Doug Hirsch, GoodRx, on how a traditional retail experience can be revolutionary

Doug Hirsch is a product guy — it’s something he’ll freely tell you but also something that’s obvious from the list of products he’s built and how he approaches challenges. He was one of the first 25–30 people at Yahoo where he ran virtually all of their community/communication products, including Yahoo! Mail, Groups, and Photos. He was then one of the first 20 employees at Facebook, where he would go on to create the concept of photo tagging with one of his now GoodRx co-founders. These experiences taught him the importance of great products and great consumer experiences. Then, when he saw the horrible process of picking up his own prescription medication, he turned his frustration into an $18BN publicly traded company working to make picking up a prescription as easy as buying anything else in your life. While that may sound simple, it’s far from it.

GoodRx was founded a decade ago with the mission of making healthcare more affordable and convenient. 10 years later, they’ve saved American consumers over $30BN on their prescription drugs and helped 18 million individuals pay for a medication they otherwise wouldn’t have been able to afford. Their core product is a tool that cobbles together ~200 billion daily cash-pay price points for generic drugs from pharmacies, pharmacy benefit managers (PBMs), and retailers to help a consumer choose the right way for them to get access to the medication they need. Going forward, they will continue to expand into telehealth and products that surround brand medications. In September of 2020, they successfully went public to help them continue to drive change in the healthcare industry and country at large.

Doug Hirsch, GoodRx, on how a traditional retail experience can be revolutionary

In this episode, we discussed:

• How Doug’s early experiences running product at Yahoo and Facebook taught him the value of building amazing products first and focusing on the business model later
• The GoodRx journey from scrappy start-up literally knocking on local pharmacy doors to a publicly traded tech giant with a new set of organizational and regulatory challenges
• How revolutionary it can be to bring the traditional retail purchasing experience to healthcare
• GoodRx’s plans for the future — mail order and creating products around brand drugs

1:00–7:00 — Origins of Doug’s entrepreneurship bug

• On what brought him to GoodRx: Doug admits that he didn’t have the patience or tolerance to work on something that he wasn’t passionate about. His obsession with doing something important eventually led him to healthcare, first at a patient support platform he founded called DailyStrength then to GoodRx. He’s careful to say that he doesn’t want that to come off as too altruistic, so he humbly suggests that this desire also comes from a place of insecurity — saying that he wanted to do something that others saw as important as well.
• On running product at Yahoo and Facebook: As Doug reflects on his early product experiences, he lights up at the fact that he didn’t have to care about the financial side of things, it was all about building amazing things. At a certain point, he decided that he didn’t want to get someone’s permission to pursue what he thought was right, so he ventured off to helm his own ship.
• Reflecting on 10 year mark for GoodRx: While GoodRx has obviously been successful, Doug debates with himself what tangible metrics of success he’s most proud of — he ultimately lands on impact in terms of both the millions of Americans they’ve helped to afford prescriptions and the hundreds of employees that they’re able to support through life’s biggest moments.

7:00–26:30 — GoodRx founding story

“I started GoodRx with my two co-founders, because I just saw an ugly problem that was important — wow, people can’t find their prescriptions for a fair price? Wow, the actual price for this product is two bucks, but people are paying $300? Or just not paying? You know, those are the kinds of things that lit me up then and still light me up, which is just seeing an incredible inefficiency out there, and a way to change consumer behavior and to potentially change, not even just the industry, but the way our government in our country operates.”

• On where GoodRx first got their generic drug pricing data: Doug laughs as he recalls having his father walk into New York pharmacies, which was one of the few states at the time that required drug price transparency, and having him ask for pricing sheets. They thought he was crazy. He goes on to describe how fragmented and regional the pharmaceutical pricing was at the time — citing that 14 states had websites, most of which were broken and which listed prices that were not the actual prices that a consumer would pay. Now, they get 200 billion price points per day and Doug notes that these have to be carefully cleaned and handled to convert them from a myriad sources into a single price that a consumer sees on a given day for a given medication, dosing, and pharmacy location.
• On the surprising first customer segment for GoodRx 1.0: Doug describes the first iteration of GoodRx as a web-scraping tool that cobbled together sources from any place that published them — including Costco, Walmart, etc. He recounts their unveiling of the product at a conference called Health 2.0 and being surprised that it was actually doctors that came up to them after the presentation dying to use this product to help their patients understand the price of their prescription, which the physicians previously had almost no way of knowing. They told Doug how many angry patients would call them to complain the drug they had prescribed was exorbitantly expensive and the patients would commonly think it was the doctor at fault.

“Most of what I think I do during the day, honestly, is just translating all these concepts that are so familiar to other industries, to healthcare, because for whatever reason, we seem to actively stop that. If you think about your experience purchasing anything else, it’s so straightforward. You want to buy toothpaste or TVs? There’s a price you pay, we all pay the same price. Healthcare is broken.”

• On gaining momentum from consumers: Doug reiterates a similar sentiment from when he spoke about his experiences at Facebook and Yahoo, which is that his focus was on building a great product, not necessarily a great business. He believes that if you build a great product, people will come — Field of Dreams esque. Doug jokes that he was supposed to go to Stanford to get his MBA and has a bit of a chip on his shoulder regarding that type of experience because he thinks that the analysis of the opportunity can sometimes get in the way of asking the simple question of ‘is there a core human need that we can fulfill?’.” He does note that they eventually found a business model, but it certainly came secondary to the consumer experience.
• On what made the GoodRx product different: Doug starts by describing what GoodRx is not — it’s not the traditional healthcare experience where you log on to your account, put in the password you barely remember, or search your wallet for your insurance and credit card. The GoodRx site takes you immediately to a search bar and as soon as you start typing a drug name, it will suggest the most common dosage form, quantity, and show you the price at pharmacies near you. Even for an individual that may have great health insurance benefits, Doug has seen that their insurance companies probably suck at communicating what those benefits are. So there’s this massive gap that Doug saw between healthcare delivery and pricing/reimbursement. Doug believed the solution was simplicity and he re-emphasizes his obsession with making products understandable and easy to use. An example Doug is especially proud of is the language GoodRx uses, underscoring their value as a consumer-focused translator in healthcare, they purposely don’t use the pharmaceutical language of pricing (e.g., Wholesale Acquisition Cost, Usual and Customary Price, Deductible, Copay) and instead use the consumer language that people are familiar with — coupon, retail price, discount price.

“I tried to never use the words deductible, maximum out of pocket and copay. And of course, you were saying average wholesale price and UNC and all these terrible terms. I don’t use those words, because those words are unique to healthcare and healthcare sucks. So I want to use words that you’re used to from other spaces. This is the retail price of this product. This is the discount price of this product. That I can kind of get my brain around”

• On how they disrupted an industry with massive institutional power: Doug, very tacitly, notes that GoodRx partners with every major player in the industry with symbiotic relationships. He describes his sense of surprise at how many major players were willing to talk to them even very early on — from people they randomly met at conferences to professors to “someone your friends, cousins, dog knew”. Strategically, he says they just kept their heads down and kept moving — a lot of people were comfortable with the status quo and he had to figure out a way to get through that. That is not to say they weren’t scared of getting “squashed” by one of the major players — early on if pharmacy X or PBM Y decided to turn them off at any moment, it could have really damaged the business.
• Doug recounts a story where, very early in their relationship with a major unnamed PBM, the PBM faxed every pharmacist in America saying that they were watching GoodRx and if the wrong price was listed on the platform, they would terminate their contract. While he chuckles now, at the time he was terrified. Now they have a great relationship with that same PBM. He finishes this train of thought with another anecdote about how their relationship with CVS started with the ultimate takeaway that you’d be surprised how many people will talk if you just ask, but you have to be careful to keep your cards close to the vest until you’re ready.
• On when Doug felt like he had first “made it” as a CEO: Doug starts by saying he isn’t sure that he’s made it at all, but admits that going public was probably that moment — the elevation in awareness was a bit of a shock. Doug misses the time when it was just the three co-founders working in the hallway of their friend’s company office. He describes how his role has changed, now focusing much more on organizational and communication challenges as opposed to the entrepreneurial challenges of starting a business.

“I think my role has changed a lot, which is tricky. One of the things that I think is underappreciated in business is, let’s say, you’re the world’s greatest engineer, accountant, legal person, whatever. And then you start succeeding, and all of a sudden, you no longer do that thing, that you’re the greatest at, you’re managing a bunch of people who do that. And it’s all about knowledge transfer. And that’s great, but that implies that you’re a really great manager. And I think that’s such a different skill set….And we somehow made it work. But it’s hard, it’s really hard.”

• On going public in September of 2020: A challenge he says he’s dealing with right now is not letting the “publicness overtake what’s so special about what we do”. He summarizes being public as having a new constituency that’s a little more fickle, having a much greater spotlight on everything you say and do, but with the positives of having the currency to be able to make market changing moves. He doesn’t want that elevated platform to change how they do business. He wants to reiterate that he’s a product guy — he wants to be building amazing things for consumers.

“I’ll get a text from someone saying, ‘Hey, you must have had a great day today because your stock went up 4%’. And I’d be like, ‘Really? Like that’s a barometer of my mood — that some random investor chose to buy or sell my stock’. I think it’s really, really hard, you know, you have this bright shining light in front of you, that you kinda have to look away from and continue to focus on what’s important.”

27:00-End — GoodRx model now and plans for the future

• On the GoodRx customer base: Doug exasperatedly recounts how he has tried to dispel the stereotype that GoodRx is for the uninsured. 70% of their users have insurance and many of them are actually doctors who are helping their patients understand the cost of the prescription. Insurance is broken and there are 1000 reasons why the insurance company is not going to pay you back (e.g., formularies, deductibles). GoodRx is competing with this old model by introducing a simpler, more transparent, and often cheaper way to get generic drugs.
• On how GoodRx can get better rates than insurance: GoodRx gathers pricing data from a LOT of sources, including all major pharmacy cash programs, PBM cash pay networks, etc. These organizations at times have prices that change on a daily basis as a result of contract terms that are changing between the manufacturers, PBMs, insurance companies, and pharmacies. GoodRx takes all these pricing changes into account and guides consumers to the price and location that’s right for them that the pharmacy is contractually obligated to accept.
• On why this cash pay network only exists for pharmacies and not medical care providers: Doug describes some of the unique features of medical sales: consumers already pick medication up in a retail environment, usually with a credit card standing at a counter — it’s something you do often, and it’s something you know the name of. He compares this to the ER where you might go for one visit and be billed 9000 codes for that one event. Always thinking of the consumer lens, he also notes that with medical care, there isn’t a natural entrance point to ask “Hey, you’re thinking about getting this procedure, let’s talk about it and get to the right answer”. He hopes someone listening/ reading this will solve this mess.
• On the telehealth business they bought in 2019: This business has exploded as a result of the pandemic, but it started, as all things at GoodRx do, with understanding the customer need. Doug recalls seeing a large swath of consumers coming to the site for a drug without a prescription. He also sees it as an experiment to test whether you can provide care at an upfront cost that consumers can understand (some visits starting as low as $19). He doesn’t think this type of care is going to ‘eat the world’, but knows that for simple things, this can be a very effective solution.
• Future plans for GoodRx: Doug sees a lot more work to be done to make generic drugs affordable and convenient. Mail order is one area he sees as having huge potential — he’s incredulous about the fact that during a pandemic, there was almost no movement in mail order penetration. They’re also working on ways to expand into products related to brand drugs — manufacturers are interested in creating affordability options, but they don’t have experience talking or working with consumers, so GoodRx is very excited to partner with them to offer new and innovative products.

“The hardest thing that one struggles with, especially as an entrepreneur, is trusting yourself and having the right amount of paranoia because I think that drives a lot of entrepreneurism, but at the same point, having the faith and trust to get through the bad days and to hear the noise and let the noise fire you up, and get you more determined than ever to to pursue what you want to pursue.”

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We are so appreciative to Doug for joining us on this episode of The Pulse Podcast! Subscribe for our new releases on Twitter, Spotify or Apple podcasts.