The Hidden Variability of Coupon Savings Cards
Author Credit: Evan Drnevich, PharmD Candidate 2022 (Duq)
‘The Card Game’
Many patients have heard of GoodRx, SingleCare, and other similar prescription drug savings cards. Patients may use these cards because they provide better pricing than their insurance or because they are uninsured. While these cards may seem beneficial, they filter into the same inflated drug cost system that patients try to escape by using these cards. Additionally, patients that struggle with cost often are not aware of the volatility of these discount cards’ prices.
‘The Rules’
Since February 8th, I have been monitoring GoodRx & Blueberry Pharmacy prices. This data was viewed weekly for 5 weeks with the last week including a daily view of pricing. GoodRx prices were listed for two pharmacies: CVS & Giant Eagle. The contemporaneous Blueberry Pharmacy member price was also listed for comparison.
Each weekly — and daily — data sheet contained several pieces of information:
- The list of queried drugs and their quantities
- The GoodRx coupon price for the relevant pharmacy (CVS Pharmacy or Giant Eagle Pharmacy)
- The list price for the drug at the relevant pharmacy
- The Blueberry Pharmacy member price
A few simple analyses were then performed on this data. This included:
- To-date price change for each respective pharmacy from 2/8/22
- To-date percentage change in price for each respective pharmacy from 2/8/22
- Week-to-week (or day-to-day) price change for each respective pharmacy
- Week-to-week (or day-to-day) percentage change in price for each respective pharmacy
‘The Hands’
First, the glaring price discrepancy between GoodRx pricing and Blueberry Pharmacy Member pricing becomes obvious. Some noteworthy cost differences are:
Second, many changes were noted in between some weeks — with some of those being fairly significant. Metoprolol succinate ER 50 mg (90 tablets) was a drug that underwent pretty volatile price changes. From 2/8/22–2/15/22, the cost decreased by nearly $10 at Giant Eagle (nearly halving the price); the following week (2/15/22–2/22/22), the cost increased by nearly $10 (nearly doubling the price). A similar fluctuation was seen at Giant Eagle for 180 tablets of Metformin ER 500 mg — increasing then decreasing by about $8 — which corresponds to a 31% price decrease followed by a 44% price increase.
Several prices simply increased since first viewing, while others simply decreased. Sildenafil has only increased in price since 2/8/22 at both CVS and Giant Eagle. Levothyroxine has only decreased in price at Giant Eagle while remaining the same at CVS. There are several other examples. Interestingly, a price increase at one location sometimes was accompanied by a decrease at the other location. This occurred with tamsulosin 0.4 mg from both 2/8/22–2/15/22 & 2/15/22–2/22/22 and with atorvastatin 40 mg from 2/15/22–2/22/22.
Finally, it was also interesting to see how seemingly random the timing of the price changes were. For the first two week-to-week periods, over two dozen changes were made in GoodRx pricing. However, the period from 2/22/22–3/1/22 showed only one minor change in pricing — a 1% ($24) increase in 240 mg dimethyl fumarate pricing at CVS. When viewing day-to-day changes, only one negligible change was seen over the four day-to-day periods during the week of 3/7/22–3/11/22.
When comparing GoodRx’s fluctuation in prices to Blueberry Pharmacy’s member pricing two things are apparent. One, Blueberry Pharmacy’s pricing is much more consistent. There have only been four week-to-week price changes throughout the five-week period compared to 30 changes in GoodRx prices. Two, Blueberry Pharmacy’s prices decreased three of the four times it changed. The only increase was a 6% ($0.43) in 90 capsules of fluoxetine 40 mg — a corresponding increase from $6.95 to $7.38.
‘Wising Up’
Taking all of this into consideration, it is important that patients are made aware of the volatility of discount prescription drug cards. As was shown through this short five-week analysis, GoodRx’s prices fluctuate with no apparent rhyme or reason. Some of these increases may also be significant as was seen for several drugs which were mentioned above. However, the cost-plus model employed at Blueberry Pharmacy was seen to be much more consistent. Price decreases were much more common than increases; which were minimal — as patient cost was starting from a reasonable baseline. Now let’s stop playing games, and show our cards! #WelcometoDifferent
References:
https://price.blueberrypharmacy.com/
https://docs.google.com/spreadsheets/d/1jkUoaQkLbn0XDRg84Tn4hxvfU2KiEHN0C_kAMBHP9WU/edit?usp=sharing
