Discount drug cards appear to be the product du jour in healthcare, from those marketed by pharmacy benefit managers (PBMs) and retailers to those from drug manufacturers and membership organizations, such as AARP.
The main motivation behind more cards and agreements to increase patient savings is the revocation of gag clauses that censored what pharmacists could tell their patients.
Some cards have a track record, while others have just entered the market. FamilyWize has been around since 2005. NeedyMeds has offered a discount card since 2009, GoodRx since 2011, and Express Scripts’ Inside Rx since 2018. Many cards have an app that offers information and help to users.
Last December, CVS Caremark partnered with Sharecare, an Atlanta-based digital health company, to launch a digital pharmacy savings card targeting the uninsured, the underinsured, and those with a high deductible. The PBM administers the program and provides medications through 68,000 pharmacies in its network.
Some skeptics question whether these cards really save customers money, but those who offer them are confident about their value, transparency, and ability to improve adherence—an important issue. According to a Kaiser Family Foundation survey, among those currently taking prescription drugs, 24% of all adults and 23% of seniors say it is “difficult” to afford their prescription drugs, including about one in 10 (overall and among seniors) who said it is “very difficult.”
In 2017, the Annals of Internal Medicine estimated that a lack of adherence causes nearly 125,000 deaths and 10% of hospitalizations a year, while potentially costing the healthcare system as much as $289 billion a year. As many as one-third of prescriptions are never filled.
Livea Byrne, vice president for product communications for Sharecare, says the company’s new card is part of a larger product vision that offers tools and features to overcome adherence barriers. “The first fill is the most important in terms of helping patients remain compliant,” she says.
Ken Majkowski, PharmD, chief pharmacy officer for FamilyWize, based in Bethlehem, PA, agrees with Byrne. “The impact of a discount card is on first fill. If consumers don’t get a discount, they might not fill their prescriptions, affecting adherence. However, it is difficult to measure the effect of a card on adherence,” he says.
“Our strategy follows a completely different model than traditional discount drug cards by including our consumer platform, which also provides content, education, safety, and messaging to address the most prevalent barriers to adherence and compliance,” says Howard Gruverman, executive vice president of enterprise at Sharecare. “It will be important to study and validate the impact cards make in improving adherence across populations.”
One of the primary features of the Sharecare Rx card is the Discover section on the Sharecare app that includes helpful search features for members, including medication prices, finding a doctor, and other tools.
With the app, users may opt to get notifications and reminders to refill their prescriptions, as well as information on how to take their medications as directed; drug-specific information on safety and side effects; alerts about interactions; and can track their medications.
Cardholders can create a profile on Sharecare’s stand-alone platform so data reside in one place. “Patients’ medical information typically lives in many different systems so that having a complete list of medications ensures members have easy and convenient access to the information no matter where they are,” Byrne says. Cardholders also may search for a specific medication, filtering results by price, pharmacy location and hours, and availability.
The company is working with its health plan and employer partners to integrate their formulary coverage and pricing into Sharecare, providing seamless access to prescription benefits and information.
Gruverman says users could save up to 80% on generics and take advantage of a wide variety of discounted brands. “This alleviates a major cost burden for people who manage chronic conditions and lack adequate insurance or the resources to purchase these medications,” he says.
The downside is that discount drug card expenses do not count toward a patient’s deductible or out-of-pocket maximums and cannot be combined with insurance; however, some of Gruverman’s peers recommend that consumers submit receipts to their insurers for potential credit.
He sees the development of innovative drug pricing models as more consumers use smartphones and digital tools to manage parts of their everyday lives, and as additional players across the healthcare landscape, such as payers, PBMs, and employers deploy tools to make medications more affordable and accessible.
Headquartered in Gloucester, MA, NeedyMeds, a nonprofit resource helping people afford their medications, has saved consumers $275 million since its card’s inception. The company claims 40,000 transactions take place per month with its card, which covers more than 6,000 drugs.
Richard J. Sagall, MD, president and cofounder of NeedyMeds, says that since the gag rule was lifted last October, which prohibited pharmacists from proactively telling consumers when prescriptions would cost less when paid for out-of-pocket rather than using their insurance plan, discount drug cards offer even more value.
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