoodRx code to fill a prescription and saves money compared to the list price at that pharmacy, we receive fees from our partners, primarily PBMs. 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."


I absolutely hate GoodRx.

Its a symptom of a horrifying lack of medical coverage and care in this country. If it actually becomes incredibly successful it will embody the same perverse incentive structure as Intuit -- to remain successful they would be best served by lobbying against universal healthcare and affordable medicine in general so their offerings remain valuable. In the same way Intuit lobbies against simplifying the tax code. Every time this happens it further entrenches the existing nightmare.

Medicine in this country needs wholesale reform, not coupon clipping for insulin.

[edit] Coupon clipping for life saving medicine is apparently as good an S-1 as it would be a Black Mirror episode.


Why is coupon clipping for food (without which you starve and die) not a problem?

One of the biggest problems with healthcare today is a lack of price transparency, and GoodRx appears to offer that. Most healthcare systems in the world operate on price transparency, and as long as that's the case, there should always be a need for the services GoodRx offers.


> Why is coupon clipping for food (without which you starve and die) not a problem?

The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill.

Then there's food banks, and SNAP. Both of which should be expanded.

The government does absolutely nothing to make drugs affordable. At all.

> Most healthcare systems in the world operate on price transparency, and as long as that's the case, there should always be a need for the services GoodRx offers.

Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage.

The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs. There is very limited socialized prescription drug coverage in Canada. So when the government permitted re-importation of drugs from Canada, they basically refused to negotiate themselves and wanted to instead rely on Canadian provinces to negotiate on their behalf. Nutty.

One way of solving this would be to have Medicare negotiate the price of all drugs in the US.

[edit] There's lots of comprehensive solutions, and none of them involve coupon clipping.


> The reason drugs in Canada are cheap is because the provinces negotiate the prices, not because they socialize the costs.

This is false. The reason they are cheaper in Canada is that the federal government sets the prices based on average price in a list of comparable countries and forces the manufacturers to follow it.

https://www.cbc.ca/news/health/prescription-drug-prices-1.32...


Yes, the government negotiates with the manufacturers, sets the price, and if they don't come to an agreement the drug cannot be sold in Canada. That's in line with what I said. Fine, it may need an overhaul, however, it's dramatically more functional than the literally nothing the US does.


To the best of my knowledge, there is no negotiation. The federal government sets the prices unilaterally and forces the manufacturers to follow it.


Sounds like a strong negotiation tactic ;) but point taken.


> there's socialized food for those in need, in the form of food banks and SNAP.

No there isn't.

That is, the places that tend to have usable, subsidized healthcare for the poor are the same places that tend to have subsidized food for the poor.

Likewise for those that don't.

Source: Years with freq periods of little/no food (and 5 kids).


I agree those programs should be much better.

It's also worth considering that the US already spends the least amount on food in the entire world [1] but the most in health care.

[1] https://www.ibtimes.com/us-spends-less-food-any-other-countr...


> Well, thanks to the government, there's socialized food for those in need, in the form of food banks and SNAP.

Yes. Why can't we have the same for prescription drugs?

> Most healthcare systems in the world operate by having the government form a bulk buying organization and negotiating the price of drugs down to a fraction of what Americans are forced to pay even in places without socialized prescription drug coverage.

This isn't true. Switzerland operates on an entirely private insurance model. Ditto the Netherlands. Singapore (which enjoys the lowest per capita health expenditures and some of the best outcomes) is almost entirely driven by transparent pricing and regulations. Germany uses public-private hybrid model. In France, the NHI operates on a reimbursement model, where you still buy drugs at a pharmacy and shop around by price.

The Canadian model is great, but it's not nearly as efficient as Singapore's.

> One way of solving this would be to have Medicare negotiate the price of all drugs in the US.

It's not the only way, you can also just institute price controls. Monopsony negotiation is in-effect the same thing.

(addressing your edit)

> The government already does an awful lot to make food affordable in the US, including subsidizing corn to well below the cost of production via continuous re-authorization of the Farm Bill.

> The government does absolutely nothing to make drugs affordable. At all.

Yes, all of what you said is correct there, and yet you still have a world where you shop for food on the basis of transparent pricing and sometimes even take advantage of coupons. Just like regulations and welfare co-exist with market pricing with food, so too can it exist with prescription drugs. Even in a world where the government offers direct subsidies on drugs, there is a place for GoodRx and its model.

> [edit] There's lots of comprehensive solutions, and none of them involve coupon clipping.

But that's just not true. GoodRx would, for example, do very well in Singapore, Switzerland, the Netherlands, and Germany.

https://www.wbur.org/onpoint/2019/06/24/us-health-care-drugs...


> Switzerland operates on an entirely private insurance model.

Switzerland probably isn't a good example, they're the second most expensive healthcare system in the world, right after America.


Switzerland also enjoys some of the best health outcomes, though. Unlike America, Switzerland has the highest average life expectancy, the lowest infant mortality, some of the best cancer outcomes, and respiratory illness outcomes. Switzerland is an often used example because they actually get something for what they pay, unlike America.

https://www.rd.com/article/switzerland-worlds-best-healthcar...

The US pays more for less. Switzerland pays more for more. Canada pays less for adequate. Singapore, however, earns the distinction of paying less for more: https://www.bloomberg.com/graphics/infographics/most-efficie...


> Why is coupon clipping for food (without which you starve and die) not a problem?

Because most food coupons (Based on my experience in the US) are for “luxury” foods like candy, junk, and snacks. Not fruit, veggies, grains, protein.


That’s not true at all. Most coupons are for any type of grocery at a store, usually promotional in nature for new products or stores.

I use coupons for all sorts of basic needs, like free ride share rides (transportation), clothing, groceries (or grocery delivery), etc. I even use promotional pricing to pay less in monthly rent in Brooklyn. Food, clothing, transportation, and shelter are not frivolous expenditures, they are basic necessities.

I won’t starve or go homeless without the coupons, but they let me save money every month, which I can use for other stuff like video games or stocks or other activities. This is good for consumers.


Neat. Sounds like your experience is different than mine.

Cool that you said my experience is not true at all though.


The difference between your description of your experience and mine is that mine is inclusive while yours is exclusive.

You are making a claim (a quite bold one at that) that coupons are only used for "luxury" food. While I don't deny that there exists coupons used for luxury food, I am making the inclusive claim that they are also commonly used for ordinary food, based on my own experience.

Unlike me, you are attempting to prove a negative — that people do not use coupons for every day basic purchases — based solely on your own experience. The burden of proof for your claim is far greater than the burden of proof for mine.


[flagged]


I never doubted that it was based on what you see. It seemed rather clear to me that you were attempting to refute the idea of comparing coupons for medicine with coupons for food — with the claim that "most food coupons are for luxury foods.", based on your experience.

I responded that coupons are used for all sorts of basic necessities, and not just "luxury"/"junk" food, and as such I have no problems with using coupons for basic necessities. This is based on what the coupons I see can be used for. It literally doesn't matter what your experience is, because you seem to think that your experience renders coupons "only for luxury", and I'm refuting that with my own experience, potentially even exposing you to how someone else might live their life. This shouldn't be difficult for you to accept.

And I'm not your bud.


While I agree, in the short term, the existence of GoodRx is probably better than not. It's expanding access to prescription drugs, even if in a sub-optimal way. Perfect is the enemy of good.


[flagged]


But heroin doesn't solve your homelessness problem at all unless you mean by killing the takers but that is very different from providing medicine affordably to people. What did I miss?


GoodRx doesn’t solve affordability either it papers over it by giving a small handful of people access to affordable prices, while putting themselves in a position to lock in the status quo — ultimately solving nothing for everyone.


The discounts GoodRx provides could be providing life-sustaining drugs to people who otherwise couldn't afford them, that's definitely solving somebody's problem.


If it empowers them to keep perpetuating the current system like intuit perpetuates the complexity of the current tax system, did we really win in the macro?


fwiw I was paying twice as much for my rx's until I brought how expensive they were with my doctor and he said to check GoodRx. I may be naive, but I had no idea the different prices pharmacies charge. I ended up getting a 450 mg Rx split into two 300 mg and 150 mg rx's as it was cheaper (the 300 was actually cheaper than the 150). I agree that this is a terrible system and needs to be fixed, but GoodRx did save me money.


They saved you a tiny amount of money now at the expense of the future accumulated effect of lobbying against medical and insurance reform.

It’s like mortgaging your future and the generations after you in exchange for a few dollars.


I guess you are you saying that I and others should pay more money for our prescriptions? Do you have any idea how expensive many prescriptions are? People with serious chronic illnesses already have a tough enough time with expenses in the U.S. and blaming them for lack of medical reform is disheartening to hear.


> “ I guess you are you saying that I and others should pay more money for our prescriptions?”

Yes, I am saying that. If you are interested in saving money and not being beholden to corporate interests and regulatory capture that cause you big costs and restrict you from medical care you may need, you should pay more money today and avoid helping GoodRX to have lobbying power.

From a purely self-interest / money saving perspective, you should spend more and be happy that your extra spending today is buying you valuable units of GoodRX-goes-away.


Are you willing to give me the difference in price? Probably not... I guess it isn’t a problem for you.


If you are only willing to avoid GoodRX if someone else subsidizes a lower price for you, then you are acting against your own self-intetest.

The point is that if you think paying a lower price now is good or necessary, you are hurting yourself and others. You should stop focusing on the lower up front price and take actions that don’t hurt yourself or others.

Asking others to subsidize a lower price for you is a rhetorical deflection. It’s not connected to a greater point, it doesn’t prove anything, it doesn’t compromise the other person’s position if they are unwilling to subsidize your lower price, and it doesn’t address the issue - your desire to do anything for a lower price in the short term is directly antagonistic to your own self-interest and cost savings in the medium term.

Finally, I am willing to pay towards that cost for you - please tax me more and provide universal medical care for all. Are you voting for single payer universal healthcare? Are you vocally supporting candidates who will enact that policy? If you want me to pay for your prescription prices to be lower, I will absolutely do it via taxation and universal healthcare.


> Finally, I am willing to pay towards that cost for you - please tax me more and provide universal medical care for all. Are you voting for single payer universal healthcare? Are you vocally supporting candidates who will enact that policy? If you want me to pay for your prescription prices to be lower, I will absolutely do it via taxation and universal healthcare.

As am I.


No, they are saying that laws around drug pricing should be designed so that prices would be the similar to what GoodRX achieves, with no opportunity for profit left.

Whether that is possible is of course an open question, but laws that impact drug pricing should encourage the source suppliers (manufacturers and wholesalers) to charge close to cost, not to invent prices that maximize revenue extraction from government programs and "discount" prices for other buyers.


Other than the app, how is GoodRX’s business model different from the multiple other discount cards out there? What did they figure out that non of the others did?


How do they get prescription prices so low? And why can't insurance companies negotiate similar deals?


They sell data. They might even assist insurance companies because I don’t think purchases made via GoodRx apply towards deductible/out of pocket maximum.


Purchases made via GoodRx almost always apply towards your deductible.

https://www.goodrx.com/blog/how-to-use-goodrx-with-high-dedu...


Interesting, I wonder why the insurance companies would let someone else undercut them.

I was partly going by information from this pharmacist:

https://youtu.be/bUVbX3-gOWc


drug companies frequently provide rebates as a way to keep prices high to insurance companies but lower out of pocket costs to individuals - I think they do the leg work to automatically source these coupons for you and get some sort of kickback from the drug company


What's the motivation behind this?

Is it really to provide a break to the individually uninsured?


Who do they sell the data to? It's certainly not the insurer/consumer/PBM/pharmacy. Each of those groups already has near total visibility as is.


Supposedly drug companies according to this pharmacist around 5 min mark:

https://youtu.be/bUVbX3-gOWc

I am not sure either, but I can’t figure out what other play there is than selling data.


Life insurance companies (speculation - but they won't have the visibility into Barry Boomer's cholesterol meds that his health insurer will)


You typically have to give permission for life insurance companies to access all of your medical history when you apply for it.


From your doctor, sure - but from databases of who bought what that the pt consented to be in as a condition of getting a discount? Is GoodRx a HIPAA covered entity? (Not being rhetorical; don't actually know.)


GoodRx does not sell anyone's data.


Making profit off human well-being, I consider this a flaw of the capitalism.

There should be an easier fix than introducing another private for profit entity in the health care system.


Aren't food companies and grocery stores in the business of profiting off human well-being?


No, as they have very low margins.


Right. The goal here is to make healthcare a low margin business also. High margins are an indicator of a lack of competition.




Consider applying for YC's Winter 2026 batch! Applications are open till Nov 10

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: